Inspection on 14/03/07 for Honeybourne House

This inspection was carried out on 14th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Honeybourne House 06/01/06

Honeybourne House 02/08/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

32 Beaumont Way

Stallcombe House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Honeybourne House 98 Sheridan Road Manadon Plymouth Devon PL5 3HA Lead Inspector Doug Endean Unannounced Inspection 14th March 2007 09:50 Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Honeybourne House Address 98 Sheridan Road Manadon Plymouth Devon PL5 3HA 01752 242789 01752 777744 01752 242789 honeybourne8@aol.com www.alliedcare.co.uk Honeybourne House Limited Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Jacqueline Kay Carter Care Home 21 Category(ies) of Learning disability (21), Learning disability over registration, with number 65 years of age (13), Physical disability (21), of places Physical disability over 65 years of age (13), Sensory impairment (21), Sensory Impairment over 65 years of age (21) Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. PD - Physical Disability, 21 service users male or female SI - Sensory Impairment, 21 service users male or female LD(E) - Learning Disability - over 65, 13 service users male or female SI(E) - Sensory Impairment over 65, 21 service users male or female PD(E) - Physical Disability - over 65, 13 service users male or female LD - Learning Disability, 21 service users male or female There will be a maximum of 21 beds in total of which 8 (eight) beds are to provide nursing care The home will maintain the employment of a currently registered nurse as the “Clinical Manager” who will manage the delivery of appropriate nursing care to the clients who are accommodated in the 8 (eight) places that are registered for nursing care at the home. 6th January 2006 Date of last inspection Brief Description of the Service: Honeybourne House is a detached property that is a part of Allied Care Ltd, a national organisation caring for people who have a learning disability. It provides both personal and nursing care. It provides personal care to a maximum of 13 people, aged 30 , with a learning disability, some of which may also have a physical disability and sensory impairment, and who reside in Honeybourne House. In the Bungalow they provide nursing care for up to 8 people within the same categories previously stated but for young adults 18 years . The home has a “Registered Manager” and also a “Clinical Manager” specifically for the Bungalow. The Home is in the residential suburb of Manadon on the outskirts of Plymouth. It is close to local shops and other amenities. There are 11 single bedrooms and one shared bedroom in the main house, 5 bedrooms being on the ground floor. The shared room has en-suite facilities. In the Bungalow there are eight single bedrooms, all with en-suite facilities with a ceiling track hoist from the bed to the en-suite. Communal space in the main house is on the ground floor and consists of a dining room and lounge. The manager’s office is on the first Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 5 floor and this area is also used for some staff training. The Bungalow has its own lounge and dining room space. A further building is used for activities and this has a separate sensory room. The home has its own transport, consisting of two minibuses (shared with a sister home), each with disabled access including wheel chair lifts. Service Users are enabled to access any health or social care services they require and are also involved in various community social and educational activities at the moment. The homes fees are based upon the homes assessment of need using a comprehensive tool that provides the full breakdown of charges for each service provided and a total cost. The present fees commence at £450 for residential care and rise beyond this for nursing care. Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This “key” inspection was unannounced and took place on the 14th March 2007 beginning at 09:50 hours and lasted 4 hours. In that time the inspector met with the home management, toured the home speaking to three individual staff and several service users and looked at the environment. He also looked at 3 sets of staff records and three sets of service users files as part of the case tracking process. The inspector received a completed pre-inspection form from the Registered Manager. This had several attachments as evidence to support information that had been written in the form. The inspector received one completed relatives survey form. What the service does well: What has improved since the last inspection? The recording of induction training has evolved to a higher level with clear documentation that has improved the description of the passage staff follow in the first months of being at the home. The sensory room and activities room have also improved with the reorganisation of the area that was already available. There is now a Registered Nurse who is in the role of Clinical Lead in the nursing unit. The office has moved to the first floor of the house and offers more space , it is shared with the Deputy Manager whilst still leaving space for staff and service users meetings. The upgrading of bathrooms and décor has improved the environment. Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standard 1, 2, 3, 4 and 5. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well able to meet the comprehensive needs of the service users having assessed their needs fully, negotiated the care to be delivered, and appropriately trained and equipped their staff. EVIDENCE: The home has a well prepared Statement of Purpose and also a separate service users guide. They contain valuable information for service users and their advocates about the home and the standard of care that a service user can expect to receive. There is a copy of each document displayed in the front foyer of the home and the home. The document is also on computer and a copy can be printed for anyone on request. In addition to these documents the registered company has a website under construction. No one is admitted to the home until a competent person has carried out a comprehensive assessment of their individual needs. The inspector saw 3 service users files and read the accumulated information that had been gathered by the home in order for them to make a decision about the suitability of each admission. The information included the homes own Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 10 assessment form and information from any other service that had been involved prior to a referral such as the specialist Community Nurse’s, Care Management, Doctors and hospital services. Following assessment the home is able to produce a comprehensive document that shows the cost for each individual portion of the service to be provided and the total cost. The inspector saw examples of this document. This is then used during contract negotiations with the funding authority. The home does allow service users to trial the home should this be appropriate. They can organise phased admissions to improve the transition from home to Honeybourne for both the service users and their carers. During the course of the inspection the Registered Manager and staff were able to demonstrate the homes capacity to meet the assessed needs of the service users in the home. They provided evidence of the training and qualifications held by staff that enables them to meet the special needs of the service users resident in the home. The nursing unit is manager by its own Clinical Manager who has the support of a registered nurse on duty 24 hours a day. They also had good communication methods that improved the ability of service users to be understood and make their wishes known. The home also welcomes the input from relatives and other advocates in the planning and delivery of care. The Registered Manager and her deputy have a good knowledge of the Mental Capacity Act. With regards to Equality and Diversity the home will only admit those people who fall within the category of registration they have. They will also raise a challenge to anyone should the service users, who have a physical and mental disability, rights be compromised by an action or activity. Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standard 6, 7, 8, 9 and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The homes risk assessment process is very through. The subsequent care plans are well written and clear to understand. Service users are included in planning their day and how it unfolds. The home provides excellent systems to protect confidentiality of service user information that staff verify in writing that they understand. EVIDENCE: The inspector chose to case track three service users sampling their records as representative of the record keeping arrangements. Each of the service users has a very through set of risk assessments that have been contributed to by health and social care staff external to the home. They cover a wide range of issues including behaviour, infection control, sleep patterns, and the risks involved in service users being in the community. From the outcomes of the risk assessments there are care plans that are well written and clear to Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 12 understand. The nutritional assessment is followed up by a full record of meals offered, the amount accepted, and regular weight monitoring. Each risk is addressed to reduce its impact on the service users and staff. The present system is undergoing change as the home is introducing the system now favoured nationally by the Registered Company. The inspector saw examples of each system and found both to be excellent but the new one has improved upon the old system. There is an improved structure overall to the presentation of information. Care plans are agreed with the service users and/or their advocates and also those who have had input such as the purchasers of the care. There are regular reviews of the care plans that involve all of the interested parties. The staff encourage the service users to be involved in day to day decision making. The inspector saw evidence of this during the tour of the home. Those with the capacity to do so do make those daily decisions of normal daily life such as what they might choose to wear, where they sit and who they socialise with. At meal times they can make choices about the food they want to eat and the people they will sit with. On a longer-term basis the service users have chosen how their rooms are decorated and laid out. The inspector saw intro the majority of the service users bedrooms and found them to be individually personalised. Many have been decorated with personal effects by the relatives of the service users who have a more intimate knowledge of the likes and dislikes of their family member. The staff were adept at communicating with those service users who have difficulties in normal speech and body language thus involving them in what was going on around them. Some service users had communication aids that also had a therapeutic outcome of improving coordination. Service users have support in managing their finances to differing degrees and each has a bank account managed by the home family or another advocate. Where the home manages pocket money the records were clear and accurate when checked by the inspector. Staff support service users who do go out to the city to shop or attend activities, such as the cinema, so that they are not exploited. Information for the service users is either passed on verbally taking time to make sure that the service users understands or in a written format. An example of this is the complaints procedure that has a pictorial presentation. It takes the service users through a journey that they can follow to raise a concern or complaint. The homes present induction process, and the new induction package soon to be introduced, introduces staff to the issue of confidentiality. It is further covered in the professionally prepared staff handbook. The home has clear policies that staff read and sign that they have read and understood the content. The inspector saw examples of each of these documents and felt that Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 13 they do make it clear what is expected of the staff. The service users advocates are also informed about the issue of confidentiality in the homes Statement of Purpose. Service users records are kept in areas away from normal public access in the staff offices that are secured when not in use. Also the staff do challenge anyone entering the home and only allow entry when they are satisfied they have a right to be in the home. They did check the identity of the inspector before allowing him into the home. Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standard 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home facilitates good social and learning opportunities for the service users. The activities are well planned and executed for the benefit of the service users. The nutritional assessments and monitoring of intake by the home is very good. EVIDENCE: The home provides opportunities for the service users to be exposed to learning skills both practical and social. Should the service users rights to access a service be compromised by the will of another, the home will challenge the individual or organisation using the appropriate legislation. Some of the service users attend college where they have one to one attention in a Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 15 variety of activities including computer skills. In the privacy of their own rooms they have electrical equipment that they use for their own entertainment such as CD player and television. There are no service users in paid employment or full time education. However they do involve themselves in learning opportunities outside of the home when they take part in the wide variety of social activities attended. This involves the use of buses and taxis, paying for admission or using an entry pass, and maintaining social skills when in a public place. The staff do act as supporters in many of these activities often for the public who lack communication skills. The range of activities that service users are involved in include use of the activities and sensory room in the home, music sessions and reflexology by a trained individual. Outside of the home they attend the cinema, Orbit Club (social club), church, and have holidays away from the home. The planned holiday this year is to Disneyland Paris. The home has two mini buses that have tail lifts for wheel chair users. The service users use them to go on trips to such places as the Eden Project where they have an annual ticket for entry. The home fund staff to attend social events when supervising service users, and the service users pays for their own entry. However, the home has arranged special deals to regularly used facilities such as the cinema where cheap annual tickets have been purchased. The daily routine of the home is flexible and rotates around the needs of the service users and not the home. The staff were seen to be respectful at all times when with the service users and protective of their dignity when caring for them. Where the care plan does identify issues of risk that may require the home to restrict an activity this is fully documented and reviewed. Evidence of this was seen during the inspector’s case tracking exercise of three service users records. The home encourage the families and advocates to remain fully involved in aspects of the care of service users at what ever level they choose. They are welcome to visit whenever they wish and join in planned activities. One relative replied to the Commission for Social Care Inspection survey making very positive replies to the questions asked and one statement, “Very caring staff.” All the service users have had a full nutritional assessment that is regularly reviewed and this review includes monthly weights unless a concern requires weight to be monitored more often. The assessment and meal planning uses the knowledge of family and advocates as informants of likes and dislikes where the service users are unable to make this clear. The Registered Manager supplied a copy of the menu’s that are presently used and have taken into account likes and dislikes. They show that a varied diet is offered to the service users who may choose to have something other than the planned meal if they wish. The main meal of the day is in the evening followed later by supper. The lunchtime meal was served during the inspection and the inspector was offered Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 16 a sample, which was very good. Honeybourne House has its own separate dining area that is nicely decorated in a homely fashion and furnished appropriately. The kitchen is next to the dining room and a cook is employed during weekdays whilst staff manage the preparation of meals at weekend. The lounge is off the dining room. Several service users in the nursing unit have specialist-feeding needs and these are managed by the nursing staff. The inspector saw the operation of the feeds taking place during the inspection and the records that were made on each occasion. At the recent Environmental Health Inspection the inspector felt that the homes standard of hazard analysis and hygiene was very good. The home has been entered for the “Choose Health Award 2007” for its smoke freedom, healthy eating and safe eating achievements. Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standard 18, 19 and 20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides very good standards of personal, emotional, and nursing care. The standard of advocacy by the home when facilitating care form external sources is also very good. EVIDENCE: The service users care plans include a moving and handling assessment. Where service users need assistance with movement this is provided by staff who have received training in this exercise and who have suitable equipment to carry out a safe lift and movement. The inspector saw that the home does have regularly serviced mobile hoists, ceiling track hoists in every bedroom in the nursing unit as well as the activity and sensory rooms. Other equipment was being used by service users to facilitate care and communication. This included special beds, wheel chairs and a communicator. Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 18 The home also plays the role of advocate for service users when there health care needs and social needs change and other professionals need to be referred to. They communicate clearly with health care professionals such as General Practitioners, Medical Consultants, Community Nurses, and Social Workers, who are involved with service users. All the service users are registered with a National Health Service Dentist and the Chiropodist visits the home on a regular basis. Each service users has a key worker and the individuals were identified on the notice board. The key workers have supervision from an identified senior who will guide them where necessary to meet the care needs of the service users. Where nursing care is provided it is delivered by a Registered Nurse. The staff do monitor service users for changes in behaviour that may be due to ill health that is not being expressed verbally. The service users are not able to manage their own health care needs without the support of the staff. The staff respond well to the clients emotional needs for emotional warmth and comfort as well as fun allowing them to express themselves within a safe environment. Acts of anger and aggression are also dealt with by an appropriate response with good records kept so as to learn from the occasion as seen in the client’s files by the inspector. Personal care was provided in the privacy of service users own rooms and in other areas such as bathrooms, where their personal hygiene was attended too. The service users help in the choice of the cloths they wear and the food they eat among other activities inside and outside of the home, such as the social and educational events in their care plans. The home has a routine for getting up, mealtimes and other normal daily activities. This is followed but there is flexibility within the routine to allow for the personal preferences and wishes of the service users. They can decline to attend social events and also get up late if they wish. Medication is managed separately in each unit. The medication storerooms are suitable for the purpose and trolleys are secured to the wall when not in use. A recent check of the pharmacy arrangements was made and the inspector saw the report that was satisfactory. The inspector looked at all the medication arrangements including the recording of drugs that are administered and found them to be satisfactory. Two people always signed medication disposal records. The home also carries out a weekly drug audit to show that the stocks held match with the administration sheets. There are two signatures for all drugs that are administered at the home as a matter of safety good practice. Only staff who have been trained in medication administration can carry out this task. Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standard 22 and 23. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The homes measures to protect the service users from any form of abuse are excellent. EVIDENCE: The home has a complaints procedure that is held within the Statement of Purpose and it includes the address of the Commission for Social Care Inspection. This is also displayed for clients and visitors to see. The Commission for Social Care Inspection has not dealt with any complaints over the past year. The homes complaints book was also seen by the inspector. The staff are involved in Adult Protection training in a variety of ways. The induction program introduces the issue. National Vocational Qualification training adds to this information. In house training brings a further awareness of the forms of abuse and the home and all staff have had Adult Protection training by an external trainer. At the present time staff are undergoing more Adult Protection training to update them on the subject. The inspector saw evidence in staff files of this training. The registered Manager and her deputy have undertaken training in “The Mental Capacity Act 2005” training and are now trainers. They have taken steps to provide service users with an Independent Mental Capacity Advocate. Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standard 24, 25, 27, 29 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides good accommodation for the service users. The level of disabled facilities and social/therapeutic provision is excellent. EVIDENCE: The “House” is a large detached home. The “Bungalow” is a purpose built single story building for nursing care to be provided. Each is well adapted for the purpose with suitable hoists and bathing facilities, lounges and activities space. It is in a mainly residential area with shops and other facilities within a reasonable distance. A bus service passes near the home providing transport into the city. The home provides each client with their own room that is of suitable size and adequately equip to meet the standards. In addition to this the rooms are furnished to meet the physical needs and personal demands of the clients who Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 21 also have had their decorative desires met to personalise their area of the home. The nursing unit, the “Bungalow” has eight rooms each with en-suite facilities that are accessed by the clients through the use of ceiling track hoists. These en-suites provide both toilet and bathing facilities. Beds in the Bungalow and the House are provided to meet the individual needs of the clients with modern height adjustable nursing beds with built in bed guards for the nursing clients and divan beds for those clients in the House who are independently mobile and not at great risk from this level of independence. Seating is also of a specialist nature in the Bungalow and domestic style in the House. The home has televisions and radio’s in the communal areas and some clients have their own televisions and music centres in their bedrooms. Each communal area was well laid out and comfortable looking. The bedrooms are fitted with door locks and some clients do have their own key. This provision is based on risk assessments that are kept in the clients case file. The windows are provided with restrictors to prevent them opening beyond safe limits as set by the Health & Safety Executive. There are a variety of bathing facilities in the home from shower in each of the en-suites in the Bungalow to a specialist bath in its own room also in the Bungalow. The bathrooms in the House have been upgraded to a good standard and provide good provision for the clients. There are two domestic style bathrooms and a wheel in shower room with ceiling track hoist in the house, each with toilet facilities. There are also toilet facilities for the clients that are separate from the bathrooms. There is an activities room and sensory room in a building in the garden area of the home. Ceiling track hoists are also provided in these rooms for the safe moving of the service users enjoying the facilities. In addition to this the home has two mini buses with tail lift facilities for safe access by wheel chair users. The buses are used regularly for taking service users out for a drive, to appointments and to social events. A staff sleeping in room is provided that is of a good standard and close to the clients should the staff member be called upon. The home was clean and well decorated having had further redecoration and improvements since the last inspection. There were no offensive odours in the home. The laundry is in a building outside of the home and has new washing facilities with sluicing cycle and a dryer. The walls and floors are washable. Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against 31, 32, 33, 34, 35 and 36. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed being led by a experience manager in the position of Registered Manager. The staff has an excellent formal induction to the role they will play. The ongoing training that they receive is more than sufficient to keep them up to date with knowledge of the service users conditions and how to provide the care needed. The home has staff in sufficient numbers and skill mix on duty at all times. EVIDENCE: The Registered Manager is a very experienced person in the field of management and also care. She has several years experience managing a major business locally and has been able to transfer that knowledge into the management of the home. Her job is well defined in her job description and she holds the Registered Managers Award amount other care related qualifications. There is also a Deputy Manager in the House who is a National Vocational Qualification Assessor and a Manual Handling trainer. The Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 23 Registered Manager is not a Registered Nurse. She has appointed a Registered Nurse as the Clinical Lead who is responsible for the care delivered in the nursing home. This person has worked in the nursing home since it opened and is very knowledgeable about the needs of the service users and how they are to be met. She accompanied the inspector in whilst the nursing unit was inspected. Together, the management team keep the aims and objectives of the home in focus when planning and delivering care. They work along side of the care staff and have first hand knowledge of the service users and their needs. The Manager does have the structure of a large care provider to support her in the task of employing staff to positions that are clearly defined in the company’s job descriptions. Also the staff are suitably inducted to their post using clear guidance and training information produced by the company and that was seen during the registration process. The induction pack has been revised and is felt by the management to be even better than the last pack. It meets the most up to date guidance. This and the ongoing training experienced by the staff prepare the staff well for the care that they have assessed as being necessary to provide. All staff have had adult protection training and this is being updated at present. Other training has included medication administration by an external major pharmaceutical service, eating and drinking, moving and handling, challenging behaviour, incontinence, epilepsy, gastrostomy management, first aid, dementia and bereavement. Over 50 of staff hold an National Vocational Qualification in care and 37 have a certificate in first aid. The staff spoken to felt that they received training that did prepare them for the work they do. The inspector read three staff files and found them to provide evidence of training appropriate to the persons role, the recruitment procedure had been followed including a Criminal Records Bureau check, identity checks and copies of qualifications gained. The home also has a series of questions for each new employee that satisfied the inspector that there are equal opportunities given to anyone seeking employment at the home. These questions and responses were seen in the three staff files that were looked at by the inspector. There is a mixed race staff group at the home who work well with each other sharing the homes cultural diversity in some of the activities that are planned for the service users. The inspector studied the staff rotas and found that there are sufficient numbers of staff on duty every day. The Manager also told the inspector that additional staff will be placed on duty should this be necessary to meet the care and social needs of the service users. There is also a suitable skill mix of staff employed at the home i.e. experienced managers, Registered Nurses and care staff who collectively help the home meet its aims and objectives. The home also employs cooks, domestics and their own maintenance man. There is only a small turnover of staff at the home and evidence of this was provided in the pre-inspection form given to the inspector. Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 24 Supervision takes place during every working day with staff interacting with each other to manage changing situations. It also occurs on a formal basis with each staff member having an identified person to carry out formal supervision with. The staff records held evidence of the supervision sessions as well as annual appraisals. Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standard Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is very well managed to the benefit of the service users. The environment is well maintained, safe and suitable for the service users to live in. Staff are very well prepared for the job that they are expected to do. EVIDENCE: The homes business is well managed by the Registered Manager who has a long history in the field of management as well as care. She also holds the Registered Managers Award. There is evidence that she does keep up to date through training and she has just become a trainer for the Mental Capacity Act 2005 soon to be enacted. Begin part of a national company she does have the Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 26 benefit of the organisation and her Regional Manager should they be needed. They have continually produced policies and procedures of good quality to be used in the home. The manager was able to show how she keeps herself up to date with the revised information including the new induction process for staff. The home has its own audits in place to measure the quality of care and systems. They carry out a weekly audit on the medication administration/procurement system to establish that policies and procedures have been followed. Staff must sign each policy and procedure they have read and the updates as the home receives them. They complete questionnaires on training they have attended to ensure that they have understood what has been taught. Quality assurance questionnaires are sent to service users, relatives, staff and visiting professionals such as General Practitioners and Community Nurses. The inspector saw copies of returns and the Manager commented on how the information is then handled. Throughout the inspection the Registered Manager provided evidence on how the home is managed for the benefit of the service users. She also provided the inspector with evidence of good risk assessment of the premises and its good maintenance through reports and invoices from competent people who have dealt with equipment such as the fire appliances and hoists. The home has its own trained fire warden and the records for fire training were good. The attention to issues that may arise by good induction and ongoing training, which is also updated, was excellent i.e. fire, infection control, food hygiene, first aid, etc. The risk assessment of the service users and subsequent planning for their care is of a very high standard. Policy management was very good with policies and their updates being read by all staff. Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 4 3 4 4 4 5 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 4 26 X 27 4 28 X 29 4 30 3 STAFFING Standard No Score 31 4 32 4 33 4 34 4 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 4 LIFESTYLES Standard No Score 11 3 12 3 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 4 X 3 X X 4 X Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Honeybourne House DS0000063212.V333326.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!