Archived: Honister

Honister is registered to provide accommodation and personal care for up to 19 people, who may also live with dementia. There were 16 people accommodated at the home at the time of this inspection.

We last inspected Honister on 15 January 2014 and found the service was meeting the required standards we inspected at that time.

The home had a registered manager. 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 felt safe living at Honister. Staff knew how to keep people safe and risks to people’s safety and well-being were identified and managed. The home was calm and people’s needs were met in a timely manner. The registered manager operated robust recruitment processes which helped to ensure that staff members employed to support people were fit to do so. People’s medicines were managed safely

Staff had the skills and knowledge necessary to provide people with safe and effective care and support. Staff received regular support from management which made them feel supported and valued. People were supported to make their own decisions as much as possible. People received support to eat and drink sufficient quantities. People’s health needs were well catered for because appropriate referrals were made to health professionals when needed.

People were complimentary about the care and kindness demonstrated by the staff team. Staff were knowledgeable about individual’s needs and preferences and people were involved in the planning of their care where they were able. Visitors to the home were encouraged at any time of the day and people’s privacy and dignity was promoted.

The registered manager had arrangements in place to receive feedback from people who used the service, their relatives, external stakeholders and staff members about the services provided. People were confident to raise anything that concerned them with staff or management and were satisfied that they would be listened to.

There was an open culture in the home and relatives and staff were comfortable to speak with the registered manager if they had a concern. The registered manager had arrangements in place to regularly monitor health and safety and the quality of the care and support provided for people who used the service.

During our inspection we looked at how people were cared for and how staff supported people living with dementia. We spoke with the manager, four staff members and two people who used the service living with dementia. All the comments we received were complimentary about the service and its staff. One person told us, "Care at Honister is good, the staff are very caring.' Another person told us, 'The staff sit and listen to me and will help me with anything I need.'

We found that staff were caring and attentive to people's needs in most cases. We saw that people had enough to eat and had access to snacks throughout the day. We saw that the service arranged activities such as reminiscence and memory games and were working with Alzheimers Society on a life history project at the time of our inspection.

We saw that the service worked well with other providers and accessed other professionals to support people when this was required. We saw evidence of documents in the care plans that had detailed information about the individual person which would be shared with other professionals to ensure people's individual needs would be met.

We saw that the service had effective quality assurance processes in place to monitor the dementia care people received.

We found that the provider was meeting the standards we had inspected. Peoples' care needs were assessed and met appropriately. A choice of suitable and nutritious food and hydration were provided. There was a system in place to assess the risk of and to prevent and control the spread of infection. The system for the management and safe administration of medicines was maintained and the staff were provided with relevant training so that they were knowledgeable and competent in their role when supporting people in meeting their needs.

The people we spoke with felt that there had been improvements made in relation to the food they had been served in the last two months. They also said that there was a programme of planned activities provided each day. One person said, 'We are getting proper food now' and another person said 'We do have daily activities now and it is a much nicer place.'

We found that the provider had ensured that a choice of nutritious meals was provided for people. We also found that a programme of planned and meaningful activities was provided during the day. However, we found that the provider had not maintained appropriate standards of cleanliness and hygiene in the home.

Currently, there are 11 people living at Honister, which is registered for 19.

We spoke with six people who use the service. Some said they were happy with the care and support they received, but others said that, since the change of management, meals had been provided in smaller portions that were not sufficient, and no activities were provided.

During our visit, we could find no evidence that a weekly menu had been planned that had been assessed for nutritional value by a dietician. The staff said that they planned the menu on a daily basis, and wrote it on the board.

There were used toilet tissues on the toilet floors and thrown into the bath. Some of the bedroom floors had not been cleaned, and the carpets were badly stained with faeces. On the day of our visit, no activities were provided or planned, as far as people

were aware.

We found that the provider was meeting the standards we had reviewed during this visit. People and their relatives had been involved in the decisions about their care and support. People's privacy and dignity had been respected. Each person had an assessment of their needs carried out before they came to the home.

The care plans and the risk assessments for people had been reviewed regularly so that up to date information was available to staff. The management and administration of medicines had been maintained appropriately.

The staff had received relevant training and support so that they were able to care for people and meet their needs. There were regular internal audits carried out by the staff. These ensured that safe practices had been maintained.