Inspection on 02/08/05 for Honeybourne House

This inspection was carried out on 2nd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 14/03/07

Honeybourne House 06/01/06

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 PL5 3HA Lead Inspector Douglas Endean Announced 2 August 2005 nd 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 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 Stationary 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 D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Honeybourne House Address 98 Sheridan Road, Manadon, Plymouth, Devon, PL5 3HA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01752 242789 / 01752 777744 01752 242789 Honeybourne House Limited Vacant 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 D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 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 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 Date of last inspection 12/01/05 Brief Description of the Service: Honeybourne House is a detached property that provides both personal and nursing care. It provides personal care to a maximum of 13 people, aged 30 , with a learning disability, some of who may also have a physical disability. 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 is in the residential suburb of Manadon on the outskirts of of Plymouth. It is close to local shops and other amenities. There is 11 single bedrooms and one shared bedroom in the main house, 5 of them being on the ground floor. The one 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. There is a large lounge on the first floor that is used for staff training. The bungalow has its own lounge and dining room space. A further building has a Jacuzzi, with a ceiling track hoist and a multi-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. There is also a people carrier that is used as Service Users transport. 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. The home has recently come under new ownership and is now part of a large organisation who have many homes across the country. Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on the 2nd August 2005 in the presence of the Administration Manager for the home and the Area Manager for the company. In the 4 hours that the inspector was at the home he looked at the personal records of three staff and 5 clients. During his tour of the home he spoke to five staff and several clients. He also received a completed pre-inspection form and comment cards from 1 client and 2 relatives. This was the first inspection of this home by the inspector since it recently changed ownership. The inspector chose to inspect most of the core standards on this occasion as well as some standards that were felt appropriate. What the service does well: What has improved since the last inspection? 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. Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 & 4 The pre-admission assessment of clients is through. The home has experienced care staff and nursing staff that collectively have the skills to provide appropriate assessment and care to the clients. EVIDENCE: The home only admits Service Users after they have vetted the details of the comprehensive assessment reports that have been completed and contributed to by Care Management and Community Learning Disability Nurses among others. The inspector looked at five files and found them to be well constructed and there was evidence of very comprehensive pre-admission assessment work by the home and the multidisciplinary team. There were satisfactory care plans in the files seen by the inspector that has been drawn up from the ongoing assessments on each client. The Care Management and Community Learning Disability Nurses do attend the home and involve themselves in the re-assessment and care planning of clients making judgements about the level of nursing involvement required by clients particularly in the Bungalow. Prospective clients do attend the home, often as day care clients, prior to respite or more permanent admissions. During these visits they experience the same services that will be offered to them should they be admitted to the home. These include ongoing assessment, nutrition by the appropriate means and social interaction with staff and other clients. Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 9. The staff do consider the fine balance between providing care and allowing independence and choice when care planning and delivering care. The Health & Safety arrangements are satisfactory. EVIDENCE: The inspector was told that all the clients have care plans that have been developed from the comprehensive pre-admission and ongoing assessments. Samples of these were seen in the 5 case files that were read by the inspector. The care plans included information about social, personal and nursing care where this was being provided. Care plans are drawn up with the involvement of client, their family (if they wish) and the multidisciplinary team involved with the client’s ongoing care. The home are in a period of change and a new care planning format is being introduced. A sample of this was seen and found to be satisfactory. The clients do express their views, wishes and desires. They also make decisions that are supported by the care staff where it is appropriate to do so such as to wear particular cloths, go to the shops or a social event or not eat a particular food that is on offer as part of a meal. The clients also express there likes and dislikes and their character in the way they have their rooms decorated with personal items. Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 9 The clients do not manage their own financial affairs. They do however handle money when shopping or out on trips or other social events. The administration manager acts as appointee for 11 clients and records were seen that provided evidence the client’s money is well accounted for. All the clients have bank accounts. All aspects of the Service Users day are risk assessed. The process of risk assessment starts from prior to admission and continues through out their stay at the home. The care manager and others are involved in these risk assessments where possible and in particular during the three monthly reviews that they are requested to attend. The home has a procedure to follow (displayed in the office) should there be an unexplained absence of a Service User. The home has risk assessments on the clients and their health and safety is considered during care planning. Maintenance of the home is good. Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15, 16 & 17 The activities that the clients are involved in at the home, and in the community, are of value to them in that they are experiencing normal life. The staff support the clients in all they do to a satisfactory level without unnecessary restrictions. EVIDENCE: The home has its own Jacuzzi and sensory room in the purpose built day unit area. Individual clients have their own music centres and collections of CD’s that were seen during the tour of the home. Written records were seen that show Service Users are assisted to access community facilities as much as possible such as the local shops, pubs and leisure centres in line with both their care plans and risk assessments. Those client’s who are able to use public buses and taxis services. The home has two (2) minibuses, which have tail lifts for wheelchair users and a people carrier. The staff involve themselves in the various activities chosen by the Service Users both social and educational. Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 11 The home encourage their Service Users families to remain fully involved in aspects of their care at what ever level they choose. They are welcome to visit whenever they wish and join in planned activities. The clients are able to form relationships if they wish and do attend places external to the home that allows them to meet other people socially such as disco’s and college. The care plans and notes record the daily routine and activities that clients can and do attend. The clients dignity is respected by the staff who call them by their preferred names and do not enter their rooms without first knocking to be invited in. Personal care is provided in the privacy of the client’s own room or other appropriate areas such as the bathrooms. All the bedrooms have locks fitted to the doors and the clients are risk assessed for their ability and suitability to be a key holder. The nutritional needs of each of the Service Users is assessed and recorded in their care plans. Meals are prepared in the homes kitchen by the staff and eaten in the dining room in the main house. The needs of those in receipt of nursing care are more complicated due to the levels of their actual physical disabilities. The clients in the Bungalow are peg fed at different intervals during the day this is monitored by the Registered Nurses. There is evidence that care the nurses and care staff have received training in the management of a peg feeding. Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 20. The arrangements to meet the client’s ongoing medical and nursing needs are satisfactory. The standard of provision of disability aids is good. EVIDENCE: The clients have their health care needs met in a variety of ways that are recorded in their case files. The inspector saw references to General Practitioner visits, visits by the Community Learning Disability Nurses and out patient appointments with a variety of Consultants. 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. The home has taken the steps of investing in 8 pressure relief mattresses to meet the tissue viability needs of the Service Users who receive nursing care. The care plans hold information regarding the Service Users risk of developing a pressure sore and the steps to be taken to avoid this occurring. The home employs Registered Nurses who are responsible for the medication related activities in the nursing wing. There are satisfactory storage arrangements for the medications kept at the home. The “administration of medication records” are satisfactory with signatures in the correct places even when medication is omitted for some reason. There are Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 13 photographs of Service Users in the medication administration files and the nurse’s station to aid identification. The medication administration records in the residential area were satisfactory. Staff who work in the residential home have received in house training in the administration of medication by Registered Nurses. The homes policy is that all medication administration is double checked by involving two staff members before the client consumes it. No Service Users is self-medicating. The home has included a list of homely remedies for each client in their records from a template that was sent to them by the local National Health Services Trust. Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23. The written procedure used to protect the clients when recruiting staff is good. Subsequent training opportunities provided for the staff to recognise and report possible situations of abuse are very good. 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 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 also has staff attending a series of training events provided by the statutory organisations that also cover the issue of adult protection. The home also has its own policies and procedures as well as the Local Authorities Alerters Guide. The staff recruitment procedure has been seen and it provides a robust path to the safe recruitment of staff. Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 Both the house and the Bungalow provide suitable homely accommodation for the clients to live in that is warm, clean and safe. EVIDENCE: The main house provides a warm homely environment for the clients that live there. The tour of this area provided evidence that the clients have made their mark by personalising their own rooms to their liking. The Bungalow is clean, well furnished and attractive being a more modern, functional design. The client’s have access to educational and entertaining equipment such as the television, music centre and computers. All rooms are of good size and shape and fit for the purpose for which they are used. The levels of furniture in the Service Users private bedrooms are to their satisfaction and meet their personal needs in both parts of the home, nursing and residential. There is a satisfactory amount of communal space in each part of the home The full time driver/handyman keeps the home well-maintained and outside contractors deal with the more specialist equipment such as the hoists, the disabled bath, fire and electrical systems. The inspector saw evidence of Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 16 maintenance by outside contractors on the hoists and household electrical items that were itemised in the Portable Electrical Appliance Test records. A new fireboard and detection system has been recently fitted in the main house to bring it up to the same specification as the Bungalow. There was evidence seen by the inspector that the fire systems in the home have been regularly tested. There is 20 hours of domestic time presently allocated at the home. The home was clean and odour free during the time of the inspection. The home has its own laundry which has had a new washing machine installed that has a sluicing cycle. This meets present requirements in respect of the regulations associated with the way it is fitted that should prevent any backflow of wastewater. The floors are impermeable and the walls are gloss painted to make them washable surfaces. The staff are aware of the safe handling of items with respect to infection control and this is covered in the homes policy. All staff are provided with gloves, aprons and hand wipes. There is a disinfecting sluice in the bungalow. Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 & 35 The home has not followed their staff recruitment record fully. Some information needs to be collected to complete staff records in line with Schedule 2. EVIDENCE: The staff recruitment procedure has been seen and it provides a robust path to the safe recruitment of staff. A sample of 3 staff records were looked at by the inspector and each were found to need some work to meet Schedule 2 with regards to holding information that will clearly identify the staff member such as proof of home address and a copy of their birth certificate. Overseas staff have a police check from their country of origin. The staff at the home work as a team with some holding more senior positions then others. As a result of qualifications and/or experience. Those on duty at the time of the inspection were all observed to communicate well with each other. This relaxed comfortable atmosphere is beneficial to the clients who respond well to this. The nursing care is provided by registered nurses who are supported by care staff. The training records provided evidence that the staff have completed in areas such as learning disability awareness, challenging behaviour and safe handling of medication. Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 There is no registered manager however the home is being run well as a result of the cooperation between external management and the care team within the home. The company’s methods of assessing the quality of the care that is provided is satisfactory. EVIDENCE: This home is under new ownership by an experienced company in the field of independent health care particularly in providing for the client group accommodated at Honeybourne. The registered managers post is vacant. The inspector did discuss ways in which the post can be filled that may improve chances of satisfactory recruitment. The home is visited regularly by the area manager who also carries out the regulation 37 visits. He attended and played a valuable part in this inspection. It is planned that quarterly quality assurance inspections will take place until a new manager is settled into post at the home. Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 19 Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 4 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Honeybourne House Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x 3 x x x x D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 21 NO Are there any outstanding requirements from the last inspection? 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. 1. Standard 34 Regulation 19(1)(b) Requirement Timescale for action 30/09/05 2. 37 8(1)(a) Staff should not be employed to work at the home unless all the information required by Schedule has been obtained such as proof of identity that may include a copy of the birth certificate and proof of the home address. The registered provider shall 30/11/05 appoint an individual to manage the care home as the post is presently vacant. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Honeybourne House D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 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 D54-D04 S63212 Honeybourne House V232990 020805 Stage 4.doc Version 1.40 Page 23 - 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. 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