Inspection on 11/03/06 for Honeysuckle House Nursing Home

This inspection was carried out on 11th March 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Honeysuckle House Nursing Home 02/08/07

Honeysuckle House Nursing Home 23/02/07

Honeysuckle House Nursing Home 19/10/05

Honeysuckle House Nursing Home 05/04/05

Honeysuckle House Nursing Home 08/02/05

Honeysuckle House Nursing Home 21/10/04

Honeysuckle House Nursing Home 23/02/04

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

CARE HOMES FOR OLDER PEOPLE Honeysuckle House Nursing Home 1a Oakthorpe Road Palmers Green London N13 5HY Lead Inspector Caroline Mitchell Unannounced Inspection 09:30 11 & 12th April 2006 th X10015.doc Version 1.40 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 Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 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 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. Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Honeysuckle House Nursing Home Address 1a Oakthorpe Road Palmers Green London N13 5HY 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) 020 8886 8086 020 8886 0964 admin.honeysucklehouse@careuk.com manager.burroughs@careuk.com Care UK Community Partnerships Limited Ms Sheila Patten Care Home 32 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (32) of places Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 18 nursing beds for service users aged over 65 years and upwards and 14 beds for personal care are available. 19th October 2005 Date of last inspection Brief Description of the Service: Honeysuckle House Nursing Home is a registered care home with nursing providing care to thirty-two older people with a diagnosis of mental disorder. Care UK Community Partnerships Limited manages the home and employs the staff. The home is owned by the London Borough of Enfield who retains contractual responsibility for funding the majority of the maintenance at the home as well as for purchase of furniture and equipment. The London Borough of Enfield block purchases the thirty-two places at the home. The home is a purpose built; two story premises that was opened in the 1990s, originally to accommodate service users following the planned closure of a long stay hospital. The home provides both residential care and nursing care in two separate units. The ground floor contains a fourteen place residential unit that has twelve single bedrooms, one double bedroom and a range of communal facilities including its own lounge and dining room. The managers office, main kitchen and a large activity room are also situated on the ground floor. The first floor contains an eighteen place nursing unit that has sixteen single rooms, one double room, and a range of communal facilities including lounge and dining room. A passenger lift as well as stairs connects the two floors and both have an appropriate range of accessible bathrooms and toilets. Facilities throughout the home are fully accessible to wheelchair users. The home is situated in a quiet residential area close to the shops and amenities of Palmers Green as well as good public transport links. Placements at the home are bought by the local authority on a block contract basis and at the time of the inspection the fees were £300 for a residential placement, and £440 for nursing placement. Service users are expected to pay separately for hairdressing, newspapers and magazines and some toiletries. Following “Inspecting for Better Lives” the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken on an unannounced basis and took around two days to complete. Due to the nature of the disabilities of most service users it is a challenge to gain their opinion on life in the home. However, the lead inspector was able to sit and talk to several service users, in some depth, and spoke privately with two service users’ relatives, who were visiting during the time of the inspection. Generally, the feedback was positive. The inspector met the new manager, briefly, the senior manager for the home. It was also possible to meet some staff members for private discussion. An application has been made for the home to admit service users with dementia. The inspector assessing the application, Francis Czuba visited the home on 13th March 2006 and the requirements and recommendations made as a result of this visit are referred to throughout this report. Prior to the variation being granted a detailed action plan is required stating how these recommendations will be addressed by the registered persons, and giving specific timescales for each action. What the service does well: What has improved since the last inspection? What they could do better: The main challenge for the registered persons is that the home is becoming very shabby and needs substantial investment in order for it to be improved. The state of the house is deteriorating and there is a need to ensure that the maintenance issues are addressed in the home as a matter of priority. Such an environment reflects on the level of respect shown to all users of the service. The premises although managed by Care UK, are owned by the London Borough of Enfield. However it is incumbent upon Care UK to ensure Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 6 that, in the agreement with the Borough of Enfield, adequate provision is made to ensure that the premises are maintained to an acceptable standard. 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. Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 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 the following standard(s): 1, 2, 3 & 4 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Prospective service users have a needs assessment carried out before they are admitted to the home. The service had received copies of the care plans, from those assessments carried out through Care Management. Each service user is provided with a statement of terms and conditions before admission to the home. It gives basic information on what residents can expect to receive for the fee they pay, and sets out terms and conditions of occupancy. EVIDENCE: No one has moved into the home since before Christmas. The lead inspector reviewed the written records for one service user, who had most recently moved into the home. These records included a brief assessment of need and care plan from the social worker involved with the service user at the time. A manager from the home had also gone to visit the service user and undertaken an assessment prior to the decision being made that the service could meet the service user’s needs. The lead inspector also saw a number of the written contracts that are in place for service users. These reflected that there is a Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 9 period of six weeks at the beginning of service users’ stay in the home, that are considered a trial period, as part of the admissions process. The registered persons have applied for a variation to the conditions of registration to allow people with dementia to be admitted. During his visit on 13th March 2006, in respect of this application, the registration inspector recommended that the term mental infirmity is not used in documents such as the statement of purpose, when referring to service users and a recommendation is made in relation to this as part of this report. Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Service users’ health, personal and social care needs are set out in an individual plan of care. The health and personal care needs of service users are generally well met and there is a clear and consistent care planning system in place that is satisfactory overall. However, some service users have cot sides on their beds, and a clear policy and risk assesments are needed to ensure their safe and appropriate use. The service users’ safety is protected by the policies and procedures that are in place regarding medication. Service users feel respected and their right to privacy is upheld. EVIDENCE: The lead inspector saw the written records for three service users in relation to health and personal care. There were service user plans setting out each persons’ health and personal care needs and risk assessments, of a good standard, regarding the pertinent risks for each service user. There was clear evidence of any input health professionals had with each person. An incident occurred in January 2006, when a service user who suffers from diabetes was unwell and an ambulance was called. The Ambulance Crew Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 11 expressed concern about the way in which the service user, was attended to by the staff in the home. An adult protection strategy meeting took place and one of the outcomes was that further training should be provided for staff in dealing with diabetes. This was being addressed by the management team. At the previous inspection the registered person was required to ensure that the policy regarding the use of cot sides is reviewed in consultation with an occupational therapist. At this inspection it was evident that the manager was working on this, and in order to allow her time to complete her work the timescale for compliance with this requirement is extended. There was a permission form in place for those service users who were using cot sides and these had been signed by the service user or their representative. The manager told the lead inspector that one service user had had a pressure ulcer recently. The records of this service user were examined. The lead inspector found that the standard of record keeping had improved since the last inspection and were clearer regarding the treatment and progress of pressure ulcers. The manager told the lead inspector that she had bought a Polaroid camera in order to help with monitoring wounds. She added that she had asked the tissue viability nurse to provide refresher training to the staff team. The lead inspector noted that good tissue viability assessments were in place generally, and that service users’ plans were detailed with regard to pressure relief, and included the settings of airflow mattresses in relation to each service users’ weight. An incident had been reported to the Commission by the home in October 2005, when an agency staff member omitted to administer some prescribed medication to one service user. The incident was discussed with the manager and service manager. This agency nurse is no longer working in the home and the agency was informed of the incident. The lead inspector saw the arrangements for the storage, administering and recording medication in the residential unit, which were in good order. There was evidence that the competence of all staff who administer medication in the home had been thoroughly assessed, and each service user’s photograph was included as part of their medication records, to help new or agency staff to identify them more easily. There are two shared rooms in the home. Curtains are provided in the double rooms, to screen the room and provide privacy when needed. The manager explained that staff are careful to ensure that service user’s toiletries and laundry are kept separate. The lead inspector observed the interaction of staff and service users and noted that staff were gentle and respectful in the way in which they approached service users. Feedback from service users and their relatives was that they did feel that they are treated with respect by staff who are caring and try to maintain service users’ privacy. Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Generally the routines of daily living and activities are flexible and varied to suit service users’ expectations, preferences and capacities. However, there is room for improvement in assessing and meeting the needs of service users from varied ethnic backgrounds. Service users are able to have visitors at any reasonable time and are encouraged to maintain contact with their friends and families. Service users are encouraged to exercise personal autonomy and choice. Service users receive a varied, appealing, wholesome and nutritious diet, which is suited to individual needs. EVIDENCE: The home has maintained a good standard of activities offered to service users. The manager explained that the activities co-ordinator was taking some time off and that two people had been appointed to cover the post on a job share basis. Care UK has chosen this home to be part of “Project Trafalgar.” This is a pilot scheme, developing activity lead care within the home. It is based on providing therapeutic inputs such as speech and language therapy, occupational therapy, physiotherapy, and other alternative therapies such as reflexology, music therapy and aromatherapy. The aim is to enhance service users’ quality of life. Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 13 During his visit on 13th March 2006 the registration inspector recommended that activities for service users with dementia are to be improved by providing more variety by the use of external inputs e.g. pianist, aromatherapy etc. The activities co-coordinators should receive certificated training in providing specialist activities for people with dementia. At this inspection the manager indicated to the lead inspector that progress had been made with these tasks and the lead inspector also noted that she has provided computer equipment in the activities room so that activity & communication materials can be developed for service users. The lead inspector looked at four service users’ file in relation to daily life and social activities. Each service user had a “patterns of activities of living” assessment that talks about the service users’ needs and preferences in a range of areas of their daily lives including communication, and eating and drinking. Some reference is made to service users’ needs in relation to their ethnic backgrounds, and their cultural and religious beliefs. However, individual assessments could be developed further, to better define the service users’ needs and preferences, and how these are being addressed. Particularly in relation to their communication needs and eating and drinking. A recommendation is made in respect of this. The inspector noted that several relatives came to visit the service users during the two days of the inspection. From conversation with service users and the relatives who were visiting at the time, it was evident that the home actively supports service users to maintain contact with their families and friends. The inspector discussed how service users are enabled and encouraged to make choices with some of the care staff who were on duty at the time of the inspection. They said that they try to provide choices that mean something to each person, and that this can be what people want to wear, or wish to eat, and it can be what time they go to bed. The home operates a four-week rotating menu, and a copy of the current, spring/summer menu was provided to the lead inspector. The menu shows a range of nutritious meals and staff were observed making sure that service users were given the menu of their choice. The manager told the lead inspector that the menu has been reviewed with the support of a dietician and improved accordingly. The lead inspector was able to eat lunch with service users on both days of the inspection. Lunchtime was relaxed and unhurried and the food was appetising. Some service users have their meals pureed for health reasons. The lead inspector noted that, where this was the case, the food was pureed separately, so that it appeared more appetising and the different flavours were maintained. The service users spoken to informed the lead inspector that they were happy with the food. Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users benefit from a complaints procedure and an adult protection protocol that ensure that their views are heard and that they are protected from abuse. EVIDENCE: There is clear written guidance for service users and their representatives about how to complain and this is displayed around the home so that service users and visitors have easy access to it. The manager told the inspector that one complaint had been received since the previous inspection. This complaint was initially raised with the Commission, and was passed to the manager of the home to look into. The manager explained that she has recently met with the complainant, the close relative of a service user, and provided an account of the investigation and the outcomes. A copy of this information has been provided the Commission. The complainant has also stated to the inspector that in their opinion, the care has improved since the new manager has been in post. The inspector spoke to two relatives who were visiting at the time of the inspection. They had no concerns to share at the time, and were clear about whom to bring their concerns to should any issues arise. The inspector saw evidence that since the last inspection twenty three staff have had attended training regarding the protection of vulnerable adults and that the manager had recently updated the staff group about the importance of reporting accidents, injuries and incidents. Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 19, 20, 21, 23, 25 & 26 Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. The home provides an environment that service users can regard as their home and their bedrooms are personalised to reflect this. There are sufficient bathrooms and the home is generally kept clean. However, the standard of the repair and décor is deteriorating, and is becoming a less comfortable environment for service users to live in. EVIDENCE: The home is situated on a quiet residential street with easy access to the shops, public transport and all other community amenities of Palmers Green. The ground floor houses the residential unit and the nursing unit is on the first floor. There is a large activity room where people socialise and take part in group activities, along with a number of lounges and a pleasant conservatory. Some service users chose to sit and chat in communal corridors. During the tour of the home it became evident that a number of requirements relating to the environment had not been complied with, despite being restated Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 16 in a number of inspection reports, and some issues are outstanding since 2003. These relate mainly to the need to redecorate communal rooms and the replacement of floor coverings throughout the home. Evidence was available that quotes were being obtained by the home, from contactors for the work to be done as the responsibility for the majority of the maintenance of the property lies with Enfield Council. A written refurbishment schedule is to be provided to the Commission relating to the interior of the premises and a requirement is made in respect of this. During his visit on 13th March 2006 the registration inspector recommended that signage be improved to easily indicate bathrooms and toilets. At this inspection the inspector was able to confirm that some progress has already been made in respect of this, and the manager showed the lead inspector the software that she has obtained in order to provide user friendly signage throughout the home. There was evidence that staff have helped service users to personalise their bedrooms. It was evident from the service users bedrooms that they are encouraged to bring small personal belongings into the home. Service users who were consulted said that they are happy with their rooms, although a number do look and feel quite stark, are in need of decoration, and the floor coverings need to be replaced. The bedroom furniture is beginning to look very tired and several pieces were in need of repair. Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 17 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The needs of the service users in the home were seen to be met by the numbers, competence and skills of the staff employed. The service recognises the importance of training, and delivers where possible a programme that meets statutory requirements. The manager recognises additional training is needed, and plans, over time, to provide this training. The service has a recruitment procedure that is adequate and generally meets the regulations and the National Minimum Standards. There is minimum use of any agency or temporary staff. EVIDENCE: The copy of the staffing rota provided to the inspector for October 2005 reflected that there tend to be six staff in the nursing unit each morning and five in the afternoon/evening, and five staff in the residential unit each morning and afternoon/evening. Both units have two staff awake on duty at night. There is a registered nurse on duty at all times in the Nursing Unit and a senior carer in the Residential Unit. Staffing levels are satisfactory to meet the needs of the service users. In addition, there are administrative and ancillary staff. The manager said that she will pursue the issue of ancillary staff tending to have basic CRB checks rather than enhanced checks and the recommendation from the previous report, that this be addressed remains relevant. Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 18 During his visit on 13th March 2006 the registration inspector had asked that a training plan be established to provide all staff with a more detailed understanding of dementia and the care of service users with those symptoms. The manager, who has experience and expertise in working with people with dementia, has provided some in house training to staff regarding the types and treatments of dementia. She has arranged for an external trainer to provide further training. There is a strategy in place to ensure that at least 50 of the care staff have training to NVQ level 2 or equivalent. At the time of the inspection 45 of the staff team had an appropriate qualification and 8 were undertaking NVQ 2. The manager said that there are very few staff vacancies and this helps in keeping the use of agency staff to a minimum. She is building a small bank of staff, who she can call upon for cover when necessary, and who are familiar with the service user’s needs. Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 19 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 & 36 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. There has been improvement in the management of the service, and although there is room for improvement in consulting service users in meaningful ways, there is a robust quality monitoring system in place. Service users’ financial interests are safeguarded and staff are appropriately supervised. EVIDENCE: A new manager has been employed in the home. She has applied to be registered with the Commission. She has extensive experience of working with this service user group. The inspector saw evidence that she is having a very thorough induction process. During his visit on 13th March 2006 the registration inspector recommended that to encourage an inclusive and empowering environment that notes from service user meetings should include staff responses to resident’s comments Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 20 and requests, actions to be taken and matters arising from previous meetings. A recommendation is made in respect of this as part of this report. The inspector discussed quality assurance with the manager and line manager. They explained that there is a robust quality assurance process in place in the home and that this is supported by the visits by the responsible person, which set out areas for improvement and timescales for action. There is a monitoring report submitted to the line manager on a monthly basis and a quarterly report is produced that monitors occupancy and sets out the details of any complaints, accidents and incidents, infection control issues, tissue viability issues, hospital admissions and deaths. This includes details of training targets, progress with any development initiatives and progress with the repair of the home. The service users’ finances are managed by their relatives or the placing local authority and individual written records regarding personal allowances are kept in the home for each service user’s small transactions. The inspector noted that staff do have formal one-to-one supervision regularly. There is a standard format for staff supervision, which includes discussion regarding staff’s personal development, so that people’s individual training needs are discussed and planned for. Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 21 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 2 X 2 X 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 3 X 3 3 X X Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 22 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 Standard OP4 Regulation Registration Regulations 2001 3(1) Requirement Timescale for action 30/05/06 2 OP8 13(4) 3 OP19 23(2) Prior to the variation to the home’s conditions of registration being granted to allow the admission of service users with dementia, the registered person must ensure that a detailed action plan is provided to the Commission, stating how the recommendations referred to in the registration inspector’s letter dated 10th April 2006 will be addressed by the registered persons, and giving specific timescales for each action. The registered persons must 30/06/06 ensure that the policy regarding the use of cot sides is reviewed in consultation with an occupational therapist. (The previous timescales of 30/01/05 & 30/06/05 were not met.) The registered persons must 30/06/06 ensure that a written refurbishment schedule is provided to the Commission relating to the interior of the premises. DS0000027810.V287701.R01.S.doc Version 5.1 Honeysuckle House Nursing Home Page 23 4 OP20 23(2)(b) 5 OP20 23(2)(b) 6 OP21 23(2)(b) 7 OP21 23(2)(b) 8 OP23 23(2)(b) 9 OP23 23(2)(b) 10 OP25 23(2)(b) The registered persons must ensure that the music lounge is redecorated. (The previous timescales of 30/06/05 and 28/02/06 were not met.) The registered persons must ensure that the quiet room, next to room 25 is redecorated and the carpet is replaced. (The previous timescales of 30/06/05 and 28/02/06 were not met.) The registered persons must ensure that the assisted bathroom next to the hair dressing room is redecorated. (The previous timescales of 30/06/05 and 28/02/06 were not met.) The registered persons must ensure that the ground floor toilet, next to the TV lounge is redecorated. (The previous timescales of 30/06/05 and 28/02/06 were not met.) The registered persons must ensure that bedroom 13 is redecorated and the carpet replaced. (The previous timescales of 30/06/05 and 28/02/06 were not met.) The registered persons must ensure that bedroom 30 is redecorated. (The previous timescales of 30/06/05 and 28/02/06 were not met.) The registered persons must ensure that the floor coverings are replaced throughout the home. (The previous timescale of 30/03/06 was not met.) 30/06/06 30/06/06 30/06/06 30/06/06 30/06/06 30/06/06 30/06/06 Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 24 11 OP23 23(2)(b) 12 OP25 23(2)(b) The registered persons must ensure that all broken bedroom furniture is replaced where necessary. The registered persons must ensure that all worn curtains are replaced where necessary throughout the home. 30/09/06 30/09/06 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 OP1 Good Practice Recommendations It is recommended that the term mental infirmity is not used in documents such as the statement of purpose, when referring to service users. It is recommended that the “patterns of activities of living” assessments be further developed for each service user in relation to their ethnic backgrounds, and their cultural and religious beliefs. Particularly in relation to their communication needs and eating and drinking. It is recommended that enhanced CRB disclosures be obtained for all staff. It is recommended that to encourage an inclusive and empowering environment that notes from service user meetings should include staff responses to resident’s comments and requests, actions to be taken and matters arising from previous meetings. 2 OP12 3 4 OP29 OP32 Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Honeysuckle House Nursing Home DS0000027810.V287701.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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