Honey Lane Care Home

Honey Lane is care home providing accommodation and personal care to up to 41 people who have needs associated with dementia. At the time of our inspection there were 33 people using the service.

People’s experience of using this service and what we found

Staff had received training for safeguarding, and this was updated regularly. Risk assessments were in place to manage potential risks within people's lives. Concerns had been raised as monitoring charts used to mitigate risks to people were not always completed effectively. However, the provider had appointed a new manager and oversight of risk monitoring had recently improved. Minor improvements were needed to medicine processes. Staffing numbers had increased to keep people safe and the provider followed the established recruitment procedures to ensure staff employed were suitable for their role.

People received personalised care and participated in activities, hobbies and events they enjoyed. People told us they knew who to complain to and would feel confident in doing so. We made a recommendation about the review of care plans.

The provider had recognised some aspects of the quality assurance processes had not always been consistent in recognising shortfalls. This had now been addressed and oversight of the service had improved.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 3 January 2019).

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding, staffing and risk. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively. This included checking the provider was meeting COVID-19 vaccination requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained the same on the findings of this inspection.

We have found evidence the provider needs to make improvements. Please see safe section of this full report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

A visiting pod had been developed to enable safe, socially distanced visiting with plastic screens in the garden.

The service has a robust admissions procedure in place in line with current guidance.

Staff followed shielding and social distancing rules and encouraged people to maintain social distancing where able to.

Risks to people and staff had been assessed and appropriate measures taken to reduce risks. People had their temperature and oxygen saturation levels monitored regularly so relevant support and treatment could be provided promptly.

Regular cleaning schedules had been developed and were followed by a team of housekeeping staff and care staff.

Infection prevention and control audit checks were in place and where actions were identified, they were addressed in a timely manner.

Honey Lane is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Honey Lane Care Home is registered to accommodate 41 older people, who have needs associated with dementia. At the time of our inspection there were 37 people living in the service.

People’s experience of using this service:

Activities within the home were extremely person centred. A range of meaningful activities were available for people to participate in if they wished and people enjoyed spending time with staff. Activities were provided throughout the day, seven days a week and were developed in line with people's preferences and interests.

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. Care plans reflected people's likes and dislikes, and staff spoke with people in a friendly manner. Our observations during inspection, were of positive and friendly interactions between staff and people.

The provider had responded to feedback relating to staffing levels from staff and relatives and had recently increased staffing at the service at a busy time. All staff had attended safeguarding training. They demonstrated a clear understanding of what abuse was and how to report concerns.abuse; they said they would talk to the management or external bodies immediately if they had any concerns. Risk assessments were in place, which identified possible risks and how to manage them.

Staff told us they received the support and training they needed to help them do their jobs well. The managers were proactive in ensuring staff completed training relevant to the needs of people living at the service. The registered manager responded and took action straight away when we identified an issue with staff practice. The service provided specialist training to enable staff to care for people with particular needs.

People were supported to eat and drink. The registered manager took immediate action to ensure fluids were recorded appropriately when active monitoring was required. 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 had systems in place to monitor the quality of the service. Actions were taken and improvements were made when required. People and their relatives felt able to speak to the registered manager or any of the staff team at any time if they needed help and assistance.

Rating at last inspection: Good (report published 6 August 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Honey Lane provides accommodation for up to 41 people who have needs associated with dementia. It does not provide nursing care. At the time of this inspection there were 36 people accommodated at Honey Lane.

A registered manager was in post at the service. 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.

The service was meeting the requirements of The Mental Capacity Act 2005 (MCA). Assessments of capacity had been undertaken and applications for Deprivation of Liberty Safeguards (DoLS) had been made to the relevant local authority.

People and their relatives told us that they felt people were safe living at Honey Lane. Staff and management were knowledgeable about safeguarding matters. Risks to people`s mobility and general safety were identified and risk assessments had been developed to mitigate these risks.

Our observations during the inspection confirmed that staffing levels in the home were appropriate to meet people's needs. Staff members did not start to work at the home until satisfactory employment checks had been completed.

There were suitable arrangements for the safe storage and disposal of people's medicines.

People were supported to make meaningful meal choices and people were assisted to eat in a calm and unhurried manner. However, measures to monitor people who were at risk of dehydration and malnutrition were not effective.

People received care and support from a staff team who had the knowledge and skills necessary to provide safe and effective care. Staff asked people for their consent before they delivered all aspects of care.

People's health needs were well catered for. 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 were encouraged at any time of the day and people's privacy was promoted. We observed sensitive and kind interactions between staff and people who used the service.

Care was centred on the needs of individuals. There were arrangements for activities and stimulation in the home.

Meetings were arranged with people who used the service, and their relatives to facilitate feedback about the quality of the service provision. People were confident to raise anything that concerned them with staff or management and satisfied that they would be listened to.

People who used the service, their relatives and staff members found the home manager to be approachable and supportive.

This is a summary of what we found:

Is the service safe?

People told us they felt safe. Safeguarding vulnerable adults from abuse procedures were robust and staff understood how to safeguard people they cared for. Systems were in place to make sure that managers and staff learnt from events such as accidents, incidents, complaints and whistleblowing investigations. This reduced the risks to people and helped the service to continually improve.

The service had policies and procedures in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS are put into place to ensure that people's human rights are protected should their liberty be restricted in any way. Staff had been trained to understand when an application should be made and knew how to submit one.

Staff knew about risk management plans and showed us examples where they had followed them. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

The service was safe, clean and hygienic. Environmental audits were carried out regularly therefore not putting people at unnecessary risk.

The provider had safe and effective staffing rotas. Policies and procedures were in place to make sure that unsafe working practice was identified and people were protected.

Is the service effective?

People's health and care needs were assessed with them. Specialist dietary, personal care and psychological needs had been identified in care plans where required. People told us that they had been involved in writing their care plans and said that they reflected their current needs.

Is the service caring?

People were treated with respect and dignity by the staff. People were supported by kind and attentive staff. We saw that support workers showed patience and gave encouragement when supporting people. People we spoke with told us, 'The staff are very good here and do as much as they can for us. They never make me feel bad for asking for help or ringing my alarm bell."

People who used the service, their relatives, friends and other professionals involved with the service completed a yearly satisfaction survey. People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People knew how to raise a concern or complain if they were unhappy.

The service worked well with other agencies and services to make sure people received care in a joined up way.

People completed a range of activities in and outside of the service regularly.

Is the service well-led?

The service had a quality assurance system in place. Records seen by us showed that identified shortfalls were addressed promptly. We were therefore assured that the provider had taken steps to continually improve the service.

Staff told us they were clear about their roles and responsibilities and staff demonstrated a good understanding of the ethos of the service.

One relative said, 'I am very grateful to the staff. They provide good care.' Another relative said, 'The staff are very good and I am very thankful.'

A healthcare professional commented, 'The staff are approachable and very helpful. They are excellent in what they do. They are respectful of the people they care for.'

We observed how staff interacted with people who were suffering from dementia. We noted that the calm approach of the staff helped to de-escalate situations where the agitated and aggressive behaviour of some individuals could have upset or injured other people who used the service.

We noted that people's nutrition and hydration needs had been met and people were neatly dressed in clean clothes. This indicated that people's wellbeing had been promoted by taking account of their physical needs.

We also spoke with relatives of two people who told us that people received care that met their needs and preferences. One person said, 'Staff are very good and very respectful. They have accommodated our food choices and do respect our religious needs.' Another person said, 'I cannot fault it. She is well cared for, and her nails and hair are always nicely done'.

The provider had systems in place to regularly check the quality of the service and follow up anything that needed to be improved. We found that people's medicines were safely managed.

People told us that staff were knowledgeable and able to support people's needs. One person said, 'The staff talk to people nicely and calm them down if they get upset, they are never unkind. They know how to care for her, and they do.' Records showed that staff received training and support to help them to do their job effectively.