Inspection on 23/02/07 for Honeysuckle House Nursing Home

This inspection was carried out on 23rd February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 11/03/06

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 Key Unannounced Inspection 6th February 2006 04:29 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.V323243.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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.V323243.R01.S.doc Version 5.2 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 www.careuk.com Care UK Community Partnerships Limited Ms Sheila Patten Care Home 32 Category(ies) of Dementia - over 65 years of age (32), Mental registration, with number disorder, excluding learning disability or of places dementia (32) Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th March 2006 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 retain 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 the1990s, originally to accommodate residents 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. Residents 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 residents and other stakeholders. Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 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 four hours to complete. Due to the nature of the disabilities of most residents it is a challenge to gain their opinion on life in the home. However, the inspector was able to sit and talk with and observe several residents as they engaged in their daily activities. Generally, the feedback was positive and residents seemed relaxed, and looked well groomed. The inspector met the new manager, who aided the inspector throughout the inspection process and showed the inspector around the home. An application for the home to admit residents with dementia was made in 2006, and has been successful. What the service does well: What has improved since the last inspection? What they could do better: The previous manager was dismissed and there is a very new manager. An application needs to be made for the new manager to be registered with the Commission. Three areas that were identified as needing improvement at the last inspection remain outstanding, and are restated as part of this report. Again, these are primarily to do with repair and redecoration in the home. There is still real room for improvement in the environment, as despite some Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 Page 6 progress made, it is showing signs of wear and tear. There is a need to replace more beds and mattresses, the carpets and curtains need to be replaced, and the bathrooms are stark and the equipment is becoming outdated. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 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.V323243.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally, prospective residents, and their representatives, have the information they need to make an informed choice about moving into the home. EVIDENCE: At the previous inspection it was recommended that the term mental infirmity not be used in documents such as the statement of purpose. At this inspection the inspector was shown the most recent statement of purpose and noted that it had been updated, the language was appropriate and it reflected the registration of the home to care for people with dementia. However, it does need to be updated to reflect the appointment of the new manager and a requirement is made in relation to this. Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 8 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvement has been made to the practice in the home in relation to the use of bed rails. EVIDENCE: At the previous inspection the registered person was required to ensure that the policy regarding the use of bed rails was reviewed in consultation with an occupational therapist. At this inspection the inspector was able to confirm that this issue had been appropriately addressed. The manager explained that no bed rails were now being used in the home. The inspector visited one resident who was in bed at the time of the inspection and noted that a special mattress was placed at the side of the bed to reduce the risk of injury through falling. The inspector reviewed the homes written records of incidents and accidents and found that, where residents had fallen, thorough records were made and made reference to the action in order to reduce the risks and the made reference to their risk assessment being updated. Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 Page 10 Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): No standards in this outcome group were reviewed at this inspection. EVIDENCE: At the previous inspection it was recommended that the “patterns of activities of living” assessments be further developed for each resident in relation to their ethnic backgrounds, and their cultural and religious beliefs. Particularly in relation to their communication needs and eating and drinking. This recommendation was not reviewed, it remains relevant, and it is planned that it will be reviewed at the next key inspection. Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Residents 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: The inspector reviewed the homes written records of complaints. Two complaints had been recorded since the previous inspection and records reflected that they had been resolved. An adult protection issue has arisen since the previous inspection. The previous manager was suspended, later dismissed, and has subsequently been referred to the POVA list. The organisation’s adult protection procedure was followed and the local authority arranged for strategy meetings to take place with respect to this issue. Areas of improvement were identified as part of the adult protection process, particularly in relation to the organisations guidance and practice regarding access to larger amounts of residents’ money. The senior management team addressed these issues at that time. The judgement remains adequate in this outcome area until the inspector is able to conduct a more thorough review of the new guidance and practice. Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 25 & 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Whereas some previous requirements have been met, it was evident that other requirements relating to the environment had not been complied with, despite being restated in a number of inspection reports, and some issues are outstanding since 2003. These relate to the need to redecorate a communal room and the replacement of floor coverings and curtains throughout the home. EVIDENCE: During the tour of the home it became evident that a number of requirements relating to the environment had been complied with. At the previous inspection the registered person was required to ensure that the music lounge is redecorated, and to ensure that a number of bedrooms, bathrooms and toilets were redecorated. The inspector was able to confirm that these tasks had been achieved. Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 Page 14 The manager told the inspector that a number of new beds and mattresses have been provided. However, a number of beds still need to be replaced and a requirement is made in respect of this. During the tour of the building it was noted that a number of bathrooms, although clean, were quite stark and in need of refurbishment. A requirement is made in respect of this. The registered person was previously required to ensure that the quiet room, next to room 25 is redecorated and the carpet is replaced, to ensure that the floor covering was replaced throughout the home and that all worn curtains were replaced. One of these requirements has been restated on three occasions over two and a half years and, the others restated from April 2006. Although a start has been made on some tasks, they remain uncompleted. The registered person must ensure that these issues are addressed as a matter of urgency. The manager provided evidence to the inspector that a capital grant has been applied for in order to replace some beds, the curtains and carpets and to refurbish a number of bathrooms. A written refurbishment schedule is to be provided to the Commission for 2007/8, and a requirement is made in respect of this. Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 29 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The organisation has a recruitment procedure that strives to protect the best interests of residents. EVIDENCE: At the previous inspection it was recommended that enhanced CRB disclosures be obtained for all staff. The manager told the inspector that Care UK had adopted this practice, and that all staff working in the home, including ancillary staff such as cooks and domestic staff are now subject to enhanced CRB checks. Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. There has been an unsettled period, with a number of changes of manager. A new manager has taken over the management of the service. EVIDENCE: A new manager has been employed in the home. She has applied to be registered with the Commission. She was very new to the post, having been working in the home for around two weeks, and sill going through the induction process. A requirement is made with respect to her applying to be registered with the Commission. She told the inspector that a relatives’ meeting had been organised and she had already met and introduced herself to the resident’s relatives and representatives. Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 Page 17 At the previous inspection it was recommended that that to encourage an inclusive and empowering environment, notes from resident meetings should include staff responses to resident’s comments and requests, actions to be taken and matters arising from previous meetings. This recommendation was not reviewed at this inspection. It is planned that it will be reviewed at the next key inspection. Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 1 2 X X 2 1 3 STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 X X X X X X Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? YES 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 OP1 Regulation 6 Requirement The registered persons must ensure that the statement of purpose is updated to reflect the appointment of the new manager. The registered persons must ensure that a written refurbishment schedule for the home for the period 2007/8 is provided to the Commission. The registered persons must ensure that the quiet room, next to room 25 is redecorated and the carpet is replaced. (The previous timescales of 30/05/05, 28/02/06 and 30/06/06 were not met.) 4. OP21 23(2) The registered persons must ensure that the bathrooms are refurbished as necessary. The registered persons must ensure that residents’ beds are replaced where necessary. 30/08/07 Timescale for action 30/04/07 2. OP19 23(2) 30/05/07 3. OP20 23(2)(b) 30/06/07 5. OP24 23(2)(c) 30/06/07 Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 Page 20 6. OP25 23(2)(b) The registered persons must ensure that the floor coverings are replaced throughout the home. (The previous timescale of 30/06/06 was not met.) 30/06/07 7. OP25 23(2)(b) The registered persons must ensure that all worn curtains are replaced where necessary throughout the home. (The previous timescale of 30/09/06 was not met.) 30/06/07 8. OP31 9 The registered persons must 30/04/07 ensure that the newly appointed manager makes application to be registered with the Commission. 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 OP12 Good Practice Recommendations It is recommended that the “patterns of activities of living” assessments be further developed for each resident in relation to their ethnic backgrounds, and their cultural and religious beliefs. Particularly in relation to their communication needs and eating and drinking. This recommendation was not reviewed. 2. OP32 It is recommended that to encourage an inclusive and empowering environment that notes from resident meetings should include staff responses to resident’s comments and requests, actions to be taken and matters arising from previous meetings. This recommendation was not reviewed. Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Honeysuckle House Nursing Home DS0000027810.V323243.R01.S.doc Version 5.2 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. 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