Hope Green Residential Home

Hope Green Residential Home was providing personal care to 46 people aged 65 and over at the time of the inspection. The service can support up to 54 people across two separate households.

People’s experience of using this service and what we found

Governance systems to monitor the quality of care being delivered to people had improved. However, some aspects required further development to ensure the cleanliness of the home was maintained as well as ensuring people received their prescribed medicines, including creams, as directed. All other aspects of medicines were managed safely.

There had been several changes of management at Hope Green Residential Home since our last inspection. This inconsistency meant some relatives didn’t always feel the management team was responsive to any issues or concerns they had raised and didn’t always feel well informed. There was a new manager recently appointed who knew the service well.

Appropriate checks on temporary (agency) and permanent members of staff were in place to ensure they were suitable for the role before starting employment. Additional recruitment was underway to ensure people received consistent care and the environment could be maintained appropriately.

Care plans were in place, supported by appropriate risk assessments, to ensure people’s needs were met. These were person centred and reflective of people’s personal preferences.

Systems were in place to monitor and appropriately report accidents and incidents to external agencies.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 20 January 2021) and there were three breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection found improvements had been made and the provider was no longer in breach of regulations.

The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We received concerns in relation to cleanliness, staffing levels and poor management of risks to people’s care. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained the same. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hope Green Residential Home on our website at www.cqc.org.uk.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Hope Green is a residential care home providing personal and nursing care to 45 people aged 65 and over at the time of the inspection. The service can support up to 54 people. Accommodation is across two separate households.

People’s experience of using this service and what we found

Governance systems to monitor the quality of care being delivered to people required improvement. Existing systems failed to identify a lack of person centred information in care plans or shortfalls in care recording.

Existing bathing facilities within Hope Green limited choice. This meant people living in one part of the building only had access to a bath, when we were told their preference would be to have a shower.

There was a lack of adequate checks on temporary workers to ensure people working at Hope Green were suitable and adequately trained. Regular staff did have appropriate employment checks in place.

At the time of inspection, the registered manager was recruiting new staff, including ancillary staff. We found additional pressures had been placed on domestic staff during this period to meet the demands of enhanced cleaning procedures as a result of the Covid-19 pandemic. However, despite this, the home was visibly clean and well maintained. We found care staffing levels were adequate, however, we have made a recommendation for the registered manager to review how staff are deployed, particularly to support people following mealtimes.

Staff had received all necessary training. This included training to recognise and respond to abuse. We found incidents had been appropriately documented and reported to the local authority. Some incidents however had not been reported to the Care Quality Commission.

We found the registered manager to be open and transparent throughout our inspection and had began to put plans in place to address the issues we found.

People told us they were happy living at Hope Green and felt well cared for. Staff told us they enjoyed working there.

During the Covid-19 pandemic, visiting opportunities had been restricted to window visits, telephone calls and video calling. There were plans in place for a purpose built pod to be placed in the grounds to enable people to see their loved ones. Relatives we spoke with appreciated this was being introduced.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 27 February 2019).

Why we inspected

We received concerns in relation to the quality of care being provided to people and the oversight of and effective management of the service. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe, responsive and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

The provider has given us assurance they will improve the checks they make on agency workers to ensure safe recruitment procedures are in place.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hope Green Residential Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to providing person centred care, record keeping and effective auditing as well as ensuring appropriate checks are in place for agency workers at this inspection. We have also identified a potential failure by the registered manager to inform CQC of notifiable incidents.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Hope Green is a residential care home that is registered to provide personal care for up to 54 people. Accommodation is provided in an adapted building over two floors. There are numerous lounges and dining rooms for people to use within the building. People also have access to secure outdoor space. At the time of our inspection there were 50 people living in the home.

People’s experience of using this service:

People and their relatives spoke highly of the staff and manager. They spoke of receiving high quality care from staff that were kind, friendly and knew them well. Relatives spoke of staff being approachable and keeping them informed of changes to their relative’s care.

People and their relatives felt that they received safe care. They received their medication at times they needed this and by staff who were trained to administer this safely.

There were sufficient staff to meet the needs of the people living in the service. Staff spoke of having time to sit and chat with people and get to know them.

Recruitment was managed safely. The necessary checks were completed prior to staff starting work. Staff received inductions when they started work and received ingoing training and support and supervision in order to maintain and develop their skills and knowledge.

The home was clean and well maintained. Regular checks were completed on equipment to ensure safety and staff had access to personal protective equipment to reduce risks of infection control.

The registered provider was acting within the principles of the Mental Capacity Act 2005. Where necessary, people’s capacity was assessed and decisions were taken and recorded in people’s best interests looking at the least restrictive options.

People’s health needs were effectively assessed and monitored. Where people needed access to other health professionals, referrals were completed and advice recorded.

People were encouraged to take part in a variety of activities and their choices and preferences were respected.

People knew how to complain and were confident that that their concerns would be listened to and acted upon.

We received positive comments about the registered manager and staff and how the home was run overall. The registered manager spoke with us about future improvements in the home and we saw what improvements had already been put in place.

More information is in the full report below.

Rating at last inspection: Good (Report published 6 August 2016).

Why we inspected: This was a planned comprehensive inspection based on the ratings at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Hope Green Residential Home is a former private residence that has been converted into a care home to provide personal care for 43 older people. It is located approximately one mile from Poynton town centre. Local facilities are all within easy access. Accommodation is provided mainly in single bedrooms although four large bedrooms can be used as double rooms if required. All bedrooms have en-suite facilities. Communal areas such as lounges, dining rooms and a conservatory are also available. At the time of the inspection there were 36 people living there.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Prior to this inspection we received feedback from Healthwatch, the local authority contract monitoring team and a visiting health care professional to seek their views of the service. They did not have any concerns about the care.

The experiences of people who lived at the home were positive. People were happy with the care and support they received. Comments included: “Excellent care here. They show mum respect. We looked at six homes before mum moved here, this one stood out, it was friendly and you could tell staff were respectful”; “Oh yes, I like it here, there are staff around who help me, they are good to me, and helpful, that makes me feel, you know, good”; “Staff speak nicely to us”; “The girls are lovely, they seem very involved with the people here, Mum’s room is clean and tidy, her clothes are fresh”.

People's needs were assessed and plans were developed to identify what care and support people required to maintain their health and wellbeing and foster their independence where possible.

People were protected from abuse. Staff were knowledgeable about the risks of abuse and reporting procedures.

We found there were sufficient staff available to meet people's needs and that safe and effective recruitment practices were followed. Staff had good relationships with people who lived at the home and were attentive to their needs. Staff respected people's privacy and dignity at all times and interacted with people in a caring, respectful and professional manner.

People's health care needs were met and their medicines were administered appropriately. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people's needs.

People were appropriately supported and had sufficient food and drink to maintain a healthy diet.

Staff received suitable induction and training to meet the needs of people living at the home. Staff were well supported by the manager. This meant people were being cared for by suitably qualified, supported and trained staff.

There were systems and processes in place to monitor the quality of the service. Audits were carried out and people’s views were sought. Where shortfalls were identified the manager was using the information to improve the service. This demonstrated that it was a learning organisation.

Staff records showed that all appropriate checks were made before any new staff were allowed to commence work at the home which ensured the safety of all people using services. Comprehensive training had been received by all staff members which provided them with the skills to meet the needs of all people at Hope Green Residential Home. There was an effective complaints system available which meant any comments or complaints people made were responded to within an acceptable time frame, that is 28 days, in an appropriate manner.

We saw that there was a programme of activities for people living in the Home with an emphasis on choice for those who wished to become involved and those who did not and with the option for people to pursue interests outside the Home.

The people who used the service talked highly of the staff and said that they treated them with dignity and respect - 'I like it very much. I like the staff ' they are very helpful' - 'The staff ask what you like and don't like ' and you tell them. They take notice.'