Honeybrook House

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

At our last inspection we rated this key question requires improvement. At this assessment we did not assess all quality statements within this key question. The overall rating for this key question remains requires improvement based on the findings of the last inspection. This meant the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff told us there was good communication between them and the registered manager. A member of staff told us, “[Registered manager] is very approachable, he seems very open to discussion of topics that may be concerning us.” Another member of staff told us, “There's good communication to an extent and there's teamwork too. The seniors and manager see to this. They are available to help at every point and provide support even to staff where needed.” The service held regular staff meetings to ensure staff were provided with opportunities to share information and ideas on how the service could improve. During our assessment the leadership of the service provided us with their positive feedback on how the service is run. They told us about their plans to improve the service, which included utilising grounds around the building.

At our last inspection we found that systems were either not in place or robust enough to demonstrate the service was well managed. This was a breach of regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this assessment we found that further improvements were needed to ensure that systems are effective to ensure people’s records were suitably maintained and monitored. The provider’s action plan following a safeguarding incident stated they would be reviewing all people’s mental capacity assessments. However, during our assessment we found that most of mental capacity assessments had not been reviewed. Advice from other professionals was not always followed. For example, a speech and language therapist (SALT) suggested a mental capacity assessment for one person. This did not take place in spite of the fact that the SALT had suggested this a year before our inspection. There was contradictory information within people’s care documents regarding their capacity. Not all important information was included in people’s hospital passports.

People were supported by staff to maintain their health and well-being through access to a range of community healthcare services and specialists as required. We saw evidence in care records of staff contacting healthcare professionals such as GPs, a pharmacist or 111.

Staff told us they were knowledgeable about people’s health and routines and any changes in people’s health and well-being would be escalated and addressed immediately. A member of staff told us, “The seniors are very good at taking any changes into account, and requesting the necessary help from professionals.”

We received feedback from 1 healthcare professional working with the service. The professional told us, “I have found the staff to be knowledgeable about [person’s] needs and of a range of behaviour management strategies tailored to him and focusing on the reduction of stress, fear and frustration.”

We found the registered manager had notified us appropriately of any reportable events and the rating from the previous inspection was displayed in the service. Records showed and staff confirmed that the service worked in partnership with a number of health and social care professionals such as GPs and social workers to ensure people's health and well-being were maintained. However, we found some processes required improvement to ensure that healthcare professionals’ advice is always sought and followed.

Staff told us learning was shared with them through handover, supervision and regular meetings. A member of staff told us, “We have staff meetings every last week of the month. Concerns are raised, the past weeks are analysed, staff are praised for their hard work, the new month is looked into with areas that need improvement, and so far it's been effective.” Another member of staff told us, “There are regular monthly staff meetings which are good. If I didn’t want to raise a concern at the meeting, I would approach [registered manager] or a senior.”

Systems and processes to assess the quality of care and drive improvements were in place, however, these were not always effective. Where action plans were produced, these were not always followed to complete all actions within a timeframe stated by the provider.