Inspection on 09/11/05 for Honister

This inspection was carried out on 9th November 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.

Other inspections for this house

Honister 30/05/07

Honister 28/09/06

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 Hazel Wynn Unannounced Inspection 9th November 2005 10:00 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 Honister DS0000019435.V267216.R01.S.doc Version 5.0 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.V267216.R01.S.doc Version 5.0 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 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.V267216.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th May 2005 Brief Description of the Service: Honister is a care home providing personal care and accommodation for 22 older people. Service users who meet this category at the point of admission may continue to be accommodated for as long as their needs can be met by the home and community service provision. Mrs Anna Theanne, a private provider, manages and owns the home. The property is a large detached dwelling set in a quiet residential part of Hatfield in Hertfordshire. The house is three-storey building and has a lift for access to upper floors. In recent years the building has been extended to provide extra single rooms on the second floor and the large shaded conservatory is now used as a dining room. Two lounges are available to service users. There are 10 single bedrooms with en suite facilities and three double bedrooms for service users whose preference is to share accommodation. The double bedrooms do not have en suite facilities. There are two communal bathrooms and six communal use toilets. The home is situated near the Galleria Shopping Centre and has easy access to the main road routes, the railway station and local amenities. The home was first registered by the National Care Standards Commission on the 1st April 2002 and was previously registered as a care home in October 2001 under the Registered Homes Act (1984). Honister DS0000019435.V267216.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted by two inspection officers from the Commission for Social Care Inspection on the 9th November 2005. We spoke to many of the service users (9 in all). We looked at records, systems in place and made general observations. We interviewed staff and met with the proprietor during the inspection process. We found that most of the National Minimum Standards were met. All of the requirements from the last inspection had been met. Some recommendations have been made and the proprietor stated that most of these were already on her agenda from her ongoing personal auditing. Service users were, overall, very happy with their care and input valuably to this inspection. The proprietor was keen to receive the service users feedback from the inspectors. The service users stated that the proprietor also checks with them how they are finding their service. The service users stated that they receive a very good service and have good relationships with the staff and proprietor. The findings published in this report are a snapshot of the evidence gained on the day of the inspection. What the service does well: What has improved since the last inspection? Honister DS0000019435.V267216.R01.S.doc Version 5.0 Page 6 All of the requirements made at the last inspection have been met. Medication was being well managed. Door guards have been fitted on a priority basis. Food in the fridge is being covered and dated on opening. Activities have been reviewed and action taken to act on service users views of these. Further maintenance has been carried out or is ongoing. The environment is being further developed on an ongoing basis (work was in progress in the garden and internally work had been planned for completion in the very short term). 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. Honister DS0000019435.V267216.R01.S.doc Version 5.0 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.V267216.R01.S.doc Version 5.0 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 the following standard(s): 3, 4 and 5. Standard 6 does not apply to this home. Full and comprehensive assessments are carried out and the proprietor will offer a placement only if the needs of the individual can be met. Service users are provided with the information and opportunity to satisfy them that needs can be met. Visits prior to moving in are encouraged so that service users and their representatives are happy with what the home has to offer. EVIDENCE: One care plan was fully examined at this inspection; the original assessment had been reviewed in light of changing needs and the care plan had been fully updated with the full involvement of the service users mother and daughter; the service user no longer has the capacity to self-advocate. A representative from the Alzheimer’s Society had provided support and advise to aid care planning and service provision and this has immensely improved the quality of life for the service user; this is evidence of the commitment of the proprietor to take any appropriate advice and look to other agencies for support or advice. Care needs were being met from the evidence seen in the well-maintained records. A small sample of other care plans was checked for updated recording and these were also found to be well and appropriately maintained. Aids have been obtained where reviews of the care plan have dictated the Honister DS0000019435.V267216.R01.S.doc Version 5.0 Page 9 need. Health needs and how these are met are very well recorded in the individuals’ notes. Honister DS0000019435.V267216.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9 and 10 The individual care plans include the service users’ health, social and personal care needs; assessed needs are met. Service users would be supported to selfadminister medication where appropriate but a lockable space needs to be provided for this and other purposes. Service users are treated with dignity and respect in this home, and their right to privacy is upheld. EVIDENCE: Three care plans were checked and one was thoroughly examined; the care plans were up to date and showed evidence in the recording that reviews are regularly held and needs are being met. The tracked care plan showed how the proprietor had invited a representative of the Alzheimer’s Society to advise and direct the home to better support the service user. The action taken in cooperation with the Alzheimer’s Society has made a tremendous difference into the meeting of need and has led to a greater improvement in the quality of life experienced by the service user. The service users spoken with during this inspection praised the home and staff for the provision of good care, a comfortable environment, and a warm, friendly and professional approach to meeting their needs and adding to their Honister DS0000019435.V267216.R01.S.doc Version 5.0 Page 11 quality of life. The service users verified that they felt they were treated with dignity and respect and that their rights to privacy were upheld. Protocols are in place for service users who would be able to self-administer medication. It was noted at this inspection that although rooms are lockable a lockable space within the private rooms was not available and a requirement was made in this respect. At present none of the service users are managing their own medication but if a service user is admitted who is able to selfadminister medication then it is necessary to have secure lockable space in the service user’s room for this purpose to ensure other service users are kept safe. Honister DS0000019435.V267216.R01.S.doc Version 5.0 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 the following standard(s): 12 - 15 Service users, who are able, help to run the home and enjoy taking part in some of the domestic chores. Structured activities have been reviewed and improved considerably since the last inspection. Contact with family and friends/others is well supported and independence actively encouraged. The food provided is good but a cooked breakfast option could be provided. EVIDENCE: At the last inspection the service users had informed the inspectors that activities had decreased; this was discussed with the proprietor who said she was taking action regarding this. An Occupational Therapist has been employed since the last inspection provides activities and exercise sessions, which the service users stated they enjoy. Service users stated that their families and friends are able to visit freely and are always made welcome. One service user has ‘friends’ who are not able to visit in the interests of her protection; a legal injunction is in place in the interests of vulnerable adult protection; the visitors were arrested and charged with serious financial offences against the service user; the alarm was raised by the proprietor who rather astutely observed that there may be issues and she followed vulnerable adult protection procedures resulting in the arrest and charge of the visitors. Immediate protection protocols were put in place for the service user and are ongoing; records show how this is being kept monitored. Honister DS0000019435.V267216.R01.S.doc Version 5.0 Page 13 The service users stated that as much as possible is done help them to have input into the running of the home including doing tasks they enjoy and making decisions to change things to how they’d prefer. One service user likes to help out in the garden but at the moment she isn’t well enough. The service users stated that they help put the menu together and enjoy the food very much but would sometimes like a cooked breakfast; we recommended that the option to have a cooked breakfast is more clearly promoted. The proprietor stated that requests for optional menu would be provided but it seems that service users perhaps need a more formal method of being prompted to take up this option. The menus reflected a nourishing and varied diet and the menu changes according to the season to allow for the use of as many fresh ingredients as possible from local producers. Honister DS0000019435.V267216.R01.S.doc Version 5.0 Page 14 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 Complaints are dealt with appropriately in accordance with the home’s complaints policy and procedure. Service users legal rights are protected and they are protected from abuse. EVIDENCE: Few complaints are raised and response is swift and in accordance with the home’s policy and procedure. The home is small and any issues are picked up and responded to swiftly and do not reach the formal complaint stage; for example: at the last inspection the service users had raised an issue about a decrease in activities and when this was discussed with the proprietor she was able to provide evidence this had been already heard from the service users and action had been taken; she was awaiting the appropriate checks before commencing the employment of an occupational therapist who would fill this need. At this inspection the service users stated that activities were now back in place and they were enjoying these. In the previous section of this report evidence is provided regarding the robust action taken in relation to a serious vulnerable adult protection matter; the home does well in this area and provides training for staff in vulnerable adult protection. Policies, procedures and staff training are in place for protection against all forms of abuse. Honister DS0000019435.V267216.R01.S.doc Version 5.0 Page 15 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, 23, 24, 25,and 26 The home is well maintained safety measures are in place. Service users rooms are lockable but need a lockable drawer/space within them to further ensure privacy. The home is comfortable, pleasant, clean and hygienic. EVIDENCE: The fire safety records were produced at this inspection and fire safety tests, drills and training were up to date and well recorded. Fire safety door guards have been fitted to most doors and the remainder are scheduled to be fitted shortly (invoice seen at this inspection). Portable appliance testing is carried out annually. One service user drew to the attention of one of the inspectors that she lacked a lockable drawer space; this was discussed with the proprietor who stated that she would provide this – a requirement was made that all rooms be provided with a lockable drawer/spaced (the rooms are lockable). Service users’ rooms are very comfortable, well furnished and personalised. Honister DS0000019435.V267216.R01.S.doc Version 5.0 Page 16 The home was observed to be clean, comfortable and hygienic. The very recent environmental health officers report was favourable requiring for new food probes that are easier to clean and with instructions for recalibration and that if the kitchen door is to maintained in an open position (during hot weather to aid ventilation) then the ingress of pests must not be allowed. The proprietor stated that she has arranged for a new kitchen door to be installed at the home, with an integral extractor fan fitted. Honister DS0000019435.V267216.R01.S.doc Version 5.0 Page 17 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 - 30 The service is adequately staffed and there is a good skill mix between the staff ensuring service users are in safe hands at all times. The homes recruitment policy and procedures are robust and ensure the service users are supported and protected. EVIDENCE: At this unannounced inspection staffing levels were seen to be quite adequate and the rota showed that these levels were maintained. The staff training programme looked healthy. One staff member had completed a BTEC in infection control as part of her level 1 NVQ and she is now working towards her level 2 NVQ. Two members of staff were making progress at level 3 NVQ. One member of staff had completed NVQ level 2 and four other were making progress at this level; providing almost 100 of a qualified staff team – this shows excellent commitment to training. Two part time members of staff who did not wish to commit to gaining a qualification are very experienced and very close to retirement. The recruitment records for the most recent staff recruitment showed robust procedures had been adhered to. All mandatory training is updated on a regular basis and copies of certificates evidenced this. Additional training is provided – the Alzheimer’s Society have been most helpful in supporting staff to be better equipped for supporting one individual and Age Concern has also given input. Honister DS0000019435.V267216.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 - 36 and 38 The proprietor manages the home and is a fit and well-qualified person to be in charge. The ethos, leadership and management approach of the home benefits the service users and it is run in their best interests. Service users financial interests are safeguard (see the section covering daily life and social activities where this is expanded upon) and staff are appropriately supervised. Service users’ and staff health, safety and welfare are promoted and protected. EVIDENCE: The proprietor has worked through a programme to achieve Level 4 NVQ Management Award. The proprietor manages the home and is a registered nurse with many years management experience. Part of the registration process for Proprietors/Managers involves a robust check into their background to the current date to ensure they are fit to practice, and these procedures were applied to this proprietor. Honister DS0000019435.V267216.R01.S.doc Version 5.0 Page 19 Service users stated that the homes staff team and the proprietor seeks their views, puts right any issues and involves them in the running of the home; they further stated that they are happy with the manner in which the home is run. The proprietor employs an Accountant and manages her plans for the home in light of the quarterly returns, setting her budget in line with her plans for the year ahead. The maintenance programme and plans suggest that the home is financially viable. A new external kitchen door fitted with an extractor was on order to fulfil the need to ensure that any ingress of pests is minimised as required by the Environmental Health officers report. The manager is very swift to take action wherever any deficit is highlighted either by herself or by any inspecting body. The service users or their elected representative manage their finances and the home manages small amounts of money wanted for day to day use by the service users; these small amounts of money are securely and transparently accounted for. Each service users cash flow could be reconciled against the clear accounts, which were being managed in accordance with the policies and procedures in place. A discussion took place with the proprietor regarding one service users visitors and concerns she had related to finances; she took very swift action – see the Daily Living and Social Activities section of this report). Fire safety records were examined and these showed that safety checks were carried out regularly. Door guards had been fitted to most doors with the remainder planned to be fitted shortly (the invoice for this was seen). Medication was being well managed and evidence was seen of a new medication fridge on order. The manager had identified a new area for the storage of medication and work had already been planned; the manager explained that the door to the new storage area will be fitted with ventilation and the temperature of the storage are will be monitored daily to ensure that medication such as lactulose will not be stored at above 20°C (above which, such medications rapidly deteriorate). The records seen at this inspection are discussed in the appropriate sections of this report and were well maintained and clear. Evidence gained at this inspection is the proprietor’s and care staff team’s commitment to providing a very warm, safe, friendly and caring service. Honister DS0000019435.V267216.R01.S.doc Version 5.0 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 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X 3 1 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 X 3 Honister DS0000019435.V267216.R01.S.doc Version 5.0 Page 21 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 OP24 Regulation 12 Requirement A lockable storage space must be provided within service users’ rooms. (see regulation 12(4)(a) 13(4)(a)-(c) 23(2)(m)). Timescale for action 30/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP9 OP15 Good Practice Recommendations Obtain a purpose printed controlled drug record to ensure contemporaneous recording that allows for no gaps. Consider offering a cooked breakfast option (obtain advice from the dietician regarding healthy eating so that service users are in a position to make a well informed choice). Record any issues on the care plan. Honister DS0000019435.V267216.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Honister DS0000019435.V267216.R01.S.doc Version 5.0 Page 23 - 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. 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