Inspection on 01/08/06 for Hinton Grange

This inspection was carried out on 1st August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hinton Grange 21/12/09

Hinton Grange 17/08/09

Hinton Grange 04/08/09

Hinton Grange 17/06/08

Hinton Grange 03/09/07

Hinton Grange 20/12/05

Hinton Grange 05/07/05

Hinton Grange 04/01/05

Hinton Grange 16/07/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Hinton Grange Bullen Close Cambridge Cambridgeshire CB1 4YU Lead Inspector Mrs Alison Hilton Key Unannounced Inspection 1st August 2006 07:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hinton Grange Address Bullen Close Cambridge Cambridgeshire CB1 4YU Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01223 246360 01223 246361 manger.hintongrange@creul.com Care UK Community Partnerships Limited Sharlene Van Tonder Care Home 60 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (28), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (30), Old age, not falling within any other category (30), Physical disability (1), Physical disability over 65 years of age (29) Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. Mental Disorder, excluding learning disability or dementia - over 65 years of age (MD(E)) not exceeding 30 places. Physical disability over 65 years of age (PD(E)) not exceeding 29 places. Old age not falling within any other category (OP) not exceeding 30 places. Dementia over 65 years of age (DE(E)) 28 places Dementia under 65 years of age (DE) 2 named individuals Physical Disability - over 60 but under 65 years of age (PD) 1 Date of last inspection 20th December 2005 Brief Description of the Service: Hinton Grange is a purpose built home registered to provide accommodation, support and nursing care for up to 60 people over the age of 65 years, some of whom have a mental disorder or have been diagnosed with dementia. It is a two-storey building, surrounded by safe, well maintained enclosed gardens, and is situated in the suburbs of Cambridge close to local amenities and shops. Public transport to the city of Cambridge is readily available. Hinton Grange Care Home provides 52 single and 4 double occupancy bedrooms some of which have en-suite facilities. There are 4 separate bathrooms, 4 separate shower facilities and ten toilets. The home is on two floors. The ground floor has the extra care unit, which caters for residents with dementia or other mental health diagnosis. The first floor can be accessed by lift or stairs and provides residential and nursing care. Carers and nurses who provide 24hr care staff the home. The cost of placement is between £ 660.00 and £690.00 per week. Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Tuesday 1st August 2006 between the hours of 07:30 and 17:00. The manager and deputy were both present during the inspection. Residents, visitors, staff and management were spoken to as part of the inspection process. Staff and resident files together with other paperwork and records were also inspected. A tour of the building was also made. Questionnaires were sent out to residents and relatives. 5 resident and 6 relative questionnaires were returned prior to the inspection. Some comments made on the residents’ forms included the need for more activities, the meals provided are “not the standard they should be”, three residents said they did not know how to make a complaint but all knew who to speak to if they were not happy, and there were differing views on the cleanliness in the home. The relative questionnaires showed that all felt welcomed at the home and able to see their relative in private. Most (5/6) felt they were kept informed and consulted about the care received by their relative. 4/6 felt there were always sufficient staff on duty. 5/6 were satisfied with the overall care provided. One relative had made comments, which were discussed by telephone and also during the inspection with the manager. What the service does well: The large grounds continue to be well kept, with wooden tables and chairs available for residents when the weather permits. Staff said that the home continues to offer a variety of training to enable them to meet the needs of residents. Relatives spoken to during the inspection said that the care provided by the home was excellent. The home had been flexible during the very hot weather in allowing staff to wear non-uniform clothing, as they do not have a summer weight uniform. Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home ensures that potential residents needs are assessed prior to their admission to the home to make certain it can provide the necessary care. EVIDENCE: Standard six is not applicable, as the home does not offer intermediate care. The statement of purpose is in the hallway of the home and there have been no changes since the last inspection. Every prospective resident is provided with a copy of the statement of purpose and residents guide, which contain all the necessary details. The manager said that prospective residents and their families were encouraged to visit where possible. However since many are discharged straight from hospital that is not always possible (for the resident), but on Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 9 talking to visiting relatives and looking at resident questionnaires, it was evident that the family had usually visited the home prior to admission. There was evidence on the four files seen during the inspection that preadmission assessments had been completed by a competent and qualified person. There were other assessments and discharge letters from the hospitals. A copy of the homes statement of purpose and inspection reports on the home are kept in the entrance hall. Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,10,11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. There needs to be an improvement in the arrangements to meet the health care needs of residents in relation to the completion of appropriate charts. These shortfalls have the potential to place residents at risk. The principles of respect and privacy are put into practice. EVIDENCE: Four residents files were inspected, two from each floor. There were comprehensive details of all health and social care needs in the care plans and they had been reviewed. The home is changing the computer system so that all information is kept on line. Currently the staff are transferring information from files to the system and therefore during the inspection some information was provided in paper files, and some on the computer. Information of the residents’ wishes in the event of their death had been recorded or noted that further discussions with relatives at a later date were needed. Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 11 When staff were asked about individual residents care needs, they were knowledgeable, and could provide the inspector with details set out in the residents plan of care. There was concern that on one file there was a plan of care in relation to a pressure area. Part of this plan was the necessary completion of a chart showing when the dressing on the wound had been changed. This was supposed to be done every 2/3 days. Records completed showed entries for 21/6, 25/6 and 7/7. This inspection took place on 1/8. Staff must be made aware that where charts are provided (such as for dressing changes in the case of pressure sores), they must be completed to provide evidence that the task has been done and the frequency maintained as per the care plan. (A requirement has been made in this report.) The home has a key worker system both for carers and nurses in relation to each resident and the manager said that the home intends to encourage more input from them in the development of individual residents care plans. Staff were seen to knock on residents’ bedroom doors before entering and treated them with respect. Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents are able to choose the activities they wish to participate in and keep in contact with friends and family. EVIDENCE: The food seen on the day of inspection was well presented, and appeared to be wholesome. The choice at lunchtime was asparagus soup, shepherds pie or sweet and sour chicken with mash or new potatoes, rice and vegetables. This was followed by Eve’s Pudding or plum pie with custard. The manager stated that the home cooks extra food so that residents can have second helpings if they wish. One resident has food brought in by his family, as he was not keen on the main meals provided by the home. He did admit that he was difficult to please and there were a few meals he enjoyed cooked in the home. The manager said that she had talked with the resident and his family but the issue of meals continued. The home has cook/chill meals and does not have a chef/cook on site. The kitchens are only used to re heat the main meals and to prepare toast and other light snacks. The home has regular input from a dietician for those with special dietary needs. It was discussed with the manager that on Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 13 the extra care unit the inspector observed residents having biscuits and tea prior to breakfast. If this was a choice they made that was acceptable but there appeared to be no alternative offered. The manager said that residents still ate breakfast but she would talk to the dietician about alternative foods being provided. The manager said that fresh fruit is now provided at coffee and tea breaks together with cakes and biscuits. This method means that fruit is not left to go off and all residents are offered the choice every day. The dining rooms provided pleasant, clean and companionable areas in which to eat. Those who needed assistance to eat were helped on a 1-1 basis. Some residents, who choose to eat in their rooms, were also assisted where necessary. Activities are provided and open to those who wish to participate allowing interests to be followed. Details of activities were displayed in each unit. Residents said they could choose to participate in activities if they wish. Questionnaires completed commented on the lack of variety of activities and the manager said that they have a vacancy for an activities co-ordinator. The home has two other part time co-ordinators but the manager is aware the hours are not enough to provide the necessary level or variety of activities for the number and needs of the residents. Information in the pre-inspection questionnaire showed that the home has outside entertainers, keyboard player, 1-1 time, aromatherapy and coffee mornings as examples of the activities provided. During the inspection there was a relatives meeting held at the home and there were discussions on how to encourage more relatives to attend. Families spoken to during the inspection said they always felt welcome in the home. Questionnaires received from relatives and friends confirmed this. Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The complaints procedure continues to be displayed in the home so that residents and visitors can see the process to be undertaken. EVIDENCE: Most staff spoken to said they had completed elder abuse courses. One staff member said she was attending a course next week. The manager is aware that staff must complete a course on elder abuse within six months of employment. There had been no official complaints made in the home since the last inspection. Residents spoken to during the inspection and those who completed the questionnaires said they knew who to tell if they were unhappy, although three questionnaires indicated that the residents were not aware of the complaints procedure. Two relatives who responded to the questionnaires stated they were not aware of the homes complaints procedure. The manager said that the information available to residents in relation to complaints is provided in the service users guide and is displayed in the entrance hall at the home. It was clear and understandable. Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 15 There was one issue detailed in a relative questionnaire. The relative was spoken to and agreed the information could be discussed with the manager at the time of inspection. The manager was already aware of the concern and had spoken to the family. It was felt that the issue had been dealt with appropriately by the home. Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents’ benefit from living in a home that is clean and has a maintenance programme. EVIDENCE: There was an unhygienic and unpleasant odour in one of the bedrooms in the home. This was discussed with the manager who said that the carpet is cleaned every day, but because of a problem of incontinence the room is hard to keep fresh. The manager said that after talking to the family the home will consider a change of flooring. On the day of inspection one shower was out of commission due to a floor not being laid properly. The fault was being dealt with at the time of the inspection. Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 17 In general the home is well maintained but one bedroom seen during the inspection was in need of re-decoration. In the pre-inspection questionnaire there were details of the decoration completed in the home but the manager is aware that some bedrooms that are occupied are in need of urgent redecoration. The garden and patio area outside is easily accessible and secure. There were wooden tables and seating for residents and a rail to assist with mobility when outside. Bedrooms were personalised with lots of individual belongings. Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home makes appropriate checks on prospective staff and the recruitment procedures are followed. The competency of some staff is not sufficient to meet the needs of the residents. EVIDENCE: On the four staff files inspected it was evident that the home makes appropriate checks on prospective staff and the recruitment procedures are followed. The number and skill mix of staff on duty is sufficient to meet the needs of the residents. Staff spoken to during the inspection said they had received the statutory training and had completed other courses to enable them to competently care for residents. Staff said they had received the necessary statutory training including moving and handling, fire, infection control and abuse training. The manager confirmed that most staff had received training in POVA. Although a list of completed training was on individual staff members files, when details of the tests completed to gain those qualifications were examined, it was evident that some staff had failed to answer many of the questions correctly. The manager Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 19 said that the trainer was aware that some staff needed extra tuition but this was not on the file and staff should only pass the course when they can show they are competent. (A requirement has been made in this report.) Details provided in the pre-inspection questionnaire indicate that 14 staff have NVQ Level 2, which is 44 of the care staff. There is an issue about funding and the manager is making every effort to get other care staff onto the NVQ programme. Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,34,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is being managed in an open way with evidence of leadership and guidance to ensure residents receive consistently high levels of care. EVIDENCE: The manager was recently away from the home and there had been comments made to the inspector that the deputy had managed very well. Staff, residents and visitors commented that the home is run in an open and inclusive way. Questionnaires returned showed that most relatives felt involved and residents were clear whom they would talk to if unhappy about any aspect of their care. The manager and her deputy work hard to improve the quality of life for residents and to improve the service provided. Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 21 Residents knew who the manager was when she came into the dining areas or lounges and it was evident they were pleased to see her. The home does not hold savings, but does hold personal allowances for some residents. Records are kept of the management of personal allowances and two were inspected and found to be correct. The fire logs and water temperatures had been completed. The fridge in the downstairs dining room needs to have the temperature taken regularly. All fire exits were free from obstruction. Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 3 X X 3 Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP8 Regulation 17 Schedule 3 16 (2) (k) 18 (1) (a) Requirement Timescale for action 02/08/06 2 3 OP26 OP30 The registered person must maintain records as in Schedule 3. (This is in relation to the completion of charts for pressure area dressings.) The registered person must 02/08/06 ensure the home is kept free of offensive odours. The registered person must 30/09/06 ensure that all staff receive mandatory training and that they are competent when the course has been completed. (Staff should not be signed as having completed a course unless they can show a reasonable level of competency). RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP12 Good Practice Recommendations The registered person should ensure that residents have a DS0000024273.V293030.R01.S.doc Version 5.1 Page 24 Hinton Grange 2 OP14 suitable and varied activities programme available. The registered person should ensure residents have choices in areas such as pre-breakfast snacks. This is in relation to residents in the extra care unit all being given biscuits with their drinks. There was no other choice available. Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hinton Grange DS0000024273.V293030.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!