Inspection on 03/09/07 for Hinton Grange

This inspection was carried out on 3rd September 2007.

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 01/08/06

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 3rd September 2007 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.V350165.R01.S.doc Version 5.2 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.V350165.R01.S.doc Version 5.2 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 manager.hintongrange@careuk.com Care UK Community Partnerships Ltd Sharlene Van Tonder Care Home 60 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places 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.V350165.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Physical Disability - over 60 but under 65 years of age (PD) 1 Date of last inspection 1st August 2006 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 diagnoses. The first floor can be accessed by lift or stairs and provides residential and nursing care. Carers and nurses provide 24hr care in the home. Copies of inspection reports are kept in the foyer at Hinton Grange. The cost of placement is between £670.00 and £720.00 per week. Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection that took place on Monday 3rd September between the hours of 07:30 and 16:15. The Annual Quality Assurance Assessment (AQAA), 16 surveys from people living in the home, 4 staff and 15 relative surveys were received prior to the inspection. The manager was 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 inspected. A tour of the building was also made. What the service does well: What has improved since the last inspection? What they could do better: The homes recruitment process must include PoVA First or CRB checks prior to the commencement of employment of any member of staff. The use of CRB checks from a previous employer is not adequate. An immediate requirement was made on the day of inspection. Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 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.V350165.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5,6 Quality in this outcome area is good. People who live in the home have had their needs assessed before admission so that the home can ensure all their needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Hinton Grange does not offer intermediate care. Either the person or a member of the family tries to visit the home before a decision to move in is made. Some people living in the home said they had not had the opportunity to visit as they were admitted from hospital, although usually a family member had been able to. The manager said that people are encouraged to visit where possible. Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 9 Staff said that pre-admission assessments are made and the placing authority provides information where applicable. A copy of the homes statement of purpose, inspection reports and complaints procedure are kept in the entrance hall. Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,10,11 Quality in this outcome area is good. The principles of respect and privacy are put into practice. The health and social care needs of people in the home is documented, ensuring they can and are being met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has changed to a computer system so that all information in relation to care plans and risk assessments is kept on line. There were comprehensive details of all health and social care needs in the care plans and they had been reviewed. Risk assessments were detailed and provided information on how to defuse situations, especially in the unit for people with dementia. Other information such as nutrition charts, waterlow information that is completed on external forms, is kept in the file for each person living in the home, not on the Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 11 computer. These were seen during the inspection. Each person in the home is weighed at least monthly and the details are kept in a folder to allow easy access. Staff were seen completing the daily notes on the computer, which makes them readable and automatically details who wrote them. Information of the residents’ wishes in the event of their death continues to be recorded or noted that further discussions with relatives at a later date are needed. 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. As a result of the care taken by staff, several people who had come to the home with pressure areas now did not have them. There were details of pressure area care completed by the home, which included the date when the pressure area had healed. These records are not kept on the computer but in a separate file, which was inspected. This meets the requirement from the last inspection. The home has a key worker system both for carers and nurses in relation to each resident and the manager said that the home encourages input from them in the development of individual residents care plans. Staff spoken to confirmed this. Staff were seen to knock on bedroom doors before entering and treated people with dignity and respect. They were heard to encourage them in various daily life tasks, which helps maintain their independence as far as possible. Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. Residents are able to choose the activities they wish to participate in and keep in contact with friends and family, which ensures their interests and social contact are maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The food seen on the day of inspection was well presented, and appeared to be wholesome. The choice at lunchtime was mushroom soup, fish in sauce or Lancashire hotpot with mash or new potatoes, and vegetables; followed by lemon sponge with custard or Rice Pudding. Those eating the meals said they were tasty, and they appeared to enjoy them. One person visiting a relative said the meals were good and their relative had gained weight. One relative survey returned indicated disappointment that no food other than sandwiches, jellies etc were produced on site. The manager commented that there had always been a problem in retaining cooks and this system was working well, Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 13 although she acknowledged it would be nice to have some baking (such as cakes) on the premises. The home has regular input from a dietician for those with special dietary needs. 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. One person had eaten a banana before breakfast as he had woken very early and felt hungry. 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 said they wished to eat in their rooms, were assisted where necessary or requested. Activities are provided, although the co-ordinator was off sick at the time of the inspection. Those who wish to participate can do so, but people spoken to said they could choose not to be involved. Details of activities were displayed in each unit, but were out of date. Surveys completed commented on the lack of variety of activities and the manager said that the new activities coordinator is putting new things in place. Information in the home showed that there had been outside entertainers, keyboard player, 1-1 time, aromatherapy, church services and coffee mornings as examples of the activities provided. There have been 2 events to raise money for the activities fund. The manager said the activities co-ordinator is trying to make sure individuals get what they need and is looking at external places and events such as jazz nights at local pubs. In each unit the day and date is displayed, but these were incorrect and would confuse anyone who read them e.g. on dementia unit it was displayed as Friday August 17th and the activities programme was for week beginning 13th August. The manager said the activities co-ordinator usually updated these when she was in, but in her absence no-one had taken responsibility. Families spoken to during the inspection said they always felt welcome in the home. Surveys received from relatives and friends confirmed this. The manager said that a newsletter is sent regularly to update everyone with any news about staff changes or events to occur. This was seen during the inspection. The last relatives support group had been held on 15th March 2007 where PAT dogs and an Easter Egg hunt had been discussed. As a result of this the home now has a PAT dog come into the home. One comment made in the relative survey was that there were problems with the wheelchairs available when taking a relative outside. The manager said that those who need wheelchairs were measured for individual chairs now and that the home Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 14 holds very dew borrowable chairs. She said that the maintenance man does as much as possible to ensure the wheelchairs are safe. The footplates are not left on the wheelchairs as some people who live in the home have managed to get them into the corridors and bump into others causing wounds/grazes. The footplates are kept in a cupboard in the corridor and are available at any time. Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. The complaints procedure continues to be displayed in the home so that anyone can see the process to be undertaken. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff spoken to said they had completed elder abuse courses, some on the computer as part of induction and others attending a longer course covering difficult behaviour. There had been 3 official complaints and 7 minor complaints made in the home since the last inspection. The minor complaints are recorded in a book with all the necessary information. The formal complaints had been dealt with according to the homes complaints procedure. People in the home spoken to during the inspection and those who completed the surveys said they knew who to tell if they were unhappy. The information available to residents in relation to complaints is provided in the service users Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 16 guide and is displayed in the entrance hall at the home. It was clear and understandable. There is currently one investigation being undertaken for the Protection of Vulnerable Adults. There has been no outcome at this time. Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,22,23,24,25,26 Quality in this outcome area is good. Residents’ benefit from living in a home that is clean and has a maintenance programme. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Bedrooms had been decorated and the relative of one person living at the home confirmed this. Those who were sitting in their rooms during the inspection could reach the call system. 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. One relative said that they had been outside when the weather was fine. Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 18 Surveys returned by staff commented on the quality and need for replacement of furniture, curtains and other household items. The manager said that the home had received a grant from the local authority and curtains, matching duvets and pillowcases, and towels had been ordered with the money. The homes internal budget was to be used to replace carpets. She also said that over the last year there had been a continual replacement of crockery and cutlery, new hoist, new weighing scales, new bedrails and mattresses. The home was free from offensive odours during the inspection. This meets the requirement from the last inspection. The home now has an extra cleaner on duty at weekends so that the cleaning standards during the week are maintained. One room was dusty and on speaking to the manager she said that the occupant did not like people in her room, but she would try to get her to leave it for a short while so that the cleaner could get in. There were also comments about the standard of cleaning and clothing being dirty or going missing from the laundry in the surveys returned to the commission. The manager said that the nametags did get detached from some clothing, and the home has a pile of clothing that is available for staff and relatives to look through if something cannot be found. The manager said some underwear did become stained but various cleaning agents were used in the laundry to try to keep it clean. There were times when this did not work and she agreed that it could look dirty. Some rooms lacked personal items, but one relative said her husband had only been living in the home a short while, and some people said they had what they wanted and did not need any more. Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. Adequate PoVA First/CRB checks must be made on staff prior to the commencement of employment at the home to ensure the safety of people living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four staff files were inspected and there was 1 file where the Criminal Record Bureau (CRB) check had not been completed by this home, but had used one from a previous employer. The manager said that the company HR department had informed her that CRB’s could be used from a previous employer if they were less than 3 months old. (This member of staff started on 21/6/07 with the previous CRB dated 6/3/07.) This is not the case; all staff must have a CRB completed (or at least a PoVA First) before they commence employment. An immediate requirement was made. The manager said there was one other staff member who did not have a CRB from this home but she would rectify that immediately. She also informed her HR department that CRB’s couldn’t be used from previous employers. The number and skill mix of staff on duty is sufficient to meet the needs of the residents. There were seven staff on each floor including at least one Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 20 registered nurse. There was also one member of staff who provided the drinks, assisted at meal times and was used as a ‘float’. The manager, administrator, 3 cleaners, laundry person, kitchen attendant and maintenance person were also on duty. A number of surveys received from relatives and people who live in the home commented on a perceived lack of staff at weekends. In discussion with the manager she said that there were the same number of care and nursing staff as during the week, however the administration team and manager were not in the home and this may be significant. Staff said they had received the necessary statutory training including moving and handling, fire, infection control and abuse training. In the surveys staff had commented that those undertaking NVQ qualifications should receive financial recognition. The manager said that this should be coming into place but could not say when. The home has a new system of computer training for statutory courses, where information is given and then there is a test at the end. The staff cannot go to the next level until they have passed the test. In house training and external courses support this training. The training manager was spoken to and he said that all staff have to evidence their competency on the floor and are then signed off by him. If there are any concerns he will train staff individually to ensure they are able to undertake tasks. This meets the requirement from the last inspection. The surveys returned by relatives and those living in the home were complimentary of the staff and they felt it was their support that ‘provided a sense of worth’ & ‘extended the life expectancy of relative’. Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,36,37,38 Quality in this outcome area is good. The home is being managed in an open way with evidence of leadership and guidance to ensure residents receive consistently high levels of care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information from the AQAA and files seen during the inspection showed that tests are completed including PAT tests, fire drills, Legionella report, COSHH files, daily/weekly lighting and fire checks, accident and incident forms. The manager maintains an open door policy and this was commented on by staff and visitors. There were comments in the staff surveys returned that Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 22 indicated some felt the manager did not offer support at all times, however other comments were that the manager “was an inspiration and cares about those who live in the home”. One relative commented they were impressed with the manager. The manager undertakes care tasks to ensure staff and those who live in the home know she understands the issues. There are staff meetings, relative support meetings and resident meetings, although the manager said that these have not been as regular as she would have wished because she currently has no deputy. Staff receive supervision and there was evidence of this on files. Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 23 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 3 Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 24 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 OP29 Regulation 19 (4) (c) Requirement Adequate PoVA First/CRB checks must be made on staff prior to the commencement of employment at the home to ensure the safety of people living there. Timescale for action 03/09/07 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 OP14 Good Practice Recommendations Where information is provided for people living in the home in relation to day and date for example, the home must make certain it is correct to prevent confusion. Hinton Grange DS0000024273.V350165.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V350165.R01.S.doc Version 5.2 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. 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