Inspection on 09/07/07 for Hope House Care Home

This inspection was carried out on 9th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hope House Care Home 10/10/06

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 Unannounced Inspection 09:30 9 & 20th July 2007 th 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.V338699.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.V338699.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 vacant post 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.V338699.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. 10th October 2006 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 £477.95 per week. Additional charges are payable for hairdressing, newspapers and toiletries. A statement of purpose and service user guide was available to prospective residents and their relatives on request. Hope House Care Home DS0000065766.V338699.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 9th and 20th July 2007. A random unannounced inspection was carried out on the 19th January 2007 to monitor compliance with the requirements issued at the last key inspection in October last year. One completed survey was received from a resident, six from the relatives of residents and three from resident’s GPs. The surveys from relatives indicated that staff had the skills and experience to look after people properly. At the time of this inspection 31 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 nurse in charge and the manager regarding issues raised during the inspection. What the service does well: What has improved since the last inspection? A new manager was appointed earlier this year. Members of staff said she was approachable, chatted to the residents and ensured members of staff received appropriate training. Since her appointment there have also been improvements to the premises. These include new dining tables, chairs and new floor covering in the dining room, new armchairs and a carpet in the lounge, new furniture in the conservatory and the first floor lounge. Hope House Care Home DS0000065766.V338699.R01.S.doc Version 5.2 Page 6 Care plans identified the needs of residents and explained how these needs were to be met. Appropriate risk assessments were in place. Wound care records included information about the care and condition of the wound. Members of staff were observed to be following the correct procedure when giving out medication to the residents. When the care workers currently working towards NVQ level 2 in care have completed the training more than 50 of care workers will have an NVQ level 2 qualification. Regulation 37 reports have been sent to the Commission to report accidents when a resident has fallen out of bed. The manager must ensure that all such incidents continue to be reported to the Commission. 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. The summary of this inspection report can be made available in other formats on request. Hope House Care Home DS0000065766.V338699.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.V338699.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): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A thorough admissions procedure ensured sufficient information was obtained in order to identify the needs of each resident. EVIDENCE: The individual records of two residents admitted within the last year were inspected. Each contained a detailed pre-admission assessment. The manager or a senior member of staff visited and assessed prospective residents in hospital or their own home prior to admission. These assessments provided important information for the care plans. Prospective residents or their relatives 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.V338699.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal and healthcare needs of each resident were identified and met. Medication was managed safely. EVIDENCE: The individual care plans of three residents were inspected. These care plans identified the personal and healthcare needs of each resident and explained how these needs were met. Risk assessments relating to falls, pressure sores and nutrition were in place. Records relating to the care of pressure sores for one resident included detailed information about the care and condition of the sores. A written report about the care given to individual residents was completed during each shift. Care plans were reviewed monthly. Resident’s and their relatives were involved in care planning. Hope House Care Home DS0000065766.V338699.R01.S.doc Version 5.2 Page 10 Residents were registered with a GP and had access to other healthcare professionals. Records for the management of medication were in place. However, written instructions stating when medication prescribed ‘when required’ should be given to individual residents was not available. 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. Registered nurses and appropriately trained care workers were responsible for administering all medication. Personal care was carried out in the privacy of the resident’s own room or the bathroom. Members of staff were observed attending to residents in a polite and friendly manner. One resident said, “The staff are very good.” Hope House Care Home DS0000065766.V338699.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. 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. Resident’s decisions were respected and they were supported by care workers to have a fulfilling lifestyle. EVIDENCE: An activities co-ordinator was responsible for organising a range of leisure activities on four days each week. These included, painting, bingo, dominoes, jigsaws, indoor hoops and basketball, baking, pets as therapy, hand massage, manicures, and visits to the local park. An outside entertainer visited the home every month. Special occasions were celebrated including birthdays, Mothering Sunday and Easter. The activities co-ordinator was also oraganising a summer fayre. Visitors were welcomed into the home at anytime and offered refreshments. Local clergy regularly visited the home and gave communion to residents who wished to practice their religion. The activities co-ordinator said laminated hymn sheets were being prepared to enable residents to sing-a-long to a CD. Hope House Care Home DS0000065766.V338699.R01.S.doc Version 5.2 Page 12 Residents were encouraged to make decisions about their lifestyle and daily routine. One resident said she could choose when to get up and go to bed. Another resident said she woke up about 6am and was given a cup of tea. 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. 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. The menus were varied and offered choice. Fresh fruit was also available. The cook said he always served fresh vegetables. All the residents asked said the meals were good. The cook explained he was given a copy of the diet form completed for each resident. This form stated their individual likes and dislikes. Hope House Care Home DS0000065766.V338699.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. 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. Staff had the training necessary to ensure residents were protected adults. EVIDENCE: A copy of the complaints procedure was displayed in the home and included in the service user guide. Four complaints have been investigated since the last inspection. Details of the investigations and the action taken were available. One resident said wouldn’t feel able to complain to the staff or the manager and would tell her relatives if she had any complaints. Policies and procedures relating to the safeguarding of vulnerable adults were in place. Training on safeguarding vulnerable adults was included in the induction programme for new employees. This issue was discussed with four members of staff. They were aware of the procedure and said they would report any concerns immediately. Hope House Care Home DS0000065766.V338699.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises were well maintained and provided a comfortable and ‘homely’ environment for the residents. EVIDENCE: At the time of the inspection the home was clean, tidy, well maintained and free form offensive odour. The dining room has recently been improved with the purchase of new tables and chairs and new floor covering. There are also new armchairs and a carpet in the lounge, new furniture in the conservatory and the first floor lounge. One resident who completed a survey stated the home was always spotless. The grounds and gardens were well kept and accessible to all residents. Laundry facilities were appropriate for the size of the home. An infection control policy was in place. Hope House Care Home DS0000065766.V338699.R01.S.doc Version 5.2 Page 15 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 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Members of staff had the skills and knowledge necessary in order to meet the needs of the residents. Inadequate recruitment practices put residents at risk. EVIDENCE: Examination of the duty rota confirmed that a registered nurse was on duty on each shift along with five care workers from 8am to 2pm, four care workers from 2pm to 8pm and two care workers from 8pm to 8am. The manager explained that an additional care worker would be on duty to accompany a resident to out patients when necessary. One resident said there was enough staff and they came as quick as they could when she buzzed. However, one resident wrote on the survey that members of staff were run off their feet and a care worker said it was hard work in the mornings. 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, infection control, basic food hygiene, first aid, fire safety and safe handling of medication. Seven care workers had NVQ level 2 qualification in care and four care workers had almost completed their training for this qualification. In addition to this a further two care workers have enrolled for NVQ level 3 training. Hope House Care Home DS0000065766.V338699.R01.S.doc Version 5.2 Page 16 The files of nine members of staff appointed since the last inspection were examined. Seven of these files indicated that all the required pre-employment checks to ensure protection of the residents had been completed prior to appointment. However, one employee appointed by the previous manager had been allowed to start working at the home before a POVA/CRB check had been obtained. A member of staff appointed earlier this year had been allowed to start working before two references were received. Photocopies of two testimonials had been accepted for one employee and one of these was dated more than a year before her application to work at Hope House. The close friend of another employee had supplied a reference. The manager was advised to ensure references were recent and were not requested from close friends of the applicant. Hope House Care Home DS0000065766.V338699.R01.S.doc Version 5.2 Page 17 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): 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is effectively managed. The views of residents and their relatives are considered when decisions about the care and facilities provided at the home are made. EVIDENCE: The manager is an experienced nurse and is in the process of applying for registration with the Commission. She is working towards the NVQ level 4 ‘registered Manager’s Award’ and maintains an up to date knowledge of current practice by reading appropriate journals and using the Internet. The home has achieved the nationally accredited Investors in People award. The relatives of residents had completed anonymous satisfaction questionnaires in December 2006 and May 2007. The manager had evaluated Hope House Care Home DS0000065766.V338699.R01.S.doc Version 5.2 Page 18 these questionnaires and created a bar chart to identify areas for improvement. The manager explained that questionnaires would be given to residents within the next few months. Meetings for relatives were held in the evenings. Minutes of the last meeting held on 24 April 2007 were available. At this meeting cheese and wine was served. Issues discussed included, care of residents, having a ‘Songs of Praise’ activity and the home environment and the gardens. Meetings for resdients were held about every three months. Minutes of the last meeting held on 17 April 2007 were seen. The manager stays until 8pm on Wednesdays to enable visitors to discuss any issues relating to the care and facilities provided at the home. A notice advertising this is displayed in the home. 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 accident records and reports sent to the Commission under regulation 37 that a significant number of accidents were due to residents falling out of bed. An objective risk assessment was not in use, which clearly determined the most appropriate equipment to use in order to prevent individual residents from falling out of bed. Where crash mats were used for residents at risk of injury from falling out of bed risk assessments for their use had not been carried out. Fire alarms and fire doors were tested weekly and emergency lighting monthly. A fire risk assessment dated April 2007 was in place. Fire drills took place monthly and a staff attendance record was kept. Hot water temperatures, wheelchairs and window restrictors were checked monthly. Senior members of staff who had received appropriate training inspected bed rails weekly. Records of all these checks were available. Records of the routine servicing of equipment were seen. These included up to date gas safety and electrical installation certificates. The testing of small electrical appliances had been carried out in March 2007. The kitchen was clean and tidy. Records maintained by the cook included fridge, freezer and food delivery, preparation and serving temperatures. A cleaning schedule was also available. Safety notices were displayed in the home. Hope House Care Home DS0000065766.V338699.R01.S.doc Version 5.2 Page 19 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 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 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 X 3 X 3 X X 2 Hope House Care Home DS0000065766.V338699.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? YES 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 OP29 Standard Regulation 19(1) Schedule 2 13(4)(c) OP38 Requirement To ensure residents are protected from abuse all the necessary pre-employment checks must be carried out prior to appointment. To prevent individual residents from falling out of bed an objective risk assessment must be completed to determine the most appropriate equipment to use. This assessment must establish if the risk to the resident is greater with or without the use of bed rails. A risk assessment must also be completed for the use of crash mats. Timescale of 16/02/07 not met. Timescale for action 27/07/07 2 31/08/07 Hope House Care Home DS0000065766.V338699.R01.S.doc Version 5.2 Page 21 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 OP9 2 OP29 Refer to Standard Good Practice Recommendations Written instructions should be available individual residents stating when medication prescribed ‘when required’ should be given. To ensure residents are protected from abuse references for new employees should be recent and not supplied by close friends of the applicant. 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