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Honeywood House Nursing Home Good

Reports


Review carried out on 9 September 2021

During a monthly review of our data

We carried out a review of the data available to us about Honeywood House Nursing Home on 9 September 2021. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Honeywood House Nursing Home, you can give feedback on this service.

Inspection carried out on 24 October 2017

During a routine inspection

The inspection took place on the 24 October 2017 and was unannounced.

Honeywood House Nursing home is situated outside the village of Rowhook. The home is a converted 18th century mansion house standing in acres of park and woodland. It offers personal and nursing care to 25 older people, some of whom live with dementia. At the time of our visit there were 23 people living at the home.

At the last inspection on 26 August 2015, the service was rated Good. At this inspection we found the service remained Good.

People and relatives told us they felt the service was safe. One person told us “I keep my door open at night. I am safe here because there are always staff on hand to call on if I need something and other people don’t wander into my room, I am settled and happy here, safe in every respect”.

The provider had arrangements in place for the safe ordering, administration, storage and disposal of medicines. People were supported to get their medicine safely when they needed it. People were supported to maintain good health and had access to health care services.

Staff considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).

People’s individual needs continued to be assessed and care plans were developed to identify what care and support they required. People were consulted about their care to ensure wishes and preferences were met. Staff worked with other healthcare professionals to obtain specialist advice about people’s care and treatment.

People and their relatives felt staff remained skilled to meet the needs of people and provide effective care. One person told us “I think the staff are well trained to help me, they do things properly. When they are helping me and we are chatting they’re always talking about doing training for different things. They seem to keep up to date”.

Staff felt fully supported by the management team to undertake their roles. Staff were given training updates, supervision and development opportunities. Staff spoke positively about training and supervisions they received. One member of staff told us “We get regular meetings and supervision. We can discuss anything we want to, I think it is a good thing”.

People and relatives continued to find staff to be kind and caring and the care they received was good. Comments included “The staff are amazing and so considerate, they have a very positive attitude and very supportive” and “All of them are very caring and so, so kind and thoughtful.

People, staff and relatives found the registered manager and management team approachable and professional. One person told us “I see the manager all the time, she’s always in and out saying hello to me. She’s really nice, they all are. I think they are a good home and do a good job. It’s a quiet, well run, happy home” A member of staff told us “The management is very good and understands the needs of the residents and staff”

Further information is in the detailed findings below.

Inspection carried out on 26 August 2015

During a routine inspection

Honeywood House Nursing home is a care home situated outside the village of Rowhook. The home is a large converted and adapted 18th century mansion house standing in 10 acres of park and woodland. It offers personal and nursing care to 25 older people, some of whom live with dementia. There is level access throughout with a shaft lift to the first floor.

The service has a registered manager. 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. In this service the registered manager is also the registered person.

We carried out an unannounced comprehensive inspection of Honeywood House Nursing Home on the 26 August 2015. As part of this inspection we checked what action had been taken to address the breaches of legal requirements we had identified at our last inspection on the 8 and 16 January 2015. Following that inspection we issued warning notices stating the provider must take action in relation to management of people’s medicines, the assessment of risk, the planning of person centred care and treatment, and obtaining people’s lawful consent to care and treatment by the 2 May 2015. We also identified the provider was not meeting the requirements of the law in relation to staff recruitment, staff supervision, staff training and appraisals and good governance.

After our last inspection, the provider wrote to us to say what they would do to meet legal requirements and sent us an action plan detailing how they intended to ensure they met the requirements of the law. At this inspection we found improvements had been made and all the breaches had been addressed. However further improvements are needed to be made in relation to the completion of medicine administration records (MAR).

The provider had taken action to improve the safe management of people’s medicines. The arrangements in place for the ordering, storage and administration of people’s medicines were safe and people received their medicines when they needed them. However some people’s MAR charts contained gaps which meant that it could not be identified whether they had received their medicine as prescribed and intended. Without this information it is difficult for the effectiveness of medicines to be monitored and is an area of practice we assessed as needing to improve.

Improvements had been made to the safety and delivery of care people received and sustained. Risks had been appropriately identified and robustly addressed in relation to people’s specific needs. For example assessments of people’s risk of falls and developing pressure areas had taken place and strategies were in place to reduce these risks, Staff were aware of people’s individual risk assessments and knew how to mitigate the risks.

Following the last inspection improvement had been made and sustained in relation to planning people’s care. People and their representatives had been involved in the development of care plans which were person centred and detailed their likes and dislikes and where known, their personal histories.

The provider had made improvements to making sure they gained lawful consent from people for their care and treatment. Mental capacity assessments had been completed in line with legal requirements. Where people lacked the mental capacity to make decisions the management and staff were guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests. The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the registered manager understood when an application should be made and how to submit one. Deprivations of Liberty Safeguards (DoLS) authorisations were in place and care plans clearly identified if someone was subject to a DoLS. The management team had been working with staff to raise awareness of DoLS and the impact DoLS had on people and this was evident from staff meeting minutes.

Staff recruitment had improved and all the relevant identity and security checks had been completed before staff were deployed to work at the service. Staffing levels had also improved and were based on the individual needs of people. People’s level of need and the number of staff required to provide safe, effective and responsive care had been assessed and the relevant number of staff had been deployed. Staff were seen spending individual time with people and responding to call bells and requests for assistance quickly. One person explained that on her “bad days” when she preferred to remain in bed, staff responded to her call bell very quickly.

Staff training had improved. Staff had completed training that was relevant to their roles and which provided them with the skills they needed to meet people’s needs. For example staff had completed training in the administration of medicines and supporting people living with dementia. One person told us “They (the staff) certainly seem to know what they are doing; I’ve no complaints about them what so ever”. Staff felt they were well supported had received formal supervision on a regular basis at which they could speak in confidence with their line manager about their personal development or any issues of concern they may have. One staff member said “We do have supervision but I don’t have to wait for that to ask for training. We can ask for that anytime”. They also had an annual appraisal of their performance and the opportunity to complete nationally recognised qualifications in care.

Everyone we met with spoke highly of the delivery of care and of the caring nature of the staff that worked there. One person told us “They are lovely (the staff).” They explained they had never heard staff raising their voices to anyone or with each other and that they always let them do things at their own pace. People felt well looked after and supported by caring staff. We observed friendly relationships had developed between people and staff. One relative told us “We are greeted like family when we come here; it’s a real homely place”. A staff member said “We’re just one big family here”. Another explained “I would be happy for my mother to be here”. An agency nurse told us “This is the nicest and most caring home I’ve worked in”.

People’s dignity and privacy was protected. For example we saw staff knocked on people’s doors and waiting for a response before entering their rooms. Doors were shut when staff supported people with personal care and made sure they were appropriately covered when lifting them in a hoist.

Dedicated activities coordinators were in post who were responsible for the oversight of stimulation, interaction and meaningful activities. People could choose how to spend their day and they took part in activities. People told us they enjoyed the activities, which included arts and crafts, exercises and being entertained by singers and musicians.

People had a choice of food at meal times and specialist diets were catered for. People who needed help to eat and drink were supported appropriately. People’s weight was monitored and referrals were made for specialist health care support as needed. For example for Speech and Language Therapy and input from GP’s.

People had been provided with a guide to the service and were aware of how to raise concerns and complaints and felt able to do so. Relative and resident meetings had been held and people were able to contribute to these meetings and suggestions for how to improve the service had been acted on. For example how improvements could be made to the menu on offer and the activities provided.

People and staff told us the registered manager and management team were approachable, open and transparent. Improvements had been made to the quality assurance systems in place and internal audits the results of which were used to help drive improvements in the service. Accidents and incidents were recorded and the results analysed to identify and emerging themes and patterns, and action had been taken to reduce the risk of re-occurrence.

Inspection carried out on 8 & 16 January 2015

During a routine inspection

This unannounced inspection took place on the 8 and 16 January 2015. Honeywood House Nursing home is a care home situated outside the village of Rowhook. The home is a large converted and adapted 18th century mansion house standing in 10 acres of park and woodland. It offers personal and nursing care to 28 older people, some of whom live with dementia.

When we inspected the home on 24 June 2013 we found a breach of regulations which related to care and welfare and consent to care and treatment. The provider sent us an action plan and told us how they would address these concerns. With the breach regarding consent by they told us they would be compliant by 18 by 11 July 2013 and care and welfare by 14 August 2013.

When we inspected on 15 July 2014 we found continued breaches with regards to care and welfare and consent to care and treatment. We also found a breach in relation to assessing and monitoring the quality of service provision. We received an action plan from the provider stating how they would address these issues.

The home has a registered manager. 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.

Staff had an understanding of abuse and had access to safeguarding policies and procedures; however these were not always put into practice. Risk assessments relating to people were not consistently completed and did not identify ways of reducing the risk. Staffing levels were not planned and organised to meet the needs of people. Staff received training but not in all subjects to ensure they could meet people’s needs living in the home. For example there was no training in the area of dementia. Staff did not receive formal supervision. Staffing recruitment records were incomplete and did not ensure all necessary checks had been undertaken to ensure people were safe. The administration of Medicines practices in the home were not safe.

Staff had awareness but lacked an understanding of the Mental Capacity Act 2005 and the principles of this had not been applied in full. Assessments had not taken place to see if people had the capacity to make specific decisions and there was no evidence of any ‘best interests’ decision processes being followed. The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The MCA DoLS require providers to submit applications to a ‘Supervisory Body’ for authority to do deprive people of their liberty following formal assessment. No applications for DoLS had been made but we were not assured that the provider followed or was ready to follow the requirements in the DoLS.

People had involvement in the choices of what meals were put on the menu. However there was always only one choice available on the menu at lunch time.

Staff were kind, respectful and caring. However, people were not provided with opportunities to be actively involved in decisions about their care and the home. Care plans did not provide detailed information to guide staff about the support a person needed. They were not personalised and did not provide sufficient guidance for staff to know how to meet people’s individual needs. People had no concerns or complaints about the home and would speak to the manager if they did.

No external auditing took place, the manager or staff carried out all audits. There was no formal way of identifying any learning was taking place as a result of the audits taking place.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 15 July 2014

During a routine inspection

The inspection team was made up of one inspector. We set out to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people who used the service, the staff who supported them and records we looked at. During this inspection we looked at the care records of five of the 26 people living in the home.

Is the service safe?

We found there were not systems in place to make sure the manager and staff learned from events such as accidents and incidents and investigations. We found there was a lack of consideration with regard to people�s capacity to make decisions in their individual records. People spoke highly of the staff group and observations showed staff were kind, respectful and knew people well.

Is the service effective?

Assessments and care plans had been completed. We found people�s care records were not an accurate reflection of people�s needs. Care plans were not always reflective of people�s choices and preferences.

Is the service caring?

We saw that people were supported by kind and attentive staff. Staff knew the people they were caring for well and changed their approach to meet service users� individual needs. Staff were observed to treat people with dignity and respect.

Is the service responsive?

Surveys had been completed by some people living at Honeywood House, which recorded people were happy with the service they were receiving. We were able to see the provider organised residents and staff meetings to ensure they could share their views on the home and services offered.

Is the service well led?

We saw that people had access to a range of services and the provider ensured people had access to the relevant professionals. Whilst staff on duty told us the staffing levels were adequate we were concerned the absence of one nurse on the morning duty rota was not covered.

Inspection carried out on 24 June 2013

During a routine inspection

During our visit we met with 15 of the 21 people who used the service and spoke with four of them about the service they received.

Some people had complex care needs, which meant they might have had difficulty describing their experiences of the service. We gathered evidence of people�s experience of the service by observing the care they received from staff.

The four people we spoke with told us that they were happy with the care and support they received. One person told us, �I'm happy living here, no worries.� Another person said, �I feel at home here and food is nice.�

People told us they felt the home was clean. One person said, �They come to clean my room everyday and what can be better than that?�

People told us that staff treated them with respect and promoted their privacy. People said staff knocked on their door and sought their permission before entering the room and assisting with personal care.

They told us they felt would be listened to if they raised any concerns.

Our evidence gathered during our inspection supported the comments made by people who used the service.

People�s care was not always planned and delivered in a way that promoted their safety and welfare.

Inspection carried out on 18 December 2012

During an inspection looking at part of the service

We observed care, spoke to eight people, three relatives, four staff and the manager. We looked at care plans for four people. Care needs were assessed and actions to meet those needs were recorded. People spoken with were very happy with the care. We were told the home was "absolutely marvellous". One person told us "I am so lucky my family found this home for me". People told us that they did not have anything to complain about.

Appropriate arrangements were in place in relation to medicines. People told us they receive all care and medicines in a timely fashion from kind and gentle staff.

The staffing and management of the home was well managed and quality systems were in place to ensure the safety and wellbeing of the people living there.

Inspection carried out on 8 November 2011

During a routine inspection

People living at the home told us they felt safe living there and that staff were always available when they needed them. They felt the staff knew what they needed and knew how they liked things done.

People we spoke with told us they were involved in making decisions about the way they lived their lives and the care they received. They felt the staff always respected their privacy and dignity and that the staff helped them to remain as independent as possible. Staff knew the people living at the home well and had a good understanding of their care needs.

People told us that they had had a very nice lunch, that they enjoyed the food and they were lucky to live at Honeywood.