Hope Green Residential Home Also known as 1-1244000026

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulations in relation to people’s safe care and treatment and the safe management of medicines.

This service scored 53 (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 have a proactive and positive culture of safety based on openness and honesty. Lessons were not always learnt to continually identify and embed good practice. For example, records used to monitor when people experienced episodes of distress did not contain sufficient detail to enable staff to understand how best to support a person. Systems to record some incidents were inconsistent. As a result, managers had not always analysed reports to determine if there were any underlying trends or themes. We raised this with the provider, and we were told this was a staff training issue. The provider gave us assurances appropriate training would be put in place.

The provider worked well with people and other healthcare partners to establish and maintain safe systems of care. They manage and monitor people’s safety. Initial assessments were completed for people moving into the home however some needed to be more detailed. The provider shared information with other health professionals when appropriate to support people’s needs and provide continuity in their care. Staff told us they were given a verbal handover about people before they moved in.

The provider did not always work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. They did not always concentrate on improving people’s lives or protecting their right to live in safety, free from abuse, avoidable harm and neglect. The provider did not always share concerns quickly and appropriately with the local authority safeguarding team or the Care Quality Commission. Staff training records did not demonstrate all staff had received safeguarding training. This potentially put people at risk as staff may not have sufficient knowledge to recognise abuse and what action they needed to take.

The provider had not always ensured applications for Deprivation of Liberty Safeguards (DoLS) had always been made where required. We raised these concerns with the provider and action was taken to address the shortfalls we raised.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. For people who experienced periods of distress, more detailed guidance was needed to guide staff about how to support them in a positive way and minimise risk of harm. There was a new manager in post who assured us they would review all peoples care needs in relation to this aspect of their care.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care. Some routine monitoring of environmental risks was not being undertaken appropriately or missed. For example, we found exposed copper pipes in the living room, some were hot to touch, which presented the potential risk of burning. We also found some windows did not have window restrictors to keep people safe. Once we identified these concerns the management team acted promptly to rectify this. An audit of the home’s environment to determine if improvements could be made to better support people living with dementia had been completed but not identified the issues. We found however other health and safety checks were completed to ensure people’s safety such as fire alarm testing.

The provider followed safe recruitment practices. However, they did not always make sure staff received effective support, training and development. For example, staff did not receive specialist training such as diabetes training. This left people at risk of being supported by untrained staff. The provider used a dependency tool and staffing hours calculator tool, which indicated there were enough staff. However, this did not fully reflect person-centred aspects of the care and support provided as staff were not always deployed effectively and did not always work together well to provide care that met people’s individual needs. We observed people were left waiting for a long period of time for their call bells to be answered and one person told us, “The bell situation isn’t best ever. I’ve got to be changed 2 to 3 times a day. Today when I pressed it, they were here but yesterday wasn’t very good.” However, a relative told us, “The staff are lovely and know how to look after [name] and make me feel very welcome when I visit.”

We raised our observations with the provider who told us they would look into deploying staff more effectively.

The provider did not always assess or manage the risk of infection. Overall, the environment was generally clean, however we noticed some lingering malodorous smells in some areas and a person’s bedroom and bathroom had soiled toilet paper on the floor. We raised this straight away and this was acted upon swiftly. We also observed staff entering the kitchen and supporting people in the toilet wearing the same personal protective equipment (PPE). Not all staff had up to date infection prevention and control training. Infection prevention and control audits had failed to identify and address the shortfalls we identified. The provider took action to address these shortfalls following this assessment by increasing the daily walkaround to twice a day, to ensure instances of potential concerns were highlighted and dealt with straight away.

The provider did not always ensure that medicines and treatments were safe or tailored to people’s needs, abilities, and preferences. People were not consistently involved in planning their care. Manager oversight of staff practices around medicines administration needed to be more robust. Risk assessments for higher-risk medicines were not in place, and care plans lacked personalised detail. Some medicines, such as those given covertly, were not supported by the necessary documentation to ensure safe and appropriate use. While staff demonstrated a good understanding of people’s needs, this information was not always recorded clearly for others to follow. The provider had a system for checking the competency of staff who administered medicines; however, they had not ensured these checks were being completed. We found medicines were stored safely and the manager gave us assurances that staff would receive training to support their development.