Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 10/10/05 for Honeywood House Nursing Home

Also see our care home review for Honeywood House Nursing Home for more information

This inspection was carried out on 10th October 2005.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is located in a very pleasant rural location with extensive well- kept gardens. The resident`s rooms are furnished to suit their individual needs and the home is generally maintained to a good standard. The residents were generally complimentary about the care and the services provided and praised the staff for their kindness and hard work.

What has improved since the last inspection?

The resident`s assessments and care plans were thorough and well maintained. Consent and risk assessments are in place for the use of cot sides. Formal staff supervision has commenced with four members of staff and plans are in place to include all members of the staff. The staffing levels for five nights have been increased and further recruitment is planned to increase the staffing levels for all nights.

What the care home could do better:

Some additions and amendments are required to the Statement of Purpose for the home. The management must ensure that the West Sussex Adult Protection Procedures are fully understood and followed where appropriate.

CARE HOMES FOR OLDER PEOPLE Honeywood House Rowhook Horsham West Sussex RH12 3QD Lead Inspector Mrs J Hough Announced Monday 10 October 2005. V245670 th 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. Honeywood House H60-H11 S24157 Honeywood V245670 101005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Honeywood Address Rowhook, Horsham, West Sussex, RH12 3QD 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) Mrs Margaret Adelaide Cutler Mrs Suzanne Stepney Care Home (CRH) 28 Category(ies) of Old age, not falling within any other category registration, with number (OP) - 28 of places Honeywood House H60-H11 S24157 Honeywood V245670 101005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17/6/05 Brief Description of the Service: Honeywood House is a care home providing personal care and nursing for 28 older people. The home is situated in a rural area near the village of Rowhook on the borders of West Sussex and Surrey. The home is a large converted and adapted 18th century mansion house standing in 10 acres of park and woodland. The residents accommodation is situated on two floors and consists of 28 single bedrooms, 6 offering en-suite facilities. The communal space consists of two lounge areas, a conservatory and a dining room. The home has formal and informal gardens which are well maintained and accessible to the residents The Responsible Individual for the home is Mrs M Cutler and the Registered Manager responsible for the day to day running of the home is Mrs S Stepney. Honeywood House H60-H11 S24157 Honeywood V245670 101005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place over 8 hours and Mrs Cutler the General Manager and Suzanne Stepney the Registered Manager were present at the inspection and provided the information necessary. The home was given comment cards from the Commission to distribute to the residents, their relatives and visitors to gain their views of the home. One comment card was completed and returned. The General Manager Mrs Cutler completed a pre-inspection questionnaire and the information contained in this document will form part of the evidence in the inspection report. A tour of the premises took place and a selection of the resident’s care plans, staff recruitment files, maintenance records, accident and complaint logs were examined. Twenty residents, five relatives, and four members of staff were spoken with to find out what it was like living and working in the home and their views on the services the home provides. What the service does well: The home is located in a very pleasant rural location with extensive well- kept gardens. The resident’s rooms are furnished to suit their individual needs and the home is generally maintained to a good standard. The residents were generally complimentary about the care and the services provided and praised the staff for their kindness and hard work. Honeywood House H60-H11 S24157 Honeywood V245670 101005 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Honeywood House H60-H11 S24157 Honeywood V245670 101005 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 Honeywood House H60-H11 S24157 Honeywood V245670 101005 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) 1,2,3 & 5 The Statement of Purpose for the home needs revising and updating. Admissions to the home are well planned. EVIDENCE: The home has a Statement of Purpose setting out all the information about the home to enable the residents to make a choice as to whether the home is right for them. Some amendments are required to some of the information provided in relation to staffing numbers, the number of care staff qualified to NVQ, the recording of complaints, the number of bedrooms in the home, and a more detailed account of the admission process and a statement about emergency admissions to the home. All residents sign a contract of terms and conditions on admission to the home that set out all the conditions of residency. Where geographically possible the registered manager or a senior member of the nursing team carry out a full assessment of the residents needs prior to Honeywood House H60-H11 S24157 Honeywood V245670 101005 Stage 4.doc Version 1.40 Page 9 admission to the home. The home encourages the resident and their relatives to visit the home to see the vacant room, the location and facilities provided. All residents are admitted to the home for a four-week trial period to allow both parties the opportunity to assess if the home is suitable to meet all their needs. Honeywood House H60-H11 S24157 Honeywood V245670 101005 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) 7,8,9,10 & 11 All residents have individual care plans setting out the level of care and assistance they require. Thorough systems are in place for administering medicines to the residents. A policy and procedure is in place for the staff to follow when caring for the resident who is dying. EVIDENCE: Four of the resident’s care plans were examined and were well documented in identifying the resident’s care needs and interests. Risk assessments were completed where appropriate to ensure safe practice. The care plans were reviewed each month but gave no written evidence that they were completed and agreed by the resident or their relative. However, the care plans are kept in the resident’s bedrooms for them and their relative to read if they wish. Honeywood House H60-H11 S24157 Honeywood V245670 101005 Stage 4.doc Version 1.40 Page 11 The twenty residents spoken with said the staff looked after them very well and were kind and caring. The one comment card received also gave a positive response. The medication administration records were examined and all were accurate and well maintained. Controlled Drugs being administered were generally recorded and stored appropriately. However following the advice from the GP and pharmacist one Controlled Drug was not being recorded in the Controlled Drug Register or stored in the Controlled Drug cupboard. The medicine is a Schedule 5 Controlled Drug so invoices must be kept for a period of 2 years so other recording is not legally necessary. However, it is recommended for good practice for care homes that the medicine be recorded and stored as the other Controlled Drugs being administered in the home. The residents said that all their personal care was given in the privacy of their rooms or in the bathroom, and all felt that the staff respected their privacy at these times. The staff were seen to knock on the resident’s bedroom doors before entering their rooms. The home has a policy and procedure for caring for the resident who is dying, and endeavours to continue to care for the dying resident with the support and advice from other professionals when needed, unless there are strong medical reasons that prevent this. Training for staff in death and dying is not routinely provided, and it was recommended that arrangements be made for this to take place, to help staff deal with these difficult and sad occasions. Honeywood House H60-H11 S24157 Honeywood V245670 101005 Stage 4.doc Version 1.40 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 standard(s) 14 The home encourages and supports the residents within their capabilities to make choices about their lifestyle. EVIDENCE: The home has a policy not to get involved with the financial affairs or handle the money of the residents. The home supports those residents who wish to continue to handle their own money and affairs. The residents who are unable to carry out this task have a relative or a representative who takes on this responsibility on their behalf. Information and advice is available on local advocacy services when needed. On touring the premises and seeing some of the resident’s rooms it was noticed that many had furnished their rooms with their own small pieces of furniture and personal possessions making the room cosy and personal to them. Honeywood House H60-H11 S24157 Honeywood V245670 101005 Stage 4.doc Version 1.40 Page 13 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 The paragraph in the Statement of Purpose with regard to the process for recording complaints needs amending. The home has a complaints procedure in place but revision is required on when complaints should be dealt with following the procedures for Adult Protection. EVIDENCE: The paragraph with regard to complaints in the Statement of Purpose for the home still requires revising as it still places the responsibility for the recording of complaints on the complainant. The complaint log was seen and three complaints were recorded since the last inspection in June 2005. One complaint remains outstanding and is still under investigation. The Registered Manager is carrying out a full investigation and keeping the complainant informed on the progress, within the appropriate timescales. One complaint was recorded as being satisfactorily resolved and the third complaint was found to be unsubstantiated. On reading the details and actions taken following one of the complaints it was seen that the actions taken although thorough, were not in line with the protocols under the West Sussex Adult Protection Procedures. This matter was discussed with the General Manager and Registered Manager for future reference and guidance. Honeywood House H60-H11 S24157 Honeywood V245670 101005 Stage 4.doc Version 1.40 Page 14 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, 21,22,25 & 26 The home provides a safe, pleasant and comfortable environment for the residents. EVIDENCE: The home is situated in extensive grounds within a quiet rural setting. The grounds were attractive and well maintained and accessible to the residents however, for those residents in a wheelchair some areas of the gardens are not so easily accessible. The home employs a full time maintenance person who routinely maintains and decorates the home and carries out regular checks on systems and equipment used in the home. The home appears to have adequate bathing and toilet facilities to meet the needs of the residents. A passenger lift provides access to all areas of the home except for two bedrooms that have difficult access, and for this reason are not in use at present. The home has four portable hoists, two on each Honeywood House H60-H11 S24157 Honeywood V245670 101005 Stage 4.doc Version 1.40 Page 15 floor. All the resident’s rooms have a call bell system for the residents to summon assistance when needed. The home was clean and hygienic on the day of inspection. The laundry facilities in the home include one industrial washing machine and tumble drier. There are no hand washing facilities in the laundry area and staff wash their hands in the staff room next to the laundry. The home does not employ a laundry assistant and this responsibility lies with the care staff. On walking around the premises there generally appeared to be a lack of storage space in the home for equipment and wheelchairs. Honeywood House H60-H11 S24157 Honeywood V245670 101005 Stage 4.doc Version 1.40 Page 16 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) 27,28 & 29 The home operates a thorough recruitment procedure. Staffing numbers appear appropriate to meet the resident’s needs during the day and most nights. EVIDENCE: The residents spoken with were happy with the level of care they received and thought generally there was enough staff on duty to attend to their individual needs. There have been instances when residents have had to wait longer than usual for staff to respond to their calls for assistance. However the residents said they understood that there were busy times for the staff and praised the staff for their hard work. Staffing numbers on the day of inspection appeared appropriate to care for the residents. Staff spoken with felt the staffing numbers were adequate for them to carry out their work and responsibilities. Since the last inspection the staffing numbers have been increased for five of the night shifts, to one trained nurse and two care assistants. A recruitment campaign is ongoing to recruit further night staff to increase the staffing numbers for all nights. This will be followed up at the next inspection. There are six members of the care team who have gained the NVQ qualifications in level 2 in care. The home employs three domestic staff to maintain the cleanliness of the home with two domestics working during the week and one over the weekend. Four staff files were examined and showed that all the appropriate checks are carried out for all new staff, before they start working in the home. Honeywood House H60-H11 S24157 Honeywood V245670 101005 Stage 4.doc Version 1.40 Page 17 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) 31,32,33,36,& 38 The registered manager is experienced to run the home. The home protects the health and safety of the residents and staff by regular maintenance of systems and equipment used in the home. The method for gaining the views of the residents and their relatives of the home needs revising. EVIDENCE: The registered manager Suzanne Stepney is a qualified nurse who has many years experience working in the care home sector and has been the registered manager at the home for the past 10 years. Both the residents and the staff said that Suzanne was very approachable and includes them in decision making for the home and how it is run. Honeywood House H60-H11 S24157 Honeywood V245670 101005 Stage 4.doc Version 1.40 Page 18 The home has developed a questionnaire for the residents and their relatives as part of a quality assurance system. The questionnaires are available in the home for anyone who wishes to complete one. However it appeared there was a poor response, as no completed questionnaires had been returned to enable the home to monitor their performance. It is recommended that the home review the way the survey is carried out to ensure they have a good response in the future. Formal staff supervision is in the process of being developed within the home for all care staff at intervals of at least 6 times a year. The maintenance records were examined showed that equipment and systems were regularly checked by the maintenance person and serviced by competent persons within appropriate timescales. Accidents, injuries and incidents were recorded and reported to the appropriate authorities. Staff had completed updated training in manual handling, fire safety and first aid. Training in infection control is in the process of being arranged for all staff. Honeywood House H60-H11 S24157 Honeywood V245670 101005 Stage 4.doc Version 1.40 Page 19 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 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 x COMPLAINTS AND PROTECTION 3 x x 3 x x 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 3 3 2 x x 2 x 3 Honeywood House H60-H11 S24157 Honeywood V245670 101005 Stage 4.doc Version 1.40 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 9 18 Good Practice Recommendations Receipt, administration and disposal of all Controlled Drugs are recorded in a Controlled Drugs register. the Registered Manager must ensure that allegations and incidents within the West Sussex Adult Protection Procedures must be reported immediately and appropriately Honeywood House H60-H11 S24157 Honeywood V245670 101005 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 2nd Floor Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 Honeywood House H60-H11 S24157 Honeywood V245670 101005 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!