Inspection on 30/01/06 for Hopes Green Care Centre

This inspection was carried out on 30th January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hopes Green Care Centre 16/07/09

Hopes Green Care Centre 11/02/09

Hopes Green Care Centre 01/02/08

Hopes Green Care Centre 27/02/07

Hopes Green Care Centre 12/06/06

Hopes Green Care Centre 23/06/05

Hopes Green Care Centre 19/02/05

Hopes Green Care Centre 09/07/04

Hopes Green Care Centre 09/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Hopes Green Care Centre 16 Brook Road Benfleet Essex SS7 5JA Lead Inspector Carolyn Delaney Unannounced Inspection 30th January 2006 08:00 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 Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 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. Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hopes Green Care Centre Address 16 Brook Road Benfleet Essex SS7 5JA 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) 01268 752327 01268 755518 Exceler Healthcare Services Limited Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Total number of service users for whom personal care is to be provided shall not exceed 50. Personal care to be provided to no more than fifty service users over the age of 65 years. 23rd June 2005. Date of last inspection Brief Description of the Service: Hopes Green Care Centre is a large home providing accommodation and personal care for up to fifty older people aged over 65 years of age who need assistance with personal care. The homes facilities include several communal lounge/dining areas and fifty single bedrooms all with ensuite facilities. The home is situated within easy walking distance of local shops and amenities, with Southend and Canvey Island main shopping centres a short car or train journey away. There are good bus and train links to the area.The garden enables service users to access a patio area and garden safely. There is ample car parking for visitors and the home has adequate wheelchair accessibility throughout. Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine inspection carried out between 08.00 and 18.00 on 30th January 2006. Inspector’s Michelle Love and lead inspector Carolyn Delaney carried out the inspection. Records including assessments, care plans, daily care notes and risk assessment documents in respect of seven people living at the home were examined. Eight residents and two relatives were spoken with during the inspection. The relatives of five residents at the home were contacted by post so as to offer them the opportunity to make comments about the services provided by the home. Four responses were received and these responses have been included in the final version of this report. Five members of staff including the acting manager were spoken with and a number of records including duty rota’s and staff recruitment files were examined. A tour of the premises was carried out and a number of records in respect of the general maintenance and regulatory checks for gas, electric and mechanical equipment were assessed. Key standards as identified in the intended outcomes sections of this report are inspected at least once every twelve months. Where key standards have not been inspected on this occasion they will have been inspected at the previous inspection. Reports in respect of previous inspections may be accessed via the Commissions website www.csci.org.uk. What the service does well: Hopes Green provides a safe, comfortable and homely environment for the people who live there. Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 6 Residents who were spoken with said that they were happy with the services provide by the home. Three of the four people who responded to the questionnaire sent out by the Commission commented that they were satisfied overall with the care provided by the home. What has improved since the last inspection? What they could do better: Information about the people living at the home and the care and treatment that they need could be better recorded so that all staff working at the home can have up to date and accurate information in order to be able to best care for residents. The home must provide a suitable range of activities and stimulation for the people living at the home. Residents could be better supported so that they can take their meals where they chose. The records in relation to complaints made about the home and the services and facilities provided should be kept up to date and made available to inspectors upon request. One relative who responded to the survey sent out by the Commission was unhappy with the care provided by the home and the way in which concerns raised were dealt with by staff. Three of the four people who responded to the survey questionnaire commented that there were not always sufficient members of staff on duty at the home. Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 7 The way in which staff are recruited, trained and supported must be reviewed so that all staff working at the home have been subject to all of the required checks in respect of their suitability to work with elderly people. Staff must receive training so that they can best care for the people living at the home and protect them from harm or abuse. 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. Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 8 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 Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 9 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 Information in relation to the assessed needs of people to be admitted to the home was not consistently recorded so as to determine that the home could meet these needs. EVIDENCE: Pre-admission assessment records for two people who had been recently admitted into the home were sampled and examined. Records were in the main detailed, however not all of the information as identified in social services assessment was included and where some care needs were identified how these needs affected the persons abilities in relation to carrying out daily activities was clearly recorded. For example one residents preference in relation of daily routines and activities were not recorded and for another resident who had been recently admitted to the home there were no details recorded in respect this persons medication. Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 10 There were no assessments in respect of individual’s dependency levels so as to determine that the home can meet the needs of the people to be admitted and those people already living at the home. Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 11 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, 10 & 11 Information in relation to the care, safety and welfare of people living at the home is not consistently recorded. Staff do not consistently store, administer medicines or keep accurate records in accordance with the homes policies and procedures and other current legislation. Staff were observed to act in a supportive manner and to treat residents with respect and dignity. Residents wishes in relation to end of life issues and preferred arrangements following death are not consistently recorded. EVIDENCE: Care plans; risk assessment and management plans and daily care notes were examined for seven people living at the home. Care plans were not written in a consistent manner and many did not include details in relation to all of the assessed needs and how these needs affected the individuals ability to carry out daily activities or how staff were to assist Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 12 and support residents in meeting their needs. For example residents preferences for getting up and going to bed, bathing etc were not recorded. The assessments in relation to risks to residents of developing pressure sores, sustaining injuries from falls or the use of bedrails were not completed and where risks were identified a detailed plan for managing risks and minimising the impact to residents was not always in place. For example where the assessment tool for identifying risks of falls indicated a risk and referred to a separate more detailed assessment this tool was not available for staff to use. Staff were noted to administer medicines to residents at appropriate times. Records in relation to the receipt and administration of medicines were not consistently maintained. Some medicines were not stored appropriately, for example some eye drops and nutritional supplements were not stored in a fridge as per storage instructions. It was positive to note that residents who chose to retain control of and administer their own medicines that they were supported in doing so and that any potential risks were assessed and kept under review. Throughout the day staff were observed to treat residents in a supportive manner. Staff asked residents how they which sauces etc they wished to have with their meals, knocked on bedroom doors before entering and spent time engaging in conversation while assisting residents carry out daily activities of living. Residents wishes in relation to end of life issues and preferred arrangements following death are not consistently recorded. Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 13 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 The home does not provide sufficient planned activities or stimulation and occupation for the people who live there. Residents may receive visitors according to their wishes. Residents are regularly consulted and supported in making decisions about their daily lives. Residents are not always supported in taking their meals in the place of their choice. EVIDENCE: The home employs an activities coordinator for twenty-five hours per week, which is insufficient to meet the needs of the people who live at the home. The activities coordinator was absent due to sickness on the day of the inspection. There were no plans in place so as to provide activities in the absence of the coordinator. Resident’s views about the variety availability of activities and means of occupation were varied. One resident said that the activities were very good, Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 14 however another resident with visual impairment said that she was awaiting a magnifying glass so as to enable her to enjoy puzzles such as crosswords. She commented that ‘the days are very long with nothing to do’ It was positive to note that residents were offered a choice of tea or coffee for the mid morning refreshments. Residents had the choice of cereals and toast for breakfast. For lunch there was a choice of shepherds pie or pasties with vegetables and mashed potatoes and sponge with custard for pudding. Staff were observed to assist residents in a positive and sensitive manner at mealtimes. Residents spoken with during the inspection said that they were happy with the food provided by the home. Residents do not have appropriate tables in the lounge area to take their refreshments, or meals should they choose to take meals in the lounge. One resident was observed to struggle to eat his lunchtime meal with his plate on his lap. Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Complaints are not consistently dealt with in accordance with the homes policies and procedures. The home is not consistently managed so as to protect the people living there from harm or abuse. EVIDENCE: The records in relation to the complaints made about the services and facilities provided by the home indicated that there had been no complaints made since May 2005. However on reading daily care notes for some residents it was clear that some issues and complaints had been made and that these had not been recorded or dealt with according to the homes policies and procedures and Care Homes Regulation 22. One relative who was contacted by post following the inspection commented that she was very unhappy with the way in which the home had dealt with her concerns about the acre provided to her husband. This persons was no longer living at the home at the time of writing the final version of this report, however the concerns raised will be forwarded to the home to deal with under their complaints procedure. Staff recruitment and training practices are not robust and sufficient so as to protect the people who live at the home. There had been a number of Protection of Vulnerable Adult alerts raised since the previous inspection in Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 16 relation to poor care practices and alleged physical abuse. These had been investigated appropriately. Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24 & 26 The home is maintained in good decorative order and residents have access to comfortable communal areas. Resident’s bedrooms are comfortable and personalised. The home is kept clean and staff act to dispel any unpleasant odours. EVIDENCE: The communal areas were noted to be clean and comfortable. Resident’s bedrooms, which were viewed, were noted to be personalised with resident’s belongings. On the morning of the inspection some unpleasant odours were detected throughout the home, however it was noted that staff worked effectively to dispel these and the home was noted to be maintained in a clean manner. Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 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): 27,29 & 30 Hopes Green employs staff in sufficient numbers so as to meet the assessed needs of the people who live there. Staff are not consistently recruited according to the homes policies and procedures so as to protect the welfare and interests of the people who live at the home. Staff are competent and supported in respect of the roles they are to perform, however they do not always receive training specific to the needs of the people who live at the home. EVIDENCE: The staff duty rota evidenced that staff did not work excessive hours without appropriate off duty time. Staff are deployed across the home according to the needs of the people living on both floors. The home employs seven members of care staff for the morning duty, six members of staff for the evening duty and four members of staff for the night duty. However four of the five relatives who responded to the postal questionnaire commented that there were not always sufficient staff on duty and that sometimes it took staff a long time to answer the door. The staff duty rota is not consistently maintained with all of the information as required by regulation, including full details of all staff employed at the home, including staff employed on a temporary basis through employment agencies, Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 19 and the start and finish times where permanent staff work part of a rostered duty. Staff recruitment files did not include evidence that all of the required checks including exploring previous employment history, obtaining satisfactory references and Criminal Records Bureau (CRB) disclosures were carried out before staff are employed to work at the home. Interviews are not routinely carried out so as to determine each candidate’s fitness and suitability to work at the home and there was no evidence that staff undertake induction when they commence work at the home. There were no details available in respect of the fitness or suitability of agency staff employed at the home. An Immediate Requirement in respect of these issues was issued during the inspection. It is positive to note that an action plan was developed with the organisations operations manager and the homes acting manager and training and support is planned so as to address the issues raised. Staff training records were not maintained with up to date information of the training received by staff working at the home. However staff were observed to carry out their duties according to good practice guidelines and the homes policies and procedures. Staff working at the home did not receive training in respect of meeting specific needs of the people living at the home, such as Multiple Sclerosis, Diabetes etc. Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 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, 32, 33 & 38 The home has not been consistently managed recently so as to best meet the needs of the people living there. EVIDENCE: There have been a number of changes in respect of the organisational and local management structures within the home. The registered manager had left the organisation and a new acting manager had been appointed since the previous inspection. It was positive to note the acting managers positive approach and commitment to working to achieve the outstanding regulatory requirements. The issues identified during this inspection were discussed with the homes acting manager and the organisations regional operations manager, who undertook to address them in a prompt manner. Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 21 There were no issues identified in relation to the maintenance of the premises. Records in respect of maintenance, repair and renewal of fire, gas, electrical and mechanical equipment at the home were well maintained, accurate and up to date. Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 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 X X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 3 X X X 3 X 3 STAFFING Standard No Score 27 2 28 X 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 X X X X 3 Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 23 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 Standard OP3 Regulation 14 Requirement The registered persons must ensure that persons are only admitted to the home following a detailed assessment of their care and general needs have been carried out and taking into consideration the needs of the people already living at the home it is determined that the home can meet the needs of each individual. Timescale for action 30/03/06 2 OP7 15 3 OP8 13(4) (5) (6) 30/03/06 The registered persons must ensure that plans in relation to the care and treatment required by people living at the home are clear, up to date and accurate and that they are evaluated and reviewed on a regular basis and when residents care needs or treatment changes. (Previous timescales following the last four inspections have not been met.) The registered persons must 30/03/06 ensure that risks to resident’s health, safety and welfare are identified and managed so as to minimise the impact on DS0000018097.V253983.R01.S.doc Version 5.0 Page 24 Hopes Green Care Centre residents. (Previous timescales following the last three inspections have not been met.) The registered persons must ensure that staff receive, store, administer and dispose of medicines in accordance with the homes policies and procedures and current legislation. The registered persons must ensure that appropriate meaningful social, leisure and occupational activities are provided which meet the needs of residents living at the home. (Previous timescales following the last inspection has not been met.) The registered persons must ensure that residents are supported so as to take their meals in the environment of their choosing. This with reference to providing suitable tables for residents to take their meals in the lounge area should they choose. The registered persons must ensure that all records as required by legislation in relation to complaints made about the service are maintained accurately and made available for inspection upon request The registered persons must ensure that the people living at the home are so far as it is practicable protected from harm and abuse. The registered persons must ensure that information in relation to the deployment of staff in the home are maintained DS0000018097.V253983.R01.S.doc 4 OP9 13(2) 28/02/06 5 OP12 16(2) (n) 30/03/06 6 OP15 16(2) (i) 30/03/06 7 OP16 22 28/02/06 8 OP18 13(6) 30/03/06 9 OP37OP27 17 & 18 28/02/06 Hopes Green Care Centre Version 5.0 Page 25 10 OP29 19 Sch. 2 &4 accurate and up to date. The registered persons must ensure staff (including agency staff) are only employed at the home after all the required checks in relation to their fitness and suitability to work providing care to elderly people. 28/02/06 11 OP30 18 12 OP32OP31 4&8 (Previous timescales following the last inspection has not been met.) The registered persons must 30/03/06 ensure that the all staff working at the home receive the training and support they require in order to meet the needs of the people living at the home. The registered persons must 30/03/06 ensure that the home is managed in a manner, which is in the best interests of the people who live there. 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 OP11 Good Practice Recommendations It is recommended that wherever it is practicable that resident’s wishes in respect of end of life issues and preferred arrangements following death be obtained, recorded and kept under review. Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Hopes Green Care Centre DS0000018097.V253983.R01.S.doc Version 5.0 Page 27 - 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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