Inspection on 04/11/08 for The Hope Residential And Nursing Care Home

This inspection was carried out on 4th November 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Hope Residential And Nursing... 30/11/06

The Hope Residential And Nursing... 18/10/05

The Hope Residential And Nursing... 16/05/05

The Hope Residential And Nursing... 21/01/05

The Hope Residential And Nursing... 21/06/04

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Claremont House

Oak Ridge

Sun Court Nursing Home

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Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Hope Residential And Nursing Care Home Brooklands Avenue Cambridge CB2 8BQ The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this full assessment a ‘key’ inspection. Lead inspector: Andy Green Date: 0 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 20 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 Care Homes for Older People Page 3 of 20 Information about the care home Name of care home: Address: The Hope Residential And Nursing Care Home Brooklands Avenue Cambridge CB2 8BQ 01223359087 01223350035 matron@hopenrch.demon.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Holy Family Sisters of Bordeaux Elizabeth Angela Cowper Hill care home 57 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration Category(ies): old age, not falling within any other category Additional conditions: Up to 44 nursing care beds Date of last inspection: Brief description of the care home: Number of places (if applicable): Under 65 0 Over 65 57 D D M M Y Y Y Y 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 625 - 910 pounds per week. Care Homes for Older People Page 4 of 20 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: How we did our inspection: We, the Commission for Social Care Inspection, undertook a key unannounced inspection of the home on 4th November 2008. We were accompanied by an Expert by Experience, who is a layperson with particular interest in the care of the elderly. The manager completed an AQAA (Annual Quality Assurance Assessment) which is a Self-assessment audit. A large number of surveys were also received from residents and staff in the home. We spoke with a selection of residents and staff to gauge opinions regarding the care and support provided in the home. Care Homes for Older People Page 5 of 20 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by telephoning our order line – 0870 240 7535. Care Homes for Older People Page 6 of 20 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 7 of 20 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have access to good information, and can make an informed choice regarding the homes services. Thorough assessments are carried out to ensure that the home can meet the prospective residents needs. Evidence: Prospective residents and their family or relatives continue to be encouraged to visit the home as part of the assessment process prior to their admission. This ensures that the prospective residents needs can be fully met and to experience life in the home. The majority of residents continue to be self-funding and an assessment form is in place. The assessment form has been reviewed and now includes new sections regarding mental health, end of life care and nutritional screening. The manager or the senior nurse carries out the initial assessments. Information is also received from health care professionals including nurses, GPs and physiotherapists. Examples of assessments were seen in care plans inspected during the day. Care Homes for Older People Page 8 of 20 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are treated with dignity and respect and receive personal care to meet their assessed needs. Care plans are kept to make sure each resident receives appropriate care and support. Evidence: Six care plans were inspected and they contained detailed information to ensure residents receive appropriate personal care and support. Examples included; pressure care, Moving and handling, continence assessments, nutrition, wound care, health care visits, blood pressure, weight charts and records of activities. There is evidence of regular reviews and a monthly dependency chart is completed. Moving and handling assessment reviews were seen in individual resident files. Residents receive visits from a variety of health care professionals including GPs, chiropodist, podiatrist, speech therapist, dietitians, nutritionist. and a dentist as required. Records of all health care visits are kept in individual resident files. The top two floors of the home are dedicated to residents with nursing care needs and there are qualified nurses on each shift to to deliver and oversee care. The ground floor is a non nursing area and district nurses make visits to individual residents when required. At weekends the nurses in the home will provide nursing care to the ground floor residents as necessary. The care staff in the home assist residents with personal care where necessary. The home has access to specialist input from a tissue viability nurses, a Parkinsons nurse and a mental health and dementia trainer. Medication administration and storage in the home is well managed and records are accurately maintained. Temperatures are monitored to ensure that medication is appropriately stored. The manager and staff team in the home are committed to maintaining service users privacy and dignity at all times. This was confirmed by residents and their Care Homes for Older People Page 9 of 20 relatives spoken with during the inspection. A number of surveys were returned to CSCI which were complimentary about the care and services that is provided in the home. Comments in surveys included; I received exceptional care when I was very ill with a chest infection. The matron and staff are always approachable and do their best to answer any problems I love my tea to be piping hot, and even in such a small scale matter the staff listened and sorted this out by arranging for me to have have my own insulated mug. If it matters to me it matters to them Care is given always with the greatest kindness Two relatives were spoken with and they confirmed that they found the care given to be of a high standard and that the staff and manager were responsive and easy to communicate with. They both felt that their relative was in safe hands at all times and that they were informed of any changes in care. One relative stated that she was actively involved in care planning meetings. The Expert by Experience met with a number of residents and made the following observations: The residents I talked to were friendly and talked about their families and asked questions about mine. They talked together at lunchtime but other times were watching television. They did not have conversation times eg. Discussion periods with a member of staff reading the newspaper and talking about the news. They were a very happy, content well cared for group of people. Some of the comments were The staff are very friendly and helpful Its a lovely place and very clean I cant think of any improvements Its a great place We had a great time when we went to the Tea Dance. I love painting and cooking. I am just going down to have a hand massage. When I admired a ladys mohair cardigan she said It has been washed but they know how to wash clothes properly here She was 101 years old. Altogether The Hope presented as a very successful caring and well run establishment. Care Homes for Older People Page 10 of 20 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is an excellent range of activities to meet the needs of residents. There is a choice of meals, which are nutritious and prepared and served in a homely way. Evidence: We spoke with the homes activities co-ordinator who provides an excellent range of activities for residents. Examples included musical entertainments, outings and access to community events. Trips in small groups have been arranged to local garden centers, pub lunches and theatre. Arts and crafts are enthusiastically attended and the cookery and exercise sessions continue to be popular. Summer fetes are held in the garden area and plans are being made for a party at Christmas. Individual preferences and activities are recorded in the individual residents care plan. Activities are also displayed on notice boards throughout the home. Not all residents wish to participate in organised activities but they are offered the choice and their wishes are respected. Relatives of service users are welcome to the home at all times and there is a lively and friendly atmosphere in the home. Varied and nutritious meals are available to service users. Dietary needs are met and the cook is made aware of any special needs eg, diabetes or soft food diets. Residents spoken to were complimentary about the meals they received. The Expert by Experience made the following observations regarding activities in the home; The home has a wonderful lady in charge of activities programme which includes painting, cooking craft work etc. she is also an aromatherapist and treats residents to hand and head massage. Also included are daily exercises. She organizes outings to various venues eg. the Arts Theatre, Fitzwilliam Museum, local Tea Dance and had just organised a Halloween party which several residents mentioned. There are large screen Care Homes for Older People Page 11 of 20 Television sets in all the lounges and residents can have T.V. in their bedrooms if they wish. There is a very nice room or salon, which is at present used only for hairdressing. With a couch installed this could double up as a therapy room. Unfortunately there is no library service There was a mobile library but the Council discontinued this service. This would appear to be discrimination of the elderly. There are no computers that can be used by residents. I suggested that they invest in a couple of lap tops for use of residents who, in the not too distant future will be mostly computer literate. It is a wonderful means of communication with the outside world. At present a telephone and help with writing letters is available. There is no shop as such but a small trolley with a few essentials is available Good menus available for lunch and supper with a choice of two different meals. Breakfast of cereal and toast etc can be taken in bed if requested. A cooked breakfast is possible but needs to be ordered the day before. Residents can request something special but chef requires some notice. On visiting the dining rooms I observed most residents enjoying pork casserole or stuffed courgettes followed by very appetising sultana sponge . Care Homes for Older People Page 12 of 20 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a complaints procedure to ensure that residents and their relatives are able to raise concerns and have them dealt with appropriately. There are suitable arrangements for ensuring the protection of from neglect or harm. Evidence: The home has a full complaints procedure in place to ensure that residents can have any concern or complaint appropriately dealt with. The complaints process is explained to residents and relatives and is also included In the Statement of Purpose and Service User Guide. Staff confirmed that received training in the safeguarding of vulnerable adults to ensure that residents are protected from abuse. Relatives also confirmed that they felt confident in raising any concern with the manager or care staff and that they were always responded to in a timely and efficient manner. There have been no complaints received by CSCI regarding the home since the last inspection Care Homes for Older People Page 13 of 20 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment of the home provides residents with a safe, homely, comfortable and clean place in which to live. Evidence: The home is kept in a clean and well-maintained manner. The home was tidy and was free from unpleasant odours. Bedrooms seen during the inspection were presented in a homely and comfortable manner in accordance with residents preferences. Residents are encouraged to bring their own furniture and equipment as long as health & safety requirements are met. The manager stated that bedrooms are redecorated when they become vacant or as required. The top floor dining room has been refurbished and redecorated and new furniture has been purchased. The first floor dining room has also been redecorated and a number of new chairs have been purchased. The carpets continue to be regularly cleaned or replaced as necessary. The gardens are well maintained throughout the year and include a variety of attractive planted areas. The maintenance person continues to attend to all ongoing minor repairs and decoration in the home on a daily basis. A part time gardener visits the home to maintain the grounds and gardens. Repairs are being carried to the front wall of the home and additional CCTV cameras have been installed to aid security. The Expert by Experience made the following observations; The Hope is a very impressive building situated in well-kept grounds. Reception area is large and hotel like and a very warm caring atmosphere was immediately evident. Living areas and dining room were well furnished and decoration was very tasteful. One toilet was inadequate because when the support rail was lowered the door could not be closed. Toilet rolls were not suitably placed and some out of reach for disabled or elderly. Bedrooms were adequate. There are six bedrooms with en-suite facilities. These two floors had been refurbished with good bathing and toilet facilities including two Parker baths which are ideal for comfortable safe bathing for the elderly. It was good to see that there were many round tables which are better for accommodating wheelchairs but the footplates had to be turned back or removed from Care Homes for Older People Page 14 of 20 them because the tables were not high enough. This oversight should be addressed. Decor was bright and furnishings new and tasteful. Some refurbishing was still taking place Care Homes for Older People Page 15 of 20 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes recruitment policy and processes makes sure that residents 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: The home has a thorough recruitment procedure including CRB/POVA checks, application form and appropriate references taken up before employment commences. This was evidenced in three of the staffs files. The training files confirmed staff receive a variety of training including health and safety, moving and handling, diabetes, fire, dementia, food hygiene, vision awareness, hearing aids infection control and safeguarding adults. Training continues to be well organised throughout the year with refreshers and updates to ensure ongoing safe practice. Two nurses confirmed that they updated their skills and knowledge and they had attended a number of study days. NVQ training continues organised in the home. Staff confirmed that they felt very supported by the manager and that they receive an annual appraisal. b Surveys received by CSCI were positive about the support, training and the management in the home. Supervision in the home has been infrequent and the manager is aware of the need to improve this area. Staff meetings are regularly held throughout the year. The manager stated that there had been difficulties in staffing during the year and this was now improving following a recent recruitment drive. Agency staff have been used where there have been shortfalls so that resident care is not compromised. The Expert by Experience made the following observations. The overall feeling was of loving care, happy residents and happy staff responding to a well-respected very efficient matron. The staff were friendly and forthcoming with information and eager to answer any questions which included; There is a handover at the end of each shift lasting 15 minutes. patients are discussed and a written statement in tabular form of all that has happened on the previous shift recorded. NVQs are encouraged and the staff on duty on one floor all staff had NVQ 3. Training courses on various aspects available e.g. dementia and staff could request courses and choose what they would like to attend by adding names to lists displayed in foyer. Care Homes for Older People Page 16 of 20 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of 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 continues to provide a clear and inclusive style of management and she is supported by her staff team and the Management Committee. The manager and senior staff to clearly monitor care and practice issues to ensure that there is a well delivered package of care for residents. As mentioned previously residents and relatives have found the manager to be responsive and approachable, this is also echoed in comments made by staff. There is a residents meeting organised twice a year to receive views, preferences and concerns from residents. A relatives meeting continues to be organised to discuss developments, events and any concerns or issues. Fire records, water temperatures, internal and external building checks, hoist safety, wheelchair checks are kept by the maintenance person. These records were inspected and were accurately kept. Service contracts are in place for equipment in the home and hard wiring and portable appliance testing is regularly carried out. Care Homes for Older People Page 17 of 20 Are there any outstanding requirements from the last inspection? Yes No Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 18 of 20 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 19 of 20 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. ©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. Care Homes for Older People Page 20 of 20 - 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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