Inspection on 10/10/06 for Hope House Care Home

This inspection was carried out on 10th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Hope House Care Home 09/07/07

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Hope House Care Home Rishton Road Clayton-le-moors Accrington Lancashire BB5 5PN Lead Inspector Mrs Susan Hargreaves Key Unannounced Inspection 10:00 10th October 2006 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 Hope House Care Home DS0000065766.V309936.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. Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hope House Care Home Address Rishton Road Clayton-le-moors Accrington Lancashire BB5 5PN 01254 397220 01254 381521 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) www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42), Physical disability (20), Terminally ill (4) of places Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. Within the overall total of 42 a maximum of 20 service users requiring nursing care who fall into the category of either OP or PD Within the overall total of 42 a maximum of 28 service users requiring personal care who fall into the category of OP. Within the overall total of 42 a maximum of 4 service users requiring terminal care. Staffing for service users requiring nursing care will be in accordance with Notice issued 17th May 2000. The registered provider should employ a care manager who is a registered first level nurse. The registered provider, should employ a suitably qualified and experienced person who is registered with the Commission for Social Care Inspection as manager of Hope House Care Home. Date of last inspection Brief Description of the Service: Hope House is a purpose built house set in its own grounds. It is situated in Clayton-Le-Moors opposite a park and close to local amenities. The home offers 24-hour personal and nursing care for up to 42 residents. Accommodation is provided in single rooms, all except one room have en-suite facilities. There is a spacious communal lounge with dining area on the ground floor. There is also a conservatory on the ground floor. Another lounge is situated on the first floor. A passenger lift facilitates access to all areas of the home. An enclosed garden with seating is easily accessible to all residents. A parking area is available for use by visitors and staff. Hope House is part of a larger company providing care throughout the UK. The current fees charged at Hope House are £400 to £450 per week. Additional charges are payable for hairdressing, optical and dental care. A statement of purpose and service user guide was available to prospective residents and their relatives on request. Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at Hope House on the 10th and 13th October 2006. No additional visits have been made since the last inspection. However, the home’s manager has investigated two complaints about staffing levels made to the Commission for Social Care Inspection. In response to the first complaint the manager informed the commission that the home had been short staffed due to staff sickness. The manager replied directly to the complainant in response to the second complaint. At the time of this inspection 38 residents were living at the home. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty, residents and visitors were spoken to. Discussions also took place with the operations manager and the home manager regarding issues raised during the inspection. What the service does well: What has improved since the last inspection? What they could do better: It is essential that care planning be improved to ensure care plans address all the identified needs of each resident. A falls risk assessment must be carried out for each resident on admission. Nutritional risk assessments should clearly identify the risk factors and the overall level of risk. Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 6 It is of serious concern that poor practice was observed in the administration of medication. Staff must not leave medication unattended for the resident to take with or after a meal. This increases the risk of error and puts other residents at risk if they mistakenly take this medication. It is important that residents are bathed regularly. Urgent action must be taken in order to provide a sufficient number of assisted baths in order to meet the personal hygiene needs of all residents. To ensure the needs of all residents are fully met serious consideration must be given to increasing staffing levels. This has been the subject of recent two complaints. Residents must not be kept waiting when they need to visit the toilet. The problem of staff absence must be addressed. Fifty percent of care assistants must obtain NVQ qualifications in care at level 2 or above. It was of serious concern to find evidence of four incidents since 19 September when residents had fallen out of bed. Urgent action must be taken to prevent residents from falling out of bed. The commission must be informed as soon as is possible if any resident falls out of bed. It is vital that the health and safety of residents is promoted by ensuring that the testing of small electrical appliances takes place annually. Wheelchairs without footplates must not be used. Where residents do not wish to use footplates, this must be subject to a risk assessment and recorded in individual care plans. 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. Hope House Care Home DS0000065766.V309936.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 Hope House Care Home DS0000065766.V309936.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admission procedures were thorough. EVIDENCE: The individual records of four residents were inspected. A pre-admission assessment had been completed for three of these residents. The other resident had been admitted for respite care in an emergency and the assessment was carried out on admission. These assessments provided important information for the care plans. Prospective residents received confirmation in writing that their needs could be met at the home. Standard 6 is not applicable to this service. Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 9 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, 9,and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Privacy and dignity was promoted for all residents. Care plans did not contain detailed information relating to all aspects of care. Medication was generally well managed but a procedure used for the administration of medication put residents at risk. EVIDENCE: The individual care plans of four residents were inspected. Three of these care plans identified the needs of the resident and explained how these needs were met. However, the care plan for the resident admitted for respite care did not address all identified needs e.g. pressure relief or nutrition. A falls risk assessment had not been carried out for the resident admitted for respite care. The risk assessment relating to nutrition for one resident did not clearly identify the risk factors or the overall level of risk. Wound care records for one resident were completed at irregular intervals but care plan clearly stated this sore should be redressed every other day. This made if difficult to determine how often the dressings were actually changed. A written report about the care given to individual residents was completed during each shift. Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 10 Care plans were reviewed monthly. Resident’s and their relatives were involved in care planning. Residents were registered with a GP and had access to other healthcare professionals. Records relating to the management of medication were in place. Medication was stored in a locked trolley and cupboards inside locked utility rooms, one on each floor of the home. The temperature of these areas was checked and recorded daily. Controlled drugs were stored correctly and a stock check was satisfactory. At the time of the inspection none of the residents were self-medicating. Registered nurses and appropriately trained care assistants were responsible for administering all medication. Poor practice was observed at lunchtime on the day of the inspection when medication was left on the dining table for a resident. This practice increases the risk of error and must cease. Personal care was carried out in private. Members of staff were observed attending to residents in a friendly and professional manner. Three members of staff explained in detail how they promoted privacy and dignity for all residents. One resident said, “The staff look after me, they help with all my needs.” Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 11 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Leisure activities were organised for residents. Visitors were welcomed into the home at anytime. The daily routine met the needs and preferences of residents. Menus offered variety and choice. EVIDENCE: Social activities were advertised in the home. These included dominoes, bingo, art and craft, hand massage and manicures, chatting circle and visits to the local park. However, discussion with residents and the activities co-ordinator confirmed that only five or six residents regularly took part in these activities. An entertainer visited the home monthly. Campaign days and special occasions were celebrated. These included world Alzheimer’s day and grandparent’s day. A trip to Blackpool illuminations had been arranged for later this month. Residents said that their relatives and friends were welcome to visit at anytime and offered refreshments. Local clergy regularly visited the home and gave communion to residents who wished to practice their religion. Residents were encouraged to make decisions about their lifestyle and daily routine. All the residents asked said they could choose when to get up and go Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 12 to bed. Several residents said they liked to get up early. Residents were encouraged to personalise their rooms with photographs, ornaments etc. The meal served at lunchtime on the first day of the inspection was wholesome and appetising. The menus were varied and offered choice. Lunchtime was unhurried allowing residents time to chat and enjoy their meal. Members of staff were observed assisting residents in a sensitive and patient manner. All the residents asked except one said the meals were good. Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 13 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints were taken seriously and investigated. Appropriate policies and procedures were in place to ensure the protection of residents at the home EVIDENCE: A copy of the complaints procedure was displayed in the home and included in the service user guide. Two complaints have been made to the Commission since the last inspection. The home’s manager was asked to investigate these complaints. Details of the investigations and the action taken were seen. Policies and procedures relating to the protection of vulnerable adults were in place. This issue was discussed with three members of staff. They were aware of the procedure and said they would report any concerns immediately. Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 14 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, 21 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was clean and comfortable and provided a homely environment for the residents. Bathing facilities were not sufficient for the number of residents living at the home. Laundry facilities were appropriate for the size of the home. EVIDENCE: At the time of the inspection the home was clean, tidy, free from offensive odour and well maintained. This provided a safe and comfortable environment for the residents. A planned programme for the routine redecoration and refurbishment of the premises was in place in order to maintain and improve the environment at the home. The grounds and gardens were well kept and accessible to all residents. However, at the time of the inspection only one bathroom was usable. The other bathrooms and shower were out of order or did not have an assisted bath. It was evident from the inspection of care records that all residents were not being bathed regularly. One resident had been bathed only three times since the 1st September. Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 15 Laundry facilities were appropriate for the size of the home. control policy was in place. An infection Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 16 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels need reviewing to ensure these are sufficient to fully meet the assessed needs of all residents. Recruitment procedures were thorough and helped to protect residents from harm. Although training was encouraged less than fifty percent of care staff had an NVQ qualification in care. EVIDENCE: Examination of the duty rota and discussion with staff confirmed that staffing levels might not be sufficient to fully meet the assessed needs of the residents. Two members of staff said that staff absence was a problem and they either worked short staffed or agency staff was used. One member of staff said the workload was hard and staff morale was low. This member of staff also said that residents were sometimes kept waiting when they asked to be taken to the toilet. Another member of staff said that it would be a problem if the night staff did not get a number of residents up in the mornings. It was also recorded in the minutes of the last residents meeting that one resident had felt rushed in the mornings because carers hadn’t the time to give proper care. It was evident from discussion with members of staff and the manager that training was encouraged. This included induction training for new employees, moving and handling, first aid, basic food hygiene, health and safety and fire prevention. Five members of staff had an NVQ level 2 in care and one had NVQ level 3 (40 ). In addition to this another member of staff was working towards NVQ level 2. Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 17 The files of eight members of staff appointed since the last inspection were examined. These files indicated that all the required pre-employment checks to ensure protection of the residents had been completed prior to appointment. Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 18 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, 35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents and their relatives were consulted about the quality of the care and services provided at the home. Procedures in place do not properly safeguard the health, safety and welfare of residents. EVIDENCE: The manager is leaving at the end of October and until a replacement is appointed the care manager, who is an experienced nurse, will be responsible for managing the home. The home had achieved the nationally accredited Investors in People award. Anonymous satisfaction questionnaires were distributed to residents and their relatives annually. The manager carried out monthly audits, which covered all aspects of the care and services provided at the home. Residents meetings were held regularly. At the meeting held in September residents discussed Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 19 meals, the time the evening drinks were served, staffing and the care provided. An annual development plan to help monitor the quality of the service and further improve outcomes for residents was in place. Records of transactions involving resident’s money were seen to up to date and accurate. It was evident from examination of the accident records that there had been four incidents since 19 September 2006 when residents had fallen out of bed. In fact one resident had fallen out of bed on two separate occasions. Although crash mats were in use for a number of residents considered to be at risk bed rails were not. This issue was discussed with the operations manager and the home manager and they were informed that urgent action must be taken to address this problem. The manager was also informed that she must notify the commission immediately if any of the residents fell out of bed. Fire alarms were tested weekly and emergency lighting monthly. A fire risk assessment was in place. Fire drills took place regularly and a staff attendance record was kept. Records of the routine servicing of equipment were seen. These included up to date gas safety and electrical installation certificates. However, the testing of small electrical appliances had not been carried out since July 2005. At the time of the inspection wheelchairs without footplates were in use. Where service users do not wish to use footplates, this must be subject to a risk assessment and recorded in individual care plans. The kitchen was clean and tidy. Records maintained by the cook included fridge, freezer and food temperatures. Safety notices were displayed in the home. Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 20 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 3 Standard No 16 17 18 Score 3 X 1 X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 X 3 X 3 X X 2 Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? 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. OP7 Standard Regulation 15(1) Timescale for action Unless it is impracticable to carry 17/11/06 out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan as to how the service user’s needs in respect of his health and welfare are to be met. The registered person shall 17/11/06 ensure that (c) unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. The registered person shall – (a) 13/10/06 maintain in respect of each service user a record which includes the information, documents and other records specified in Schedule 3 relating to the service user. Schedule 3 (n) a record of the incidence of pressure sores and of the treatment provided to the service user. Detailed records must be kept of each dressing change. The registered person shall make 10/10/06 arrangements for the recording, DS0000065766.V309936.R01.S.doc Version 5.2 Page 22 Requirement 2. OP7 13(4)(c) 3. OP8 17(1)(a) Schedule 3 4. OP9 Hope House Care Home 13(2) 5. OP21 23(2)(j) 6. OP27 18(1)(a) 7. OP28 18(1)(c) (i)(ii) 8. OP38 13(6) handling, safekeeping, safe administration and disposal of medicines received into the care home. The registered person shall having regard tot the number and needs of service users ensure that (j) there are provided at appropriate places in the premises sufficient numbers of lavatories and of wash-basins, baths and showers fitted with hot and cold water supply. The registered person shall, having regard to the size of the home, the statement of purpose and the number and needs of service users – (a) ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. The registered person shall, having regard to the size of the home, the statement of purpose and the number and needs of service users – (c) ensure that persons employed by the registered person to work at the care home receive – (i)training appropriate to the work they are to perform; and (ii)suitable assistance, including time off work, for the purpose of obtaining further qualifications appropriate to such work. 50 of care assistants must have an NVQ level 2 or above. The registered person shall make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. The registered person shall give DS0000065766.V309936.R01.S.doc 29/12/06 01/12/06 30/03/07 27/10/06 9. Hope House Care Home 37(1) 13/10/06 Page 23 Version 5.2 OP38 (e) 10. OP38 13(4)(a) 11. OP38 13(5) notice to the commission without delay of the occurrence of, (e) any event in the care home which adversely affects the wellbeing or safety of any service user. The commission must be informed without delay if any of the residents fall out of bed. The registered person shall 01/12/06 ensure that (a) all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their health and safety. The registered person shall make 27/10/06 suitable arrangements to provide a safe system for moving and handling residents. 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. OP8 Refer to Standard Good Practice Recommendations Nutritional risk assessments should clearly identify the risk factors and the overall level of risk. Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 Hope House Care Home DS0000065766.V309936.R01.S.doc Version 5.2 Page 25 - 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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