The inspection took place on 2 January 2016 and was unannounced. Honeybourne House is a nursing home providing care and accommodation for up to 21 people with learning disabilities and accommodation is provided within the main house and a purpose build bungalow in the grounds. On the day we visited there were 11 people in the main house and eight people in the bungalow. The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
People were not able to fully verbalise their views and staff supported us when we spoke to people. We met and spoke to most people during our visits and spent time observing people and staff in each other’s company. We observed a happy, friendly lively atmosphere within the service. People and staff were relaxed in each other’s company. One comment included; “I’m going out on a trip today I enjoy going out with staff.” A thank you card recorded; “Our daughter has been happy and well looked after in her home.” People who were able to said; “yes” when asked if they were happy in the home.
People and their relatives were happy with the care staff provided. Professionals and relatives said the service knew people well and the staff were knowledgeable and competent to meet people’s needs.
People were encouraged and supported to make decisions and choices whenever possible in their day to day lives. People were observed to have their privacy and dignity maintained. Staff were observed supporting people with kindness and patience.
People were protected by safe recruitment procedures. Staff were supported to complete an induction and ongoing training was provided to develop their skills and staff competency was assessed. All staff we spoke with agreed the service had sufficient staff on duty. Staff told us they had enough time to support people and didn’t need to rush them.
People had access to healthcare professionals to make sure they received appropriate care and treatment to meet their health care needs such as GPs and consultant psychiatrics. Staff ensured guidance provided by professionals was followed. This ensured people received the care they needed to remain safe and well, for example people had one to one staff support when needed.
People’s medicines were managed safely. Medicines were managed, stored and disposed of safely. Senior staff and nurses administered medicines and had been appropriately trained and confirmed they understood the importance of safe administration and management of medicines.
The registered manager had sought and acted on advice where they thought people’s freedom was being restricted. This helped to ensure people’s rights were protected. Applications were made and advice sought to help safeguard people and respect their human rights. Staff had completed safeguarding training; they clearly understood how to report concerns and were able to describe the action they would take to protect people against harm. Staff were confident any incidents or allegations would be fully investigated.
People were supported to maintain a healthy, balanced diet. People were observed enjoying their meals and one person told us their meals were nice. An observed mealtime was not rushed and staff supported people appropriately and discreetly.
People’s care records were very comprehensive and detailed people’s preferences. People’s methods of communication and preferences were taken into account and respected by staff.
People’s risks were considered, well-managed and regularly reviewed to keep people safe. Where possible, people had choice and control over their lives and were supported to engage in activities within the home and outside where possible. Records were updated to reflect people’s changing needs. People or their representative, for example family or advocates, were involved in the planning of their care.
People and staff described the management team as very supportive and approachable. Staff talked positively about their jobs and took pride in their work. We observed and staff confirmed the management team made themselves available, assisted when needed and were very good.
People’s opinions were sought formally and informally. Audits were conducted to ensure the quality of care was of a high standard and the environment was safe. Accidents and safeguarding concerns were investigated and, where there were areas for improvement, these were shared for learning.