Background to this inspection
Updated
26 October 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This was an unannounced inspection and was conducted by two inspectors on 01 September 2015.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
Before this inspection we reviewed previous inspection reports and notifications that we had received from the service. We requested the service to complete a provider information return (PIR). This is a form that asks the provider to give us some key information about the service, what the service does well and improvements they plan to make.
We contacted the local authority safeguarding team and the commissioners of the service to obtain their views about the service. The commissioners had recently carried out a review of this service and had expressed concerns about the way in which the home was being managed. Senior managers from within the company were taking steps to address this issue.
During the inspection we spoke with five people who used the service, two visitors, three care staff members, the cook, the nurse in charge, one nurse, the financial administrator and the registered manager from a neighbouring Leonard Cheshire Home. We looked at the care records for seven people who used the service and medication records for seven people. We also looked at a range of records relating to how the service was managed; these included training records, quality assurance audits and policies and procedures. We also conducted a tour of the building to look at the décor, services and facilities provided for people who used the service.
Updated
26 October 2015
Honresfeld is a large period building that has been extended to provide 28 single bedrooms for people with physical disabilities who are over the age of 18 years. The home provides 24 hour nursing care and has a wide range of equipment and facilities to assist people with their care needs. This was an unannounced inspection which took place on 1 September 2015. On the day of the inspection 23 people were accommodated at the home.
We last inspected this service on the 25 February 2015 and found the service did not meet the regulations for medicines management, Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 or for staffing levels, Regulation 22 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We issued compliance actions that required the provider to make the necessary improvements in relation to the management of medicines and staffing. Following this inspection the service sent us an action plan to tell us how they were going to meet the regulations.
The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. However, on the day of our inspection the registered manager was absent from duty and the deputy manager was on annual leave. The nurse in charge and other administrative staff helped us conduct the inspection.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
People who used the service told us that Honresfeld was a safe place to live and they were well looked after.
Staffing levels had improved and were sufficient to meet the needs of people using the service.
Safeguarding procedures were robust and members of staff understood their role in safeguarding vulnerable people from harm.
We found that recruitment procedures were thorough so that people were protected from the employment of unsuitable staff.
The home was clean and appropriate procedures were in place for the prevention and control of infection.
Members of staff had a good understanding of the needs and preferences of people who used the service.
People were registered with a GP and had access to a full range of other health and social care professionals.
Several members of staff had been trained in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) so they knew when an application should be made and how to submit one.
All the people we asked told us the meals were good and they were offered a choice of menu at mealtimes.
People who used the service told us they liked living at the home and received the care and support they needed.
People were supported by staff to make decisions about their care and daily routine.
Leisure activities were routinely organised within the home and in the local community.
Structured Induction training was in place for new members of staff. Training for all staff was ongoing in order to ensure they were kept up to date with current practice.
An effective system for staff supervision so that staff could formally discuss work related issued and training was not in place.
Visitors were welcomed into the home at any time.
Leisure activities were routinely organised within the home and in the local community.
A copy of the complaints procedure was displayed in the home and included in the service user guide supplied to each person on admission to the home.
People who used the service and their representatives were given the opportunity to express their views about the service by completing a questionnaire and attending regular meetings.
In the absence of the registered manager members of staff were supported by the deputy manager, the registered manager from another Leonard Cheshire home and more senior managers from within the company.
The arrangements in place for monitoring and assessing the quality of the service provided had not identified and addressed the shortfalls we found with the management of medicines, care planning and staff supervision.