Archived: Honeywood

Updated 10 June 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

One inspector carried out the inspection.

Service and service type

This service provides care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave a short period notice of the inspection because some of the people using it could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this.

Inspection activity started on 4 April and ended on 11 April 2022. We visited the office location on 4 April 2022.

What we did before inspection

We reviewed information we had received about the service since they registered in December 2020. We sought feedback from the local authority who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We met with the six people who lived at Honeywood. Where people were unable to talk with us, we used observation to help us understand their experience of using the service. We had contact with five relatives for feedback about the care their family members received.

We spoke with the registered manager, the regional manager, senior service manager and four members of care staff including permanent and agency members of staff.

We reviewed a range of records. This included three people's care records and selected medication records. We looked at two staff files in relation to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service, including policies and procedures.

Updated 10 June 2022

About the service

Honeywood is a supported living service providing personal care for up to six people with a learning disability and autistic people. At the time of the inspection there were six people using the service.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

The service was not able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture.

Right Support

• Although people were supported to engage in activities within the service, people’s access to the community was restricted by staff availability.

• The provider had created standards to recognise people's choice, control and independence. However, where people were deemed to lack capacity to make decisions about their care and support, management and staff had failed to recognise and assess whether people may be deprived of their liberty, despite completion of e-learning.

• People were supported to maintain their health by accessing health professionals. People's medicines were being managed safely.

• The service is a bungalow, adapted for wheelchair users close to Grays town centre, which enables people to access the local community and its facilities.

• People had exclusive possession of their own rooms with adjoining wet room, in shared accommodation with communal areas. The service liaised with the housing provider to maintain the environment.

Right Care

• The service had an over reliance on agency staff. Staffing levels and skill mix of staff did not enable people to take positive risks or promote what they could do, to ensure they had a fulfilling and meaningful everyday life.

• People were supported by staff to pursue some activities and their interests but were not always being supported to achieve their aspirations and goals or try new activities to enhance and enrich their lives.

• People could communicate with permanent staff and regular agency staff because they supported people consistently and understood their individual communication needs. However, relatives were not assured that agency staff were able to communicate and provide necessary home and community support to the same standard.

• People were not always sufficiently protected from the risk of harm. Although management and staff had completed safeguarding training they had not always recognised and mitigated risk.

• The provider and registered manager were consulting with local authorities and working on strategies for the recruitment and retention of staff.

• People were treated with kindness and staff respected their privacy and dignity.

Right culture

• Change had not been reliably implemented by the provider. The service had been impacted upon due to high turnover of staff and higher management changes. This meant effective support had not been provided for the registered manager and remaining staff at Honeywood.

• The provider was committed to learning lessons and driving improvements. They acknowledged the registered manager required more support to build and lead a strong, consistent workforce effectively. In turn enabling more time for the registered manager to gain increased oversight of systems and processes to ensure safe and best practice support to people.

• People and those important to them were involved in planning their care. However, information in people’s support plans and care records was inconsistent.

• The provider and registered manager acknowledged a lack of systems to assure themselves people were receiving the support they were entitled to at home and in the community. Management were also working towards developing a consistent work force and positive culture; to enrich people’s lives within the community as well as at home.

• Management was working with people, relatives, commissioners of care, safeguarding and other professionals in an open and transparent way to drive improvements. Relatives consistently reported how effective the registered manager’s communication was.

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 the service under the previous provider was good, published on 4 August 2018.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support, right care, right culture.

This was a planned inspection of a newly registered service. The inspection was prompted in part by concerns received about insufficient staffing levels, high use of agency staff and a lack of effective leadership. A decision was made for us to inspect to assure ourselves people were receiving safe, good quality care.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to staffing and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.