Archived: Honeyfield

During our inspection we found serious failings in the way people were being cared for. As a result of these concerns we carried out further inspections on Wednesday 13 November, Saturday 16 November at 03:00 and Thursday 28 November at 19:00. We further visited the location on Saturday 30 November and Sunday 1 December to ensure people were receiving the appropriate care and support. This report is therefore based on our findings over these dates.

We spoke with members of the Avante Partnership Senior Management team including the Chief Executive Officer, Chair of the Board of Trustee's, Chief Operations Officer, Head of Pharmaceutical Care and Clinical Standards, Service Development Manager and the Assistant Operations Director. We also spoke with 16 members of care staff, five people who used the service and the relatives of four people who used the service.

As a result of this inspection, we raised our concerns with Kent County Council and other local authorities who were funding placements at Honeyfield. We were required to consider urgent enforcement action which included the immediate closure of the home. This action was averted because of the assurances we received from the Provider and also from the support and input from Kent County Council.

We identified major concerns about the way in which care was being provided and managed and the impact that this was having for the people living in the home. We saw that people did not have accurate care plans for staff to provide appropriate planned care.

We found that staff were not suitably trained to care for people with dementia or for those with complex care needs. We found that staff lacked the skills, attributes and in some cases, the compassion and empathy to care for the people at Honeyfield.

We judged that care practices were out dated and were not evidence based.

People were identified as being at risk from malnutrition and dehydration because their care needs had not been appropriately assessed.

We identified concerns with the infection control processes and protocols at the home. Mattresses were found to be soiled with urine and/or faeces and we found that these were not routinely replaced when people left the service.

The premises was dated, in need of redecoration and was not adequately maintained.

The Provider did not have an effective system in place for assessing and managing the risks to people. The Provider was not learning from incidents and accidents that were occurring. Audits were taking place but were ineffective because staff were not implementing recommendations.

At the time of this inspection, the Registered Manager, Mrs. Julie Ayres was not responsible for the day-to-day management of Honeyfield. The service was being managed by an experienced manager from Avante Partnership Limited.

Overall, we have found that Honeyfield operated in an institutionalised way and was no longer fit for purpose.

We found that people and their relatives were involved in the planning of care. The service listened to people and considered people's views when planning and delivering services.

Although people's needs were assessed, we found concerns that care and treatment was not always planned and delivered in a way that ensured people's safety and welfare.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. However, people were not fully protected against the risk of unlawful or excessive control or restraint because the provider had not made suitable arrangements.

People were not being cared for in a clean, hygienic environment. People were not protected from the risk of infection because appropriate guidance had not been followed.

Staff were not always following the provider's guidance in relation to medicine management.

We found that there were not always enough staff available to meet the care and social needs of people.

We spoke to four people who used the service on the day of our inspection. They told us that they liked living at the home, one told us 'It's nice here' and the food was 'Pretty good'.

One person told us that the staff looked after them 'very well'. This was confirmed by our observations on the day as we saw that staff spoke to people in a respectful and caring way. We noted that the staff and the people were very relaxed in each others' company.

We also spoke to six relatives who gave us their views. They all told us that the staff were very caring. Comments included that the care was 'extremely good' and that staff gave the home a 'lovely atmosphere'. One relative told us the food is 'good' however another told us that the food quality was 'variable'.

One relative told us that the home was 'Quite clean but it smells a bit at weekends' whilst others told us that the home 'Always smells on the ground floor'.

One relative told us that more staff were sometimes needed particularly when two staff were needed to help people. Most relatives told us that the service needed extra staff and that staff were busy.