Inspection on 08/05/06 for Honeywood House Nursing Home

This inspection was carried out on 8th May 2006.

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 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 05/09/06

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 Key Unannounced Inspection 8th May 2006 09:30 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.V290452.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. Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 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 Mrs Suzanne Stepney Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th October 2005 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 and accessible to the residents. The Responsible Individual for the home is Mrs Margaret Cutler and the Registered Manager responsible for the day-to-day running of the home is Mrs Suzanne Stepney. Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on 08/05/06 over seven hours and the deputy manager Sandra White provided the information needed. A follow up visit took place on 09/05/06 for one and a half hours to check documents not available on the day of inspection and the Registered Manager Suzanne Stepney and the Responsible Individual Margaret Cutler provided the information needed. Evidence was gained from checking the resident’s care plans and assessments, staff files, maintenance records, staff rotas, menus, accident and complaint records, and the information provided in the pre-inspection questionnaire. A tour of the building took place and eleven residents, three relatives and five staff were spoken with to find out their views of the home. There were twenty residents accommodated at the time of the inspection. All the key National Minimum Standards plus those standards not fully met at the last inspection were assessed on this inspection. Two requirements were made as a result of this inspection. Current Scale of charges £550 to £700 a week. What the service does well: The home is a large converted and adapted 18th century mansion house located in extensive grounds in a rural location. The formal gardens are mainly laid to lawn with numerous hedges, shrubs and trees. The home has a general homely and welcoming atmosphere and visitors are welcome to come and go as they please. The residents are complimentary about the care and the services provided and praised the staff for their kindness and hard work. The home offers a well-balanced and varied diet and the residents can choose what they wish to eat and generally all said the food was very good. The staff are provided with the necessary training for them to carry out their work to a good standard. Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 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 Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 Page 7 contacting your local CSCI office. Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 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.V290452.R01.S.doc Version 5.1 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): 1,2,3,4,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with all the relevant information about the home. The admission process for the home ensures the home is able to meet all the resident’s needs. EVIDENCE: The home has a Statement of Purpose setting out all the information about the home and the services it provides so that anyone considering moving into a care home can make the choice as to whether the home is right for them. The section on complaints contained in the Statement of Purpose needs reviewing in line with the home’s complaints procedures. Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 Page 10 All prospective residents are encouraged to visit the home and see the facilities and meet with the staff and other residents. All residents move into the home on a four-week trial basis. All residents sign a contract of terms and conditions on admission to the home that set out all the conditions of residency. Two files examined of two residents who had recently moved into the home and no pre-admission assessments on file. On speaking with the relatives of the residents about the home’s admission process they said they were not aware the home had carried out their own assessment prior to moving into the home. An assessment was completed for one resident from social services and the other had a nursing assessment carried out by the health authority. On speaking with the registered manager about the admission process she confirmed she visits all new residents prior to them moving into the home and in the case of an assessment being carried out by health or social services the accuracy of the assessment is checked to ensure the home is able to meet all the needs of the resident. Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 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 area is good. This judgement has been made using available evidence including a visit to this service. The residents receive a good standard of care. The medication procedures in the home ensure safe practice. EVIDENCE: Three care plans and assessments were examined and care plans were thorough in identifying the needs of each resident and the level of assistance needed by the staff. There was no evidence that the resident or relative had been consulted or agreed with the care plan, but the care plans were accessible to the residents and their relatives as they are kept in their rooms. All care plans were reviewed and updated on a monthly basis. The residents spoken with all said they were looked after very well and all residents looked smartly dressed and tidy. One resident said you couldn’t wish for anything better as we live in lovely surroundings are cared for very well by the staff and the food is very good. Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 Page 12 The home has four mobile hoists and on speaking with the staff they felt that was sufficient for the needs of the home and confirmed that a hoist was always available for use when needed. The medication administration records were examined and in most cases were accurately completed with no gaps noted for administration of medicines. Handwritten entries on the records were not signed and dated and the numbers of medicines held in stock were not recorded. Medicines are dispensed from blister packs. None of the present residents have expressed a wish or have been assessed as capable of keeping or taking their own medicines so the registered nurses do this for them. The method used for recording the blood sugar and the dose of insulin given to one resident on a separate piece of paper was far from ideal and staff confirmed that plans were in place to obtain a printed chart for future recordings. The Controlled Drugs register and the number of Controlled Drugs in stock was checked and found correct. The home uses a clinical waste company for the disposal of their medicines. Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 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 had been made using available evidence including a visit to this service. The activities provided suit the resident’s needs. The home offers the residents a varied and well-balanced diet. EVIDENCE: The home does not employ an activities organiser but staff take the residents for walks or push them around the extensive grounds and spend time talking or reading to them as required. Musical entertainment takes place once a month and music and movement takes place twice a week. The residents spoken with expressed satisfaction with the activities provided, and many of them said they were content sitting in their own rooms. One resident enjoyed classical music and spent time sitting in the reception area listening to the radio or tapes of his choice. The visiting arrangements for the home are open but visitors are encouraged not to visit before 10am but the home is flexible if there is a good reason visitors wish to come before that time. Visitors spoken with said that the staff always made them very welcome and there had been no restrictions made to the time they visited. Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 Page 14 The residents felt that the staff respected their privacy and dignity at all times and said that staff always knocked on their bedroom door before entering. The menus were looked at for three weeks and showed that the home offers a well-balanced and varied diet to the residents. A cooked breakfast is offered and fresh fruit is available at all times. All the residents spoken with praised the quality of food and said there was always an alternative choice if they did not like the meal on offer that day. Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 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 area is good. This judgement has been made using available evidence including a visit to this service. The home provides the residents with clear written information about making a complaint. The residents are protected from abuse. EVIDENCE: A revised complaints procedure had been written that stated how and to whom a complaint should be made and the timescale in which complaints should be dealt with. In the section giving contact details of the Commission the title needs amending to the Commission of Social Care Inspection. As previously mentioned in this inspection report the section on complaints contained in the Statement of Purpose is not in line with the complaints procedure so requires amending. The complaints log was not available on the day of inspection due to the nurse in charge not having access to the general office where the book was kept. There was a question raised as to how the staff would record a complaint when the book was unavailable to staff when the registered manager was off duty and the office locked. This was apparently an unusual situation as the book is generally available to staff. A further visit was made the following day when the complaints log was examined and found to have no recorded complaints Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 Page 16 since the last inspection in October 2005. The outstanding complaint from the last inspection had been satisfactorily resolved. Both visitors and residents spoken with said they would not hesitate to speak with the Registered Manager or Mrs Cutler about any concerns or complaints. The Registered Manager had an open door policy and said that small issues are often dealt with at the time and would not be recorded as a complaint in the complaints log. Staff spoken with confirmed they had training on abuse and all but one member of staff understood their responsibilities in reporting all incidents and allegations of abuse within the home. The West Sussex Adult Protection Procedures were available to staff for reference. Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 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): 19,21,22,24,26. Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The home is comfortable and safe for the residents. EVIDENCE: A tour of the premises was made and all resident’s rooms were seen. The home was generally well maintained and areas have been re-decorated when needed. All areas of the home were clean and fresh and many of the residents had their rooms furnished and decorated with their own personal furnishings and belongings. Residents spoken with were happy with their rooms and said the home was always kept clean. The home is situated in very pleasant rural location and the extensive grounds with numerous shrubs and trees are kept immaculate. Many of the resident’s rooms have wonderful views of the grounds and all residents said they loved the location of the home and the house. Some of the residents loved watching the birds and bird feeders were hung or stuck on their bedroom windows so they could watch the birds feed at close hand. The lounge areas were comfortable with nice furnishings and a variety of Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 Page 18 armchairs and couches. The presence of vases of fresh flowers situated around the home was very pleasant. The home had a friendly and homely atmosphere but the dining area appeared bare and unwelcoming with the table and chairs positioned along the walls in straight rows and no tablecloths on the tables. Many of the residents ate their meals in their rooms and at lunchtime only a few residents were seen sitting in the dining room. The home has adequate toilet and bathing facilities for the number of residents. The home had a fire safety assessment carried out in July 2004 when it was considered that the fire safety measures were being satisfactorily maintained. However, the fire exit leading from the conservatory via a sloping path was slippery on the day of the inspection with no handrail other than a low brick wall to one side. Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 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 poor. This judgement is made using available evidence including a visit to this service. The staffing numbers are appropriate to meet the resident’s needs. The home does not follow the correct recruitment procedures. EVIDENCE: Staff rosters were examined and staffing levels appeared consistent and appropriate to meet the needs of the residents accommodated. Staffing levels in the morning period were one or two trained nurses plus six care assistants and in the afternoon from 1pm to 3pm there was one trained nurse plus four care assistants and after 3pm there were three care assistants with one trained nurse. Each night there was a trained nurse plus two care assistants. The residents spoken with had no concerns regarding the staffing numbers and most said they did not have to wait long for assistance when needed. The staff spoken with also felt the staffing levels were good and said they had time to give the residents the assistance and attention they needed and were not too rushed. One negative comment had been received with regard to one resident wishing to get up first each morning, but it had been explained that staff have to respect all the resident’s wishes, so it is allocated who gets up early each day to be fair to all. Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 Page 20 Staff files were not available on the day of inspection as kept in the general office in a locked filing cabinet and no staff on duty that day had a key to access the files. On a further visit to the home that was carried out the following day five staff files were examined and four new members of staff had commenced working in the home before having a satisfactory Criminal Records Bureau and Protection of Vulnerable Adults check and were not working under constant supervision. This was discussed with the Responsible Individual Margaret Cutler who said that the checks were taking eight or more weeks to come back. Staff files showed the induction programme for new staff includes an introduction to the premises during the first day of working followed by health and safety issues for residents and staff, management of the resident’s day, the admission procedure, the role of the staff team, the home’s policies and procedures, treatments and therapies available, communication and staff development. Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 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): 31,33,35,36,38. Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. The method used for gaining the views of the residents and relatives about the home needs reviewing. Staff are not appropriately supervised. Systems and equipment are well maintained. EVIDENCE: The registered manager is experienced and qualified to run the home but is due to retire in June 2006. The home had developed questionnaires for the residents and relatives as part of the quality assurance system. The questionnaires were seen available in the Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 Page 22 reception to the home for anyone to take and complete. All new residents are given a questionnaire when moving into the home. This method was proving unsuccessful as not many questionnaires were being returned and effective feedback is not being received. It was recommended at the last inspection that the home should consider giving out the surveys to residents and sending them to relatives in the hope that responses would increase. The pre-inspection questionnaire showed that the maintenance to systems and equipment had been carried out within the appropriate timescales and new central heating boilers are on order. Staff training had taken place for male catheterisation, moving and handling, adult abuse, infection control, bereavement and care of the dying, incontinence and related skin care and fire training. Future training was planned for food hygiene. On speaking with the staff on duty on the day of inspection it was confirmed that staff were not having formal staff supervision. In-house maintenance checks were seen and weekly checks are carried out for fire alarm systems, emergency lighting, equipment, and water temperatures. All accidents, incidents and injuries are recorded and reported to the appropriate authorities. Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 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 3 3 3 3 3 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 3 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 1 X 3 Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 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. 1 Standard OP29 Regulation 19(5)(i) Requirement The registered person shall not employ a person to work in the care home unless a satisfactory Criminal Records Bureau check (CRB) and Protection of Vulnerable Adult (POVA) check has been received The registered person shall ensure that persons working at the care home are appropriately supervised. Timescale for action 31/05/06 2 OP36 18(2) 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Honeywood House Nursing Home DS0000024157.V290452.R01.S.doc Version 5.1 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. Extracts may not be used or reproduced without the express permission of CSCI Honeywood House Nursing Home DS0000024157.V290452.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. Re-publishing this information is in breach of the terms of use of that website. 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