CARE HOMES FOR OLDER PEOPLE
The Hope Residential And Nursing Care Home Brooklands Avenue Cambridge CB2 2BQ Lead Inspector
Andy Green Key Unannounced Inspection 30th November 2006 10:00 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 The Hope Residential And Nursing Care Home DS0000024310.V309331.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. The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service The Hope Residential And Nursing Care Home Address Brooklands Avenue Cambridge 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.V309331.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Up to 44 nursing care beds Date of last inspection 18th October 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 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 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 charges range from £562 - £825 per week. The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Regulation Inspector, Andy Green undertook this unannounced inspection on 30th November 2006. The inspector met with the manager, care staff and service users to gather views regarding the care and services that are provided in the home. A number of records were inspected including care plans, training records, fire records and medication. A tour of the building and grounds was also undertaken. What the service does well: What has improved since the last inspection? 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
The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 6 contacting your local CSCI office. The Hope Residential And Nursing Care Home DS0000024310.V309331.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 The Hope Residential And Nursing Care Home DS0000024310.V309331.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): 1,2,3,5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective service users have access to good information, and can make an informed choice regarding the home’s services. However a variation to the home’s registration needs to be made to accommodate one named service user. EVIDENCE: The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 9 There have been no changes to the Statement of Purpose or Service User Guide since the last inspection. The manager stated that these documents would be reviewed during the year to ensure that they remain effective and provide up to date information. Prospective service users and their family/relatives continue to be encouraged to visit The Hope as part of the assessment process, prior to admission. This ensures that the prospective service users need’s can be fully assessed and also gives the person a chance to experience life in the home. The majority of service users are self-funding and an assessment form is in place, which has recently been reviewed to include a section regarding incidents of falls. The home is currently accommodating a service user with a diagnosis of dementia and an application for variation to the home’s registration must be submitted to CSCI. This issue was discussed with the manager and she is aware that this will be made a requirement in this report. The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are treated with dignity and respect and receive personal care to meet their assessed needs. Care plans are kept to make sure each service user receives appropriate care and support. EVIDENCE: The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 11 Four care plans were inspected and a variety of information is in place with evidence of regular reviews. There are sufficient guidelines to ensure that staff are aware of the care that is required to meet the assessed needs of service users. It was recommended that a detailed personal profile should be added to each of the service user’s plans so that staff have a wider perspective of the service user’s life and their achievements. The manager stated that this would be a proactive addition to service user plans and she will develop this over the forthcoming months. Service users continue to receive visits from a variety of healthcare professionals including GPs, chiropodist and a dentist as required. The care staff in the home assist service users with personal care where necessary. Medication administration and storage is well managed and records are accurately maintained. The manager and staff team in the home are committed to maintaining service users privacy and dignity at all times. This was confirmed by service users on the day of inspection and was observed by the inspector. Five service users spoken to were complimentary regarding the care and support they received from the management and staff team. The inspector gave the manager feedback received from service user and relative’s questionnaires, which were complimentary about the care and services that is provided in the home. A nun who lives in the adjacent property in the grounds also provides chaplain services in the home for service users regarding their spiritual needs. The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There a wide range of activities and access to the community to meet the needs of service users. Service users have a choice of meals, which are prepared and served in a homely manner. EVIDENCE: The activities co-ordinator continues to provide a wide range of activities, including musical entertainments, outings and access to community events. Trips to local garden centres, seaside and theatre have been organised. An arts and crafts group, cookery and exercise sessions also continue to be provided. Individual preferences and interests are recorded in the service users plan. Summer fetes held in the garden area and plans are being made for a number of events at Christmas. Relatives of service users are welcome to the home at all times and there is a lively and friendly atmosphere in the home. Four relatives of service users that were spoken to were most complimentary regarding the services, care and support provided in the home for their relatives. They all stated that the manager and her staff were helpful and considerate and that any concerns or requests were dealt with appropriately. The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 13 Varied and nutritious meals are available to service users. Service users, spoken to on the day of inspection, were complimentary about the meals they received. The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 14 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): 16,17,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints process to make sure that service users and their representatives are able to raise concerns and have them dealt with appropriately. There are suitable arrangements for ensuring the protection of service users from neglect or harm. EVIDENCE: The home has a full complaints procedure in place that includes the CSCI contact details, which was reviewed and updated in August 2006. This policy has been explained to service users and relatives and is also included In the Statement of Purpose and Service User Guide. Staff receive training in the protection of vulnerable adults to ensure that service users are protected from abuse. There have been no complaints regarding the home and its care and services since the last inspection The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 15 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): 19,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment of the home provides service users with a safe, comfortable, clean place to live. EVIDENCE: The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 16 The home is kept in a clean and tidy manner and was free from odours. Bedrooms of service users seen on the day of inspection were presented in a homely and comfortable manner in accordance with service user’s preferences. Service users are able to bring their own furniture as long as health & safety requirements are met. The manager stated that bedrooms are redecorated as required. The downstairs lounge is due to be redecorated and a number of new chairs have also been purchased. The carpets are regularly cleaned or replaced as necessary. The gardens are well presented and maintained throughout the year with a variety of attractive planted areas. The maintenance person attends to all ongoing minor repairs and decoration in the home on a daily basis. There have been no further changes to the environment since the last inspection. The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 17 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s recruitment policy and processes makes sure that service users are protected from harm. Training is provided to make sure that care staff are competent to deliver personal care to the service users they support EVIDENCE: All staff are issued with job descriptions and clear details of their areas of responsibility. The home has a thorough recruitment procedure including CRB/POVA checks and appropriate references taken up before employment commences The home’s training files was seen with evidence to show that staff members receive a variety of training including health and safety, moving and handling, diabetes, infection control and POVA. Training is well monitored throughout the year with refreshers/updates to ensure safe practice. NVQ training is also organised in the home. This was confirmed through conversations with three members of care staff. Staff also confirmed that they felt supported by the manager and that they receive an annual appraisal. Supervision in the home needs to be improved as the emphasis has been on group discussion, as opposed to individual recorded sessions. The manager was reminded that the National Minimum Standards recommend that staff should receive at least 6 supervision sessions throughout the year to monitor their performance, care practices and development needs. The manager stated that she would organise a supervision programme with the aid of her senior staff who will have designated groups of staff to formally supervise.
The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 18 Consequently a requirement will be regarding this issue. The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 19 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): 31,33,36,38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is well managed and the manager provides supportive leadership to ensure high quality care is delivered. EVIDENCE: The manager has worked in the home for a number of years and she continues to provide a clear and inclusive style of management supported by members of the Management Committee. The manager meets regularly with senior staff to discuss care and practice issues along with detailed handovers to aid continuity and communication. There is a residents meeting organised twice a year to receive views, preferences and concerns from service users. There is also a relatives meeting organised every six weeks to discuss developments, events and any concerns or issues.
The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 20 Fire records are kept and recorded regularly. Service contracts are in place for equipment in the home and hard wiring and portable appliance testing is regularly carried out. The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 2 X 3 The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14(1) (a) Requirement The home must submit an application to vary their registration to include one named person in the category of DEE for the duration of their stay in the home. The registered person must ensure that there are suitable arrangements in place to ensure that staff receive individual recorded supervision on at least 6 occasions throughout the year. Timescale for action 31/01/07 2. OP36 18(2) 31/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 OP7 Refer to Standard Good Practice Recommendations It is recommended that a detailed personal profile should be added to each of the service user’s plans to give a wider perspective of the service user’s life and their achievements. The Hope Residential And Nursing Care Home DS0000024310.V309331.R01.S.doc Version 5.2 Page 23 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
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