Hope Green Residential Home

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment was effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. Basic information was sought about people as part of pre-admission assessments and their needs were assessed, however, there was no evidence to show how people had been involved in their own assessments and reviews, or how their views and opinions were captured, respected, listened to and implemented as part of day-to-day support. The provider had a ‘more about me’ document which detailed people’s specific preferences, history and hobbies, some of these had not been completed.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. We found they did not always follow legislation and current evidence-based good practice and standards. For example, the service had not always followed the principles of the Mental Capacity Act 2005 [MCA] or Deprivation of Liberty and Safeguards [DoLS] to ensure people’s rights and freedoms were protected. The National Institute for Health and Care Excellence (NICE) guidance was not followed in respect of covert medicine administration (where a medicine is disguised in food or drink). Prompt action was taken by the provider when we raised these issues. NICE guidance says advice should be taken from professionals, like a pharmacist, before giving medicine without someone knowing. This helps make sure the medicine is safe to give this way—for example, whether it can be crushed or mixed with food or drink. When we raised this with the provider, the new manager quickly contacted the GP and pharmacist to fix the issue. The provider did use nationally recognised assessment tools for other aspects of people’s care, such as for skin integrity and the risk of malnutrition.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Where people received care from other health teams, staff worked collaboratively to ensure peoples' needs were met. For example, they worked with the district nursing team where people required additional support with their skin integrity and diabetes care.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Where people experienced swallowing difficulties, they were referred and assessed by the Speech and Language Therapists (SaLT). Advice was included in people’s care records and catering staff were informed. We observed meals were prepared according to SaLT advice. People told us they enjoyed the food on offer and could make choices. One person said, “Food is good, and we have 3 choices.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. A relative of a person we spoke with told us, “They have moved [Name] to the ground floor where there are more people and [Name] seems to appreciate that and has seemed better.”

People were told about their rights around consent and staff respected these when delivering person-centred care and treatment. The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. Staff had not always ensured mental capacity assessments had been undertaken and could not always demonstrate how decisions made in a person’s ‘best interest’ had been agreed. Staff demonstrated they understood their responsibilities in relation to consent and that people had the right to refuse care or medication.