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Inspection on 18/10/05 for The Hope Residential And Nursing Care Home

Also see our care home review for The Hope Residential And Nursing Care Home for more information

This inspection was carried out on 18th October 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The employment of a full time activities co-ordinator continues to be an asset to the home. On the day of inspection residents were being taken to see an exhibition of photographs. The records kept of activities each resident takes part in are comprehensive and detailed. Residents said they were well looked after and treated well by staff at the home. The home was having CCTV put in place in vulnerable and dark areas of the home to ensure the safety of staff and residents.

What has improved since the last inspection?

Residents said they felt they were treated with respect and were provided with the help they needed. Some areas of the care plans have improved and the signatures and dates are now written down. The home has a new mini bus, which is being used regularly by the activities co-ordinator to provide visits and trips out.

CARE HOMES FOR OLDER PEOPLE The Hope Residential And Nursing Care Home Brooklands Avenue Cambridge Cambridgeshire CB2 2BQ Lead Inspector Mrs Alison Hilton Unannounced Inspection 18th October 2005 12:10 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 The Hope Residential And Nursing Care Home DS0000024310.V259860.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. The Hope Residential And Nursing Care Home DS0000024310.V259860.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Hope Residential And Nursing Care Home Address Brooklands Avenue Cambridge Cambridgeshire CB2 2BQ 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 359087 01223 350035 matron@hopenrch.demon.co.uk Holy Family Sisters of Bordeaux Elizabeth Angela Cowper Hill Care Home 57 Category(ies) of Old age, not falling within any other category registration, with number (57) of places The Hope Residential And Nursing Care Home DS0000024310.V259860.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 44 nursing care beds Date of last inspection 16th May 2005 Brief Description of the Service: The Hope is a large detached property near the centre of the city of Cambridge. It is owned by the Holy Family Sisters of Bordeaux registered as the Hospital Management Trust. The home is set in attractive well-kept gardens and is within walking distance of local amenities. Cambridge railway station is close by allowing easy access for visitors. There is adequate parking available in the grounds with some spaces clearly marked for anyone with a disability. Entrance to the home is through automatic doors. The Hope has a large reception area, which contains seating and has information about the home including the last inspection report, menus and statement of purpose and service user guide. Residents accommodation is arranged on three floors, which can all be accessed by lift or stairs. Each floor contains bedrooms, sitting rooms, dining areas and office space for staff. On the top floor is a large chapel, which is used for weekly religious services for the residents. It can also be used (on request) for funeral services. The home caters for up to 57 older people over the age of 65 years. Up to 44 beds can be used for residents requiring nursing care. The Hope Residential And Nursing Care Home DS0000024310.V259860.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place between 12:10 hrs and 15:30 hrs on Tuesday 18th October 2005. The inspector toured the building; spoke to 3 residents and the Registered General Nurse in charge. 2 residents files and two staff files were also seen. The inspection continued on Tuesday 1st November to check if issues raised in relation to pre-admission assessments, references and the location of criminal record certificates identified on the 18th October had been looked into. The certificates are kept separate from personnel files for staff in the managers office in a locked cabinet. What the service does well: What has improved since the last inspection? What they could do better: The Hope Residential And Nursing Care Home DS0000024310.V259860.R01.S.doc Version 5.0 Page 6 Pre admission assessments need to be more detailed to ensure the home does not take residents outside the categories they have on the registration certificate. Information in relation to wounds would be clearer if one page related to one wound. More detail is needed in the care plans for residents. Where risk assessments are completed and show an element of risk it would be good practice to have an action section so that other workers would know what is expected, especially on the Waterlow and Norton assessments. If references provided for staff are from overseas via e-mail the home should obtain a third reference where possible. 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 Hope Residential And Nursing Care Home DS0000024310.V259860.R01.S.doc Version 5.0 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 The Hope Residential And Nursing Care Home DS0000024310.V259860.R01.S.doc Version 5.0 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): 3,5 The home had not gathered enough information to ensure it could provide an appropriate placement for residents where their needs will be met. EVIDENCE: There was evidence in files and when speaking to residents that they or their family had visited the home prior to admission. Although there had been pre-admission assessments completed by other professionals and the home, it was evident to the inspector that the two recent admissions had a primary diagnosis of dementia and were outside the categories of registration held by the home. The home will have to apply to vary the conditions of registration if they wish to keep these residents. The home must be more careful in the future to scrutinise the information provided by placing authorities and be more thorough in their own assessment of an individual residents needs. This was discussed with the manager and she is aware of the issues. The Hope Residential And Nursing Care Home DS0000024310.V259860.R01.S.doc Version 5.0 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): 7,8,10 There were specific areas in the care plans that need to be more detailed to ensure the safety of staff and residents. EVIDENCE: Most information in the two plans seen was adequate to ensure staff knew how to deal with the needs of the residents, but specific issues especially around behaviour need to be more detailed to ensure the safety of residents and staff. Certain areas of the care plan in relation to pressure sores need to be much clearer and the evidence of how they are dealt with and when they have healed needs to be more explicit. Residents spoken to during the inspection felt treated with respect. One resident had had an issue with staff but this had been resolved to his satisfaction. The Hope Residential And Nursing Care Home DS0000024310.V259860.R01.S.doc Version 5.0 Page 10 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 The activities co-ordinator continues to provide a varied and interesting programme of activities in an effort to meet social, religious and recreational needs within the home. EVIDENCE: The home has an activities co-ordinator who was interviewed on the day of inspection. She was pleased that the home had a new mini bus that enabled her to take residents out on trips. She had taken some residents to see a photographic exhibition in the morning of the inspection and was preparing to take different residents there in the afternoon. Details of activities attended by each resident are kept on their individual files. The information contained in the files continues to be excellent. Residents spoken to during the inspection said their families and friends visited them. They said that activities were provided and one said she had been outside in the garden in the summer for a garden party. Some had their own telephones and had papers delivered. One commented that he liked to read and listen to music tapes. The Hope Residential And Nursing Care Home DS0000024310.V259860.R01.S.doc Version 5.0 Page 11 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 Complaints are handled sensitively and residents are confident their concerns will be listened to and acted upon. EVIDENCE: One resident said he had complained and his complaint had been dealt with satisfactorily. Another said there was nothing to complain about. The Hope Residential And Nursing Care Home DS0000024310.V259860.R01.S.doc Version 5.0 Page 12 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): 20,24 Improvements to the security of the building for residents and staff were being made on the day of inspection. EVIDENCE: On the day of inspection the home was having CCTV and lights fitted to vulnerable areas such as the rear of the building where staff have to go at night. Residents said they felt safe in the home. They all had single rooms that had personal belongings and photos in them. There were no unhygienic odours when the inspector toured the building. The Hope Residential And Nursing Care Home DS0000024310.V259860.R01.S.doc Version 5.0 Page 13 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): 29 The homes practice of using e-mail references in the recruitment process does not protect residents. EVIDENCE: Two staff files were seen during the inspection. Although there were two references on each file (from 4 different referees), they were very similar including the misspelling of a word. All were completed via e-mail as they were overseas referees, and therefore there were no signatures, office headed paper or any other way of verifying these references. It would be good practice for the home to try to obtain a third reference from someone in the UK where possible. All other information required by the standards was available. The Hope Residential And Nursing Care Home DS0000024310.V259860.R01.S.doc Version 5.0 Page 14 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): None of the standards were inspected on this occasion. EVIDENCE: The Hope Residential And Nursing Care Home DS0000024310.V259860.R01.S.doc Version 5.0 Page 15 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 X 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 x X 3 X X X 3 X X STAFFING Standard No Score 27 X 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X The Hope Residential And Nursing Care Home DS0000024310.V259860.R01.S.doc Version 5.0 Page 16 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 person shall not provide accommodation to a service user at the care home unless the needs of the service user have been assessed. This was a requirement from the last inspection. The timescale for action was 31st May 2005. Failure to comply may result in legal action being taken. The registered person must ensure that a written plan as to how the service users needs in respect of his health and welfare are to be met. This was a requirement from the last inspection. The timescale for action was 30th September 2005. Failure to comply may result in legal action being taken. The registered person must ensure that verbal contact is made to verify and validate the contents of at least one DS0000024310.V259860.R01.S.doc Timescale for action 01/12/05 2. OP7 15 01/12/05 3. OP29 19 01/12/05 The Hope Residential And Nursing Care Home Version 5.0 Page 17 reference. 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 2 Refer to Standard OP8 OP7 Good Practice Recommendations The registered person should ensure that records kept in relation to pressure sores, their treatment and healing are clear. The registered person should ensure that where risk assessments are completed and show an element of risk ,an action section so that other workers know what is expected, (especially on the Waterlow and Norton assessments) would be useful. The Hope Residential And Nursing Care Home DS0000024310.V259860.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Hope Residential And Nursing Care Home DS0000024310.V259860.R01.S.doc Version 5.0 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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