Inspection on 08/09/05 for Honeyfield

This inspection was carried out on 8th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Honeyfield 10/10/07

Honeyfield 23/04/07

Honeyfield 16/05/06

Honeyfield 21/04/05

Honeyfield 14/09/04

Honeyfield 20/04/04

Honeyfield 23/09/03

Honeyfield 13/06/02

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

CARE HOMES FOR OLDER PEOPLE Honeyfield Honeyfields Rowhill Road Swanley Kent BR8 7RL Lead Inspector Ruth Burnham Announced 08 September 2005 09:30 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 Older People. 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. Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Honeyfield Address Honeyfields Rowhill Road Swanley Kent BR8 7RL 01322 664433 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) Kent Community Housing Trust CRH Care Home 68 Category(ies) of Dementia - over 65 (68) registration, with number of places Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users can be admitted from 55 years of age. Date of last inspection 21 April 2005 Brief Description of the Service: Honeyfield is a large purpose built, detached premises with accommodation for older people with a mental infirmity. The home is owned by Kent Community Housing Trust, a charity providing residential accommodation for some 600 people in 14 homes in Kent and Greenwich. As part of KCHT and according to it’s aims and objectives this home provides care and support which promotes independence, provides choice and maintains dignity, particularly for people with dementia, including Alzheimer’s disease.The home is located in the village of Hextable.There are 13 en-suite bedrooms on the second floor, 33 bedrooms without en-suite facilities on the first floor and 21 bedrooms without en-suite facilities on the ground floor. All bedrooms are single. There is an alarm call system and a passenger lift. There are a number of dining rooms and lounges for communal use. There is a small front garden and larger garden to the rear. There is a large car park to the front of the property. The home employs care staff who work a rota which includes a 4 members of staff on waking night duty. In addition to the care staff admin and management support is available at the local area office, which is shared with other homes.The registered manager has resigned since the last inspection and there is an experienced manager in charge of the home, there are 2 assistant managers. Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection which was carried out by 1 inspector, accompanied by a member of business support staff, who were in the home from 9.30 a.m. to 2 p.m. During this time a tour of the premises was carried out, records were examined and a number of service users were seen and spoken with around the home. the manager was also spoken with and other staff were observed as they carried out their duties. What the service does well: What has improved since the last inspection? What they could do better: There must be adequate numbers of staff on duty, worked out in relation to the needs of service users and in line with current Department of Health guidelines to ensure that needs are met and there are enough staff to supervise all service users throughout the day and night. The home must be maintained in an adequate state of repair and decoration to provide comfortable and safe surroundings for all service users, the Trust must take action to meet these requirements and implement an effective quality assurance system to ensure that minimum standards are met. Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 6 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. Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1&3 (6 not applicable) Service users benefit from accessible information about the home, however, service user guides are out of date which means that prospective service users, relatives and representatives are receiving some information which is now inaccurate. Thorough assessment procedures mean that prospective service users can feel confident that their needs will be met. EVIDENCE: The registered person has produced a statement of purpose which sets out the aims, objectives, philosophy of care, services and facilities, and terms and conditions of the home. This statement is displayed in the entrance of the home for the information of service users, relatives and visitors. Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 9 There is a service user guide provided to current and prospective residents which includes a brief description of the services provided, a description of the individual accommodation and communal space; relevant qualifications and experience of staff and a complaint procedure. Service users have a copy in their bedrooms, copies seen in bedrooms were out of date and therefore inaccurate. Good assessment procedures are followed with initial assessment carried out by trained staff prior to admission, this and care management assessment where applicable forms the basis of the care plan which means that service users can be sure that their needs will be met. Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 8 & 10 Service users benefit from systems which promote their health, privacy and dignity. EVIDENCE: Records and discussion with the manager demonstrate that service users’ health is promoted by regular access to professional health care and the provision of appropriate care and equipment to maintain skin integrity and avoid pressure areas. Professional advice is accessed in relation to continence and suitable aids and equipment are provided to ensure comfort and dignity, psychological health is also monitored and nutritional screening is carried out and weight is monitored. Service users register with GPs of their choice and access to hearing and sight tests and appropriate aids is provided. Supervision of service users has been improved by the fitting of coded locks dividing the home into 4 separate units which minimises the risk of service users wandering around the home and grounds without staff knowing where they are. Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 &15 Service users can enjoy a fulfilling lifestyle with good outside links maintained and as much choice and control over all aspects of their lives as their individual limitations allow. EVIDENCE: Service users are free to come and go within their units as they choose and rise and retire at will throughout the day, routines are flexible and relevant. There are a variety of activities available to service users who are supported by activities coordinators, service users were enjoying dancing and singing with an outside entertainer on the morning of the inspection. This home has a very active volunteer group, which involves relatives as much as possible and greatly benefits service users through environmental improvement and befriending, visitors are welcomed at all reasonable times and are provided with refreshments. The division of the home into separate units continues to have a beneficial effect on the general atmosphere which was notably calm and restful during the inspection. Service users enjoy food that is wholesome and well presented with choice which is offered in a way that is easily understood. Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16&18 Service users and their representatives can have confidence that their concerns will be addressed and that they will be protected from abuse. EVIDENCE: There is a complaints procedure which is simple, clear and accessible to service users and their representatives. Formal complaints are dealt with promptly with records kept . Service users now benefit from an improved system for dealing with informal complaints and negative feedback in that the home now uses the complaints procedure for recording this information; any investigation; and providing feedback to the complainant. Information is available about how to complain to the Commission. Service users are protected through an adult protection procedure and staff checks through the criminal records bureau prior to recruitment. Financial records are maintained wherever staff act on behalf of service users. The number of incidents and injuries reported to the Commission, including incidents where one service user has assaulted another, have reduced and service users are benefiting from the reorganisation of staffing and accommodation. Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 24, 25 & 26 The quality of life and safety of service users is adversely affected by the failure to carry out the much needed improvements to the environment which have been highlighted in reports. EVIDENCE: Service users benefit from the convenient location of the home which is within easy walking distance of village shops, pubs etc, the gardens are beautifully kept by the volunteer ‘Friends’ of Honeyfield which means that service users benefit from the hard work and enthusiasm of these volunteers. Safety has been improved now the car park has been resurfaced however although accessibility to the home remains compromised at night due to the poor lighting in the car park area. The accommodation is arranged on 3 floors with self-contained units on each floor, there are still a number of areas used by service users where lack of replacement, repair or redecoration has an adverse effect on their quality of life. Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 14 Risk to service users in the event of a fire has been minimised by comprehensive risk assessment for the premises which has been drawn up in consultation with the Fire Safety Officer and the home meets fire safety regulations. Service users comfort continues to be undermined as noted in the previous 3 inspection reports where, several toilets are large, cold and institutional; some rooms are not carpeted although there are risk assessments where alternative flooring has been laid; bedrooms vary in standards of décor, many need redecorating and repair where there is damage. Not all rooms have bedside or over bed lighting that service users can control when in bed. There are still unpleasant odours in a number of areas and cracked sinks in several bedrooms have still not been replaced. Some corridors are still ill lit which places service users, particularly those with a visual impairment, at risk and lighting in a number of areas is still not domestic in character. Service users, who are able to make use of this facility, are provided with keys to their bedrooms and individual assessments of each service users room have been made in relation to the furniture and fittings to ensure that they are adequate and meet the needs of the service user. There has still been no assessment of the premises by a suitably qualified person such as an occupational therapist with specialist knowledge of the client group to improve the environment for service users. There is a suitable water supply and ventilation which meets the needs of service users. Rooms are individually and naturally ventilated. Pipe work and radiators are guarded or have guaranteed low temperature surfaces to protect service users from risk of burning. Emergency lighting is provided throughout the home. Water is regularly checked and certified free from Legionella. Pre-set valves are fitted at outlet to prevent risk of scalding. There are now facilities in sluices for staff to clean their hands and evidence was seen that staff are provided with some training to protect service users from risk of infection and all areas of the home were clean on the day of the inspection however, a number of toilets did not have lidded bins for the disposal of pads. The Laundry is well equipped and sited so that soiled articles are not carried through food storage or preparation areas. Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29 Low staffing levels adversely affect the home’s ability to meet the needs of service users however successful recruitment has resulted in greater consistency of care. EVIDENCE: Low staffing levels result in difficulties in supervising service users at all times to ensure their safety. Some improvements have been made since the last inspection in that fewer staff now take their breaks at the same time. Staffing levels are worked out within a formula which does not take account of a number of service users who require increased levels of support and supervision to maintain their safety, figures submitted prior to the inspection indicate that there is a significant shortfall of staffing hours against Department of Health guidelines. Service users are benefiting from the success of the home in recruiting new permanent staff to fill vacancies which have reduced significantly since the last inspection. The manager confirmed and records reflect that all permanent staff receive formal induction training within 6 weeks of appointment including care principles, safe working practices, roles and relationships and the specific needs of the client group. All permanent staff receive foundation training within the first 6 months which relates to meeting service users needs as defined in the care plan. Where in house training is provided evidence is available of the qualifications of the trainers to evidence that service users are cared for by competent staff. Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 & 38 Good safety systems and training protect service users in the home. Failure to comply within reasonable timescales on a number of issues identified within previous Commission for Social Care Inspection reports over several years continues to have a negative affect on the comfort and safety of service users. Service users are protected from financial abuse through good accounting procedures EVIDENCE: Several requirements in relation to the environment from previous reports over a number of years which compromise the safety and quality of life of service users have still not been addressed. The manager stated that some of these are in process of being actioned and evidence was seen that the home manager makes requests for action but delays occur further up the organisation which continue to adversely affects the quality of service users lives. Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 17 The manager confirmed that service users are protected financially through sound financial management systems which include written records of all transactions. Personal monies are not pooled and appropriate records and receipts are kept, the manager does not act as agent for service users records are kept of all incoming and outgoing payments and secure facilities are provided for storing money and valuables and records and receipts are kept in relation to these. Service users are protected through; regular servicing and maintenance of equipment and installations; safe storage and disposal of hazardous substances; a signed health and safety policy; a risk assessment in relation to fire safety; Significant incidents/accidents are reported in line with regulations. Suitable safety procedures are posted; staff training in moving and handling, fire safety, first aid, food hygiene, health and safety and infection control. Security systems are in place and the manager is aware of and complies with all relevant legislation. Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 2 2 x 2 2 2 STAFFING Standard No Score 27 2 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 1 x 3 x x 3 Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 19 YES 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. 2. Standard 1 19 Regulation 5 23(2)(b)& (d) Requirement Information within the service user guide should be accurate and up to date The registered person shall ensure that the premises are kept in a good state of repair internally and externally and all areas are reasonably decorated. Sufficient numbers of bathrooms and toilets should be available which are suitable to meet the service users needs i.e warm and non institutional An assessment of the premises shall be made by a suitably qualified person, specialising in the needs of older people and people with dementia and that assessment provided to the commission service users rooms must be maintained in a good state of repair and decoration and damaged sinks must be replaced Lighting in residents areas should be adequate and domestic in nature Adequate facilities and procedures should be in place to ensure infection control. Sufficient numbers of staff Timescale for action By 31/10/05 By 1/4/06 3. 21 23(1)(a) & (2)(f)&(j) 23(1)&(2) (a) By 1/4/06 4. 22 By 1/4/06 5. 24 23(2)(b)& (d) 23(p) 13(1)(3)& 16(2)(j) 18(1) By 1/4/06 6. 7. 8. 25 26 27 By 1/4/06 By 31/10/05 Action plan Page 20 Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 9. 33 24 should be on duty to ensure that service users needs are met and they are adequately supervised at all times Quality assurance systems must be effective in picking up shortfalls where the home is not meeting national minimum standards By 31/10/05 By 31/10/05 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 25 Good Practice Recommendations Bedrooms should be provided with easily accessible bedside or overbed lighting. Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Honeyfield H56-H06 S23967 Honeyfield V238809 080905 Stage 4.doc Version 1.40 Page 22 - 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. 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