Inspection on 30/05/07 for Honister

This inspection was carried out on 30th May 2007.

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

Honister 28/09/06

Honister 09/11/05

Honister 16/05/05

Honister 21/02/05

Honister 13/07/04

Honister 11/09/02

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Honister Ellenbrook Lane Hatfield Hertfordshire AL10 9RW Lead Inspector Pat House Unannounced Inspection 10:00 30th May & 6th June 2007 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 Honister DS0000019435.V340781.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. Honister DS0000019435.V340781.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Honister Address Ellenbrook Lane Hatfield Hertfordshire AL10 9RW 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) 01707 274918 01707 274918 FP Mrs Anna C Theanne Mrs Anna C Theanne Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Honister DS0000019435.V340781.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th September 2006 Brief Description of the Service: Honister is a care home, which can provide personal care and accommodation for up to 22 older people. The property is a large detached dwelling set in a quiet residential part of Hatfield in Hertfordshire. The house is a three-storey building and has a lift for access to the upper floors. There are three double bedrooms but these are only used for single occupancy at present. In recent years the building has been extended and 10 of the single bedrooms now have en suite facilities. There are two communal bathrooms and six communal use toilets. Two lounges are available to service users and there is an additional, newly constructed dining room. The home is situated near to the Galleria Shopping Centre and to the many facilities offered in the town of Hatfield. There is easy access to the main road routes and the railway station. The home’s Statement of Purpose and Service User’s Guide are displayed in the reception hall and copies are available on request together with copies of the last CSCI inspection report. Current fees for a place at the home are £407.38 per week. Honister DS0000019435.V340781.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted by one inspector and took place over two days. Most areas were inspected on the first day, 30th May, while staff recruitment and training records were examined during the second visit on 6th June. Residents, staff members and some relatives were spoken with on both days and meals were seen served. All areas of the home were visited briefly and a selection of care plans and records was checked. The manager was present at both inspection visits. What the service does well: What has improved since the last inspection? The system for administering medication in the home is sound and records are now not signed until each individual has been seen to take the prescribed drug. No hazardous substances were seen left in any areas of the home. There is a new Fire Prevention Policy and Recruitment Policy in operation and new recording forms have also been introduced. Honister DS0000019435.V340781.R01.S.doc Version 5.2 Page 6 The manager has employed an outside agency and a skills audit has been produced with individual profiles completed for every member of staff. 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. The summary of this inspection report can be made available in other formats on request. Honister DS0000019435.V340781.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 Honister DS0000019435.V340781.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): Standards 1 and 3. Standard 6 does not apply to this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed written information about the home is provided for all prospective residents and detailed assessments are completed in all cases. This ensures that all parties can be sure that the home can meet the needs of the individual concerned. EVIDENCE: The home’s Statement of Purpose and Service User’s Guide were updated in March this year and give clear information about services and facilities provided at Honister. The home is able to provide care for emergency placements and there had been one such recent admission made. The service user records examined all contained written care summaries from referring agencies as well as detailed assessments by senior staff at the home. Initial care plans had been completed from these assessments. Honister DS0000019435.V340781.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): Standards 7,8,9, 10 and 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures in place at the home ensure that individual care needs are recorded and met and that residents benefit from this attention and from having their dignity and privacy respected. The system in place for administering medication helps to protect residents and individuals can be assured that their wishes will be supported at times of illness and death. EVIDENCE: Care planning in the home has been reviewed over the last year and records examined were all very clear and gave detailed and meaningful information about the individual concerned. Staff spoken with said they found the plans useful and were made aware of the reviews and updates which were completed. A variety of risk assessments were in place and these reflected areas, which had been noted when speaking with residents. Individual risk assessments for the prevention of falls are currently being completed for all residents and those seen were detailed and appropriate. Honister DS0000019435.V340781.R01.S.doc Version 5.2 Page 10 Evidence was seen that nutrition and hydration was being monitored for all residents and any subsequent action was also documented. However, it was recommended that the manager replace the existing weighing scales to be sure that accurate weight could be recorded for the residents who could not easily stand on the present scales. The manager has plans to provide this new equipment. The care plans examined had details of visits to and from Health professionals and residents spoken with confirmed they had regular checks for sight, hearing, chiropody and dentistry. The Sensory Disability Team has also visited the home and provided equipment and advice. During the second inspection visit an optician came to see some of the residents and a physiotherapist called as part of planned treatment. Staff spoken with said they had an excellent relationship with the local District Nurse, who was very supportive. The levels of confusion amongst the current residents are increasing and the home has links with the local Alzheimer’s Society and has had input from the Memory Clinic based at the local hospital. Services provided at the home for those with a dementia are currently under review and the manager may introduce more specialised services for this need in the future and may look at amending the home’s registration with the CSCI. Residents spoken with confirmed that staff respected their privacy and dignity and said they were always treated with respect. Visitors were seen and spoken with and said they were made welcome at the home at all times. One resident had died in the home earlier that morning and the family had been supported to remain with their relative and were present at the death. Care staff spoken with said that all possible help and support was provided at such times and that they worked closely with the doctor and nurse to ensure that residents who were very ill could remain in the home, if that was their wish. The system for administering medication in the home was checked and no errors were found. Most drugs are provided in blister packs and all unused medication is returned to the pharmacist at the end of the month. Packets of medication had the date of opening recorded and all drugs administered in the home are prescribed. Some residents keep their own creams and inhalers in their rooms and procedures for this were appropriate. There were no controlled drugs in the home at the time of the inspection but the home has appropriate storage for such medication. The local pharmacist makes regular visits and reports are kept in the home and those seen showed no concerns. Staff confirmed that only those trained in medication administration are involved in this procedure in the home. Honister DS0000019435.V340781.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): Standards 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures in place and daily activities provided in the home ensure that residents have interesting and varied ways of spending their days. Meals provided in the home are enjoyed and promote good health and contact with the families and friends of residents is promoted by staff so that residents still feel part of the wider community. EVIDENCE: A group of residents spoken with in the lounge said that, normally, there was a different activity provided each day, but that the regular activity co-ordinator for craft was on holiday that week. The residents said they especially enjoyed the craft sessions and had scrapbooks they had completed as part of this activity. The manager had asked Age Concern for input in activity planning and this organisation had found a variety of people who now regularly visit the home and organise dog visiting, flower arranging, bingo and other events. Care staff at the home take residents out on a regular basis and two ladies were going out for a walk with staff on the first day of this inspection. Honister DS0000019435.V340781.R01.S.doc Version 5.2 Page 12 Records of which activities residents took part in are recorded and monitored during the monthly review process. Residents confirmed that a hairdresser visits the home regularly and one lady had her hair done during the inspection. Those residents spoken with said that mostly families handle the finances of the residents and staff said that advocates would be sought where this was needed. The Local Authority had recently inspected the kitchen and meal arrangements in the home and care staff are now using the recording and information pack that had been provided. Temperature checks for food and equipment were being recorded and the cook will soon be going on an Intermediate Food Hygiene course, which is certificated. All staff working in the kitchen have current Food Hygiene certificates. At the last inspection, plans were in place to change the conservatory into a dedicated dining room. This work had been completed by the inspection visit made on 6th June and residents were going out with the manager that afternoon to buy plants and fittings for this new room. The mid-day meal was served during the first visit and this looked appetising and nutritious. Residents spoken with said they enjoyed the food and always had a choice of meals available. The manager said that a new menu board would be installed in the new dining room. Honister DS0000019435.V340781.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies and procedure followed in the home ensure that residents are protected from abuse and have any concerns listened to and acted on. EVIDENCE: The home has written policies for Adult Protection, Whistle blowing and Complaints. The complaints’ record was checked and there had been no recent complaints made. Residents spoken with said they would have no hesitation in making a complaint if they had one and would tell staff of any concern. Staff have all received training in Adult Protection and were aware of the connected implications. Honister DS0000019435.V340781.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users enjoy living in well-maintained surroundings, which meet their needs and have their health promoted by the good hygiene standards found in the home. EVIDENCE: The home was clean and looked well maintained on both inspection days. Residents said that standards of cleanliness were always good and that their rooms were comfortable and how they wanted them. At the last inspection, the manager said that the conservatory would be converted to a dining room and the ground floor bathroom was to be upgraded to a shower room. Both areas of renovation have been completed and residents said they enjoyed using the new shower room, which looked very attractive. Honister DS0000019435.V340781.R01.S.doc Version 5.2 Page 15 The laundry was clean and there were no hazardous substances left unlocked. All bathrooms and toilets contained liquid soap and soft paper towels. Honister DS0000019435.V340781.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users in the home have their needs met by well trained and professional staff and are protected by the thorough recruitment procedures in operation at the home. EVIDENCE: Residents and care staff spoken with said they thought there were usually enough staff working in the home. Residents felt that staff were competent and said that call alarms were answered promptly. There is a new recruitment policy in place, which was examined and there are new forms in place covering all areas of staff employment. A selection of staff files was checked and procedures followed had been thorough and evidence of appropriate recruitment checks was seen. The manager had recently employed an external training company to complete an audit of staff training needs in the home. The company has completed a skills audit report, which has identified training needs for every member of staff. Honister DS0000019435.V340781.R01.S.doc Version 5.2 Page 17 Since that time a wide variety of training has taken place and more courses have been booked. Most members of staff have now updated all their basic training although some is booked for later in the year. The manager provided a training overview during the inspection and courses needed have all been identified and booked. In addition, five members of the care staff have completed NVQ level 2 training and two of these workers have nearly completed level 3. One care worker has completed NVQ level 1 and the deputy manager has completed the Registered Manager’s Award. Remaining care workers are currently doing NVQ level 2 training. The home has therefore already achieved the requirement that at least 50 of care staff in the home are trained to NVQ level 2. Honister DS0000019435.V340781.R01.S.doc Version 5.2 Page 18 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): Standards 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a well run home where their views are listened to and where the health and safety of both staff and residents is promoted. EVIDENCE: All residents and staff spoken with praised the home’s management and said that they could and did approach the manager and deputy at all times of the day. Residents clearly felt able to come into the office whenever they wanted and said that everyone in the home often “got together” over a cup of tea to discuss the day to day running. Last week the residents had been looking at theatre advertisements in order to choose the pantomime they would book for later in the year. Honister DS0000019435.V340781.R01.S.doc Version 5.2 Page 19 Minutes of staff and residents meetings were seen during the inspection and these records also showed how information was shared with those not present at the meetings. Staff at the home do not handle residents’ money and families or the Local Authority mostly take charge of service users’ finances. Some residents keep small amounts of money locked in their bedrooms and sometimes families are invoiced for items paid by the home on behalf of a resident. Receipts are always provided. The manager is currently working to produce a new Quality Assurance programme and this will be assessed at the next inspection. The home has a written Health and Safety policy and completed risk assessments for the home were comprehensive and are regularly reviewed. Equipment servicing is up to date. There is a gate at the top of the stairs in the home, which was installed as a result of a request from a resident. A discussion took place about this equipment and the manager will now complete a new risk assessment and reassess all the associated implications. Fire records were checked and appropriate tests and drills were recorded. The manager has also completed a new written Fire Policy for the home. The record of accidents was checked and was well documented and the manager regularly monitors these records. The local “Falls Prevention Team” has visited the home and is booked to return. Honister DS0000019435.V340781.R01.S.doc Version 5.2 Page 20 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 x 3 x x 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 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 3 x x 3 Honister DS0000019435.V340781.R01.S.doc Version 5.2 Page 21 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 Honister DS0000019435.V340781.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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. 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