Inspection on 05/09/06 for Honeywood House Nursing Home

This inspection was carried out on 5th September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Honeywood House Nursing Home 08/05/06

Honeywood House Nursing Home 10/10/05

Honeywood House Nursing Home 30/05/05

Honeywood House Nursing Home 21/12/04

Honeywood House Nursing Home 08/06/04

Similar services:

Springfield House

The Shelley

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Honeywood House Nursing Home Rowhook Horsham West Sussex RH12 3QD Lead Inspector Mrs J Hough Unannounced Inspection 5th September 2006 11:00 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 Honeywood House Nursing Home DS0000024157.V307562.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. Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Honeywood House Nursing Home Address Rowhook Horsham West Sussex RH12 3QD 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) 01306 627389 Trustees of Honeywood House Post Vacant Care Home with Nursing 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th May 2006 Brief Description of the Service: Honeywood House is a care home providing personal care and nursing for twenty-eight older persons. 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 twenty-eight single bedrooms, six 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 that are well maintained with most areas accessible to residents. The Responsible Individual for the home is Mrs Margaret Cutler and a new manager Sandra White was appointed in July 2006 and is in the process of making an application to the Commission of Social Care Inspection to become the Registered Manager for the home. Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on 5th September 2006. The registered manager for the home retired in June 2006 and the deputy manager was appointed as manager for the home and is in the process of completing her application to be registered with the Commission of Social Care Inspection (CSCI) as the registered manager for the home. Sandra White was present at the inspection and provided the information required. During the inspection a tour of the premises took place and some of the resident’s rooms were seen. A selection of the resident’s care notes, staff recruitment files, accident and complaint logs were examined. Time was spent talking to residents, staff and one visitor. At the last inspection two requirements were made with regard to recruitment procedures and formal staff supervision that had both been fully met. This was a key inspection and all the key standards were assessed. No requirements were made as a result of this inspection. The scales of fees charged are from £600 to £700 per week. What the service does well: The home offers residents a comfortable and clean environment with a homely atmosphere. Residents spoken with praised the location of the home saying no one could wish for a better setting in which to live. Staff have the skills and experience individually and collectively to provide the residents with the care required, with more than half of the care team having gained the National Vocational Qualifications in Care. (NVQ) Team working was evident on the day of the inspection. Residents are supported to make choices about what they wish to do and how they are cared for. Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 6 Residents spoken with all felt the staff were kind and caring and treated them with respect. A good variety and quality of food was offered daily and residents praised the food and said there was always plenty to eat. What has improved since the last inspection? What they could do better: It was thought that staff would benefit from being informed of the feedback given on the residents/relatives surveys. Any action taken as a result of feedback from surveys should be documented as evidence that comments are acted upon. The Statement of Purpose still requires amending in the section relating to the procedure for complaints. Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 7 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 Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 8 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 Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 9 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): 1,3,6 Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. Prospective residents and their relatives are given the opportunity to visit and assess the facilities and suitability of the home. They are given information about the home so that they can make a choice as to whether the home is right for them. A comprehensive assessment of needs is carried out before residents move into the home. The home does not provide intermediate care. EVIDENCE: The Statement of Purpose is updated but requires some amendments to the section relating to the process for complaints. The pre-admission assessment was seen of a recent admission to the home that was detailed and informative in identifying the resident’s needs. Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 10 All new residents are admitted to the home for a trial period of one month to enable both the home and resident to decide if the home is right for them. Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 11 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 is good. This judgement has been made using available evidence including a visit to this service. The care planning system ensures that the health and personal care needs of residents are fully met. Medication procedures for the home ensure safe practice. Resident’s are treated with respect and their wishes and preferences are discussed and supported. EVIDENCE: Care plans and assessments seen were detailed and informative of resident’s individual needs and were updated regularly. Risk assessments and nutritional assessments were completed in all cases. Residents were weighed monthly unless specifically assessed as not needing to be done. Care plans were kept in resident’s rooms for reference. Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 12 The home provides the necessary equipment for resident’s individual needs. Two residents who had pressure sores had the appropriate pressure relieving equipment such as a cushion and mattress. Two portable hoists were situated on each floor. Resident’s spoken with said the staff were kind and looked after them very well taking into account their personal wishes. All personal care was provided in private. Medication administration records were checked and all completed accurately. Each record contained a photograph of the resident with any relevant details with regard to allergies. All handwritten entries were signed and dated. Medicines were stored and administered safely. The home had no Controlled Drugs being stored or administered at present. No record was kept of medicines that were destroyed and collected by the clinical waste disposal company. The manager confirmed that two members of staff were responsible for the disposal of all medicines. It was advised that on completion of this task the two members of staff sign a medicine disposal book to confirm this has been completed satisfactorily. Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 13 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 is good. This judgement has been made using available evidence including a visit to this service. The residents are given every opportunity to participate in the activities provided. Residents are supported and encouraged to maintain links with their family and friends. The meals provided are nutritious and varied. EVIDENCE: The home does not employ an activities organiser but staff where able take the residents for walks or push them around the extensive grounds and spend time talking or reading to them as required. Planned activities provided in the home consist of musical entertainment, exercising to music and visits by a physiotherapist and aromatherapist. Residents spoken with were happy with the activities provided although some chose not to participate as preferred to sit in the privacy of their own rooms. The visiting arrangements for the home are open but visitors are encouraged not to visit before 10am although the home is flexible if there is a good reason Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 14 visitors wish to come before that time. A visitor spoken with said that the staff always made her very welcome and there had been no restrictions made to the time she visited. Visitors were able to have a meal when visiting the home with prior arrangement with the kitchen. Lunchtime was observed in the dining room and residents seemed to enjoy their meal, and all said the food was well presented and there was a good choice and plenty to eat. Breakfast and supper is served in resident’s rooms and lunch is served in the dining room or the resident’s rooms if wished. Menus showed that the food on offer was well balanced and nutritious. Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 15 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 is good. This judgement has been made using available evidence including a visit to this service. The home has a robust complaints policy and procedure. Complaints are taken seriously and acted upon. Policies and procedures and training for staff are in place to protect residents from harm. EVIDENCE: The complaints log was seen and there was one complaint recorded since the last inspection in May 2006 that was found to be unsubstantiated. The complaints log is accessible to staff for recording any concerns or complaints together with the actions taken. The complaints procedure was displayed in the entrance to the home and residents were given a copy on moving into the home. Residents said they would not hesitate to discuss any concerns with the manager or Mrs Cutler the Responsible Individual. Staff were provided with training on promoting safety and protecting residents from abuse. Staff were aware of the Whistle Blowing policy and the home follows the Adult Protection Procedures for West Sussex County Council. Further training for staff on abuse is scheduled for October/November 2006. Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 16 Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 17 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): 19,26 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, comfortable and homely environment. EVIDENCE: A tour of the premises took place and all areas of the home were fresh and clean. However it was noticed that in some areas carpets were stained. Generally the home is well maintained and decoration and maintenance work was carried out routinely by the handyman. Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 18 The grounds are extensive and the garden is well maintained. Some paved areas were considered unsafe for residents as paving slabs were uneven. However access to the garden can be gained via other routes. The slope leading from the conservatory is also steep and there are no handrails other than a low brick wall. The gravel pathways would make it difficult for residents using wheelchairs to easily access all areas of the garden. The kitchen was clean and tidy and fridge and freezer temperatures being recorded daily. A recent environmental health assessment highlighted that more ventilation was required in the kitchen area and it was seen that two large fans were in place. It was also recommended that food temperatures be recorded at frequent intervals that are now being done. The laundry area was neat and tidy and the bulk of the laundry is sent out for washing. The home has one washing machine and one tumble drier considered appropriate for the home’s needs. The inspector was informed that a fire safety assessment is being carried out next week by the local fire service. Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 19 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 is good. This judgement has been made using available evidence including a site visit to this service. Staff numbers appear appropriate to meet the resident’s needs during the day and night. Residents are supported and protected by the home’s recruitment procedures and practices. Staff are provided with the appropriate training for their work. EVIDENCE: Staffing numbers were discussed with the manager who confirmed that one trained nurse plus six care assistants were on duty in the morning and in the afternoon one trained nurse plus three care assistants. The manager is also on duty during the day to support staff. During the night there was one trained nurse plus two care assistants. The home had staffing vacancies for care assistants to work at weekends but these posts were now in the process of being filled. Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 20 Residents and staff spoken with felt the staffing numbers were adequate to provide the level of care needed and residents confirmed that staff were able to give them the time they required. The home employs three domestic staff to maintain the cleanliness of the home with two working during the week and one over the weekend. Two staff recruitment files were read for new care assistants. Both files contained evidence that a Protection of Vulnerable Adults check (POVA) had been carried out prior to working in the home. Criminal Records Bureau checks (CRB’s) were also applied for although some were taking several weeks to come back. Under these circumstances staff commence working in the home and complete the induction programme. It was confirmed that during this period new staff are under constant supervision. Staff are encouraged and supported to achieve the National Vocational Qualifications in Care (NVQ). The ratio of staff that had achieved this qualification was over 50 . Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 21 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): 31,33,38 Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. The home is run well taking into account the interests of the residents. The health and safety and welfare of the residents are protected as far as practicable. EVIDENCE: Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 22 The present manager Sandra White was the deputy manager of the home and was appointed to manager following the retirement of the previous manager at the end of June 2006. Sandra White is in the process of her application with the Commission of Social Care Inspection (CSCI) to become the registered manager of the home. Sandra is a qualified and experienced nurse having worked in the care of the elderly for many years. Both staff and residents said that Sandra was very approachable and they would feel happy to talk with her on any matters. Quality assurance surveys had been sent to relatives in July 2006 and results and feedback from those surveys were seen. Twelve surveys were completed and returned and eleven gave positive feedback in all areas. One survey gave some negative feedback that had been addressed by the home. It was thought that staff would benefit from being informed of the feedback given on the residents/relatives surveys, which was not being done at present. Residents/relatives surveys were also available in the reception area of the home. Formal staff supervision had commenced in June 2006 for all staff at least six times a year. Staff spoken with confirmed this was taking place and stated that they found it supportive and helpful for their daily work. Accidents, injuries and incidents were recorded and reported to the appropriate authorities. The accident log was read and there had been 28 minor accidents recorded and one accident resulting in the resident being admitted to hospital. The home records all trips and falls even if no injury results. The maintenance man carries out regular checks on equipment and systems within the home as well as external engineers carrying out appropriate safety checks. There is a staff training programme to ensure all staff are updated in manual handling, fire safety, first aid, infection control and food hygiene. Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 23 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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. 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. Refer to Standard Good Practice Recommendations Honeywood House Nursing Home DS0000024157.V307562.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Worthing LO 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. 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