All inspections: Honeysuckle House - Care Quality Commission

At our last inspection of this service on 16 October 2014, the provider was in breach of the regulation relating to medicines management, Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which corresponds to Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014). The provider sent us an action plan after the inspection detailing how they would meet this standard. At this inspection we found that improvements had been made, medicines were being managed safely and the provider was no longer in breach of this regulation.

This inspection took place on 30 March 2016 and was unannounced. This inspection was carried out by a single pharmacist inspector. This report only covers our findings in relation to the safe management of medicines within the safe section. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Honeysuckle House on our website at www.cqc.org.uk .

Honeysuckle House provides accommodation for up to 32 older people some of whom are living with dementia. There were 31 people living at the home on the day of our inspection.

There was a registered manager in post but they were away on leave on the day of the inspection. 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 and associated Regulations about how the service is run.

We were assisted during our inspection by the deputy manager.

All of the issues we found with medicines at the last inspection had been addressed. Medicines were stored safely, and there were no omissions in recording on people’s medicines administration records. All staff administering medicines had been assessed by the provider as competent to do so. On the day of our inspection, we fed back three minor areas for improvement with medicines relating to recording medicine refusals, pain management reviews and the covert administration of medicines.

This inspection took place on 16 October 2014 and was unannounced. At our last inspection in February 2014 the service was meeting all the regulations we looked at.

Honeysuckle House provides accommodation, nursing and personal care for up to 32 older people with dementia.

There was a registered manager in post, but she was away during the two days of the inspection. 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 and associated Regulations about how the service is run.

We were assisted throughout the two days of the inspection by the deputy manager and the regional director.

People were positive about the service and the staff who supported them. We saw people being treated with warmth and kindness. Staff were aware of people’s individual needs and how they were to meet these needs. Relatives and friends we spoke with were positive about the home and the staff.

Although the service had a number of systems in place to monitor and maintain people’s safety, these were not always being followed. We found the medicines room on the nursing floor was unlocked and medicines were left out during the inspection. There was a risk that people who were walking around the nursing floor could have gone in the room and taken medicines. This is a breach of regulation and you can see what action we have told the provider to take at the back of the full version of the report.

We also observed times when there were insufficient staff to meet the needs of the people at the home, particularly during lunch time on the nursing unit.

People felt the staff had the knowledge and skills necessary to support them properly. They told us that staff listened to them and respected their choices and decisions.

People using the service, their relatives and friends were positive about the manager and management of the home. Everyone we spoke with knew who the manager was and said they were approachable and available.

Where people were at risk of coming to harm if they left the service unaccompanied, guidelines relating to the Deprivation of Liberty Safeguards (DoLS) were being appropriately followed in order to keep people safe.

Honeysuckle House provides nursing care and support specifically for people with dementia. There are two floors, the ground floor provides residential accommodation and personal care and the first floor provides nursing care to those people with more complex physical needs.

People were positive about the service and the staff who supported them. People's comments included 'everything is good here' and 'I couldn't describe them any better.' We observed kind and professional interactions between staff and people with dementia.

Throughout the inspection we observed staff involving people in decisions about their care and respecting their preferences. One person with dementia told us 'they have never asked me to do something I didn't want to do.' Another person told us 'they discuss everything.'

The care and treatment plan for people with dementia was based on their initial assessment of needs and involved a number of healthcare professionals including doctors, nurses, occupational therapists and physiotherapists.

People with dementia and their relatives told us they were satisfied with the way the home met their health and social care needs. Records we saw indicated that people had good access to dentists, opticians and chiropodists on a regular basis. We saw that people were able to access social work support as well as attend day centres and access advocacy services.

Staff told us that there was very good communication between themselves and that they worked well as a team. Staff told us that the care of people with dementia was discussed at each shift handover to ensure the continuity of support for people.

The service had a number of quality assurance initiatives to ensure that the quality of care provision was monitored and included the views of people with dementia and their relatives.

We used a number of different methods to help us understand the experiences of people using the service, because people had complex needs which meant they were not always able to tell us their experiences. We observed that the way staff were supporting people in the home had a positive effect on their well being. People who use the service told us that staff were kind and respected their privacy. They confirmed that staff treated them with respect and dignity. One person told us the staff were, 'helpful and nice.' A relative told us they were 'immensely pleased with the care provided. It could not be better.' They also described staff as 'marvellous and exceptional.' People told us they had good access to healthcare professionals such as doctors, dentists and chiropodists.

People were confident that their concerns would be taken seriously and felt the manager was very approachable. A relative told us they thought the manager was 'excellent.'

Staff told us they felt supported by the management team and that there were good training opportunities available within the organisation.

People were positive about the service and confirmed that the management and staff often asked them for their views about the quality of care they received and if there were any suggestions for improvements.

People who use the service told us that staff were kind and respected their privacy. Comments included, 'I see a lot of respect from staff' and 'Everyone who works here seems happy'.

We observed staff supporting people in a friendly and professional way and saw that people were being offered choice with regard to menus and activities.

People told us that staff listen to them and involve them in aspects of their care and the general activities in the home. One person told us, 'They look out for you'.

People gave us examples of how they are given choices about their care and what they like to do. They confirmed that the management and staff included them in some decisions about the running of the home. People told us that they had good contact with the local community.

Staff we interviewed were able to give us examples of how they maintain peoples' dignity, privacy, independence and how they offer choices to people on a daily basis.

We asked people who use the service what they thought about the care and treatment they receive at the home. They responded positively and comments included, 'It's quite a nice home', 'They look after you' and 'They treat you well'.

People said they felt supported by the staff team and that they were included in decisions about their care as far as possible. One person commented, 'They don't tell you what to do. They don't pressure you in any way'.

People told us they were satisfied with the activities available at the home and that they could go out if they wished to. We saw activities taking place during our visit and people from the residential and nursing units were enjoying the contact with staff.

Staff we spoke to confirmed that they asked people how they wanted to be supported at the home.

We observed staff supporting people in a kind and professional manner.

People who use the service told us they felt safe at the home and that they would talk to the manager or staff if they were concerned about anything.

Staff we interviewed were aware of the different types of abuse that can happen to people in a care setting. Staff were also able to give us examples of signs they would look out for that may indicate a person may be being abused.

Staff told us that if they ever suspected abuse was taking place they would inform the manager immediately.

People told us that they had confidence in the staff team and that staff responded to their needs appropriately. One person commented, 'I appreciate what the staff have done for me'.

People also said the management and staff were approachable and friendly.

We observed staff being appropriately supported by the management so that they could provide for the care needs of the people who use the service.

We asked people who use the service what they thought about the quality of care they receive at the home.

People were positive about this and told us they were asked for their view about the quality of service provision at meetings and in one to one sessions.

One person commented, 'The staff ask you how things are going'.

People told us they felt the service listened to their views and opinions.

Archived: Honeysuckle House

All Inspections

30 March 2016

During an inspection looking at part of the service

16 and 17 October 2014

During an inspection looking at part of the service

11 February 2014

During a themed inspection looking at Dementia Services

18 March 2013

During a routine inspection

25 October 2011

During a routine inspection