Hope Valley Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs. This is the first assessment for this newly registered service. This key question has been rated requires improvement.This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to people’s safe care and treatment, staff training, person centred care and governance at this inspection.

This service scored 46 (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 were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs. Whilst some records included person centred details on how people wished to be cared for, for example how they liked to wear their hair, some contained inconsistent information which impacted on staff providing person centred care. For example, a typing error in a behaviour support care plan had recorded the outcome for one person as ‘to become withdrawn.’ Additionally, staff were completing repositioning charts for some people who were independently able to reposition themselves. This suggested that care planning and monitoring were not always reflective of the person’s actual capabilities and instead followed a task-based approach. Leaders were aware of this issue and had plans to address this within the digital care planning system.

People and relatives fed back positively on specific staff member’s person-centred approach. Feedback included, “They know the residents well and adjust their care accordingly.”

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. Feedback indicated that the use of agency staff had affected the consistency of care, with concerns that information was not always shared effectively. The provider acknowledged this and had taken steps to recruit a full permanent team, assuring us that this would improve continuity going forward.

The provider had also identified when additional support or funding was needed as people’s needs changed. For example, where one to one support was needed. Whilst some relatives felt communication could be improved about what this meant for their loved one, we found that the provider worked appropriately with funding authorities to support people and their families, whether they wished to remain at the home or move on. This was reflected in feedback from relatives such as, “[Provider] has been out to see [person] at the hospital as one of my fears was that they would say that [person] couldn't go back there. Speaking to the manager I said that we want [person] back at Hope Valley, and they've been very supportive in trying to make that happen.” Another added, “We have also applied for relevant funding which the care home has been very helpful with.”

The provider was not fully aware of their responsibilities to meet the Accessible Information Standard. Once explained, the provider shared that they will make improvements to ensure key service documentation could be made available in various formats as required, such as large print, easy read, or translated materials. However, overall, people’s communication needs were suitably assessed, and care plans provided guidance to staff on how to tailor their communication to meet people’s needs. This included using short, clear sentences and being patient when engaging with individuals who may require additional time or support to process information.

There were systems in place to provide opportunities to feedback, this included surveys, meetings and a formal complaints process. However, some feedback from people using the service indicated that communication from leadership could be improved. Some individuals told us they did not always feel informed about changes or outcomes following concerns raised, and that updates about their relatives’ wellbeing were not consistently shared. Feedback included, “The main thing that would make a difference for us is if they would let me know more about how [person] is getting on.” The provider assured us the implementation of a resident of the day initiative would improve communication with families.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. The provider did not always ensure the service was accessible to everyone. During the inspection, we observed a lack of clear signage to support navigation around the home, and poor lighting in some areas. This increased the risk of confusion and disorientation, particularly for people living with dementia. Additionally, there was a lack of specialist equipment and tailored support for a person with a visual impairment during mealtimes, which affected their ability to eat independently and with dignity. The provider responded and assured us settings on lights could be modified to ensure they stayed on, and would review adaptive aids for mealtimes for people.

People had access to their walking aids and pressure relieving equipment as required.

Staff and leaders did not always actively listen to information about people who were most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. For example, we received some feedback that there were some barriers to people’s care. This included communication barriers linked with hearing impairment and dementia.

However, most staff had completed equality, diversity and human rights training and staff were able to explain how they could make reasonable adjustments in their roles to include people with protected characteristics, for example when planning activities.

People were not supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. End of life care plans did not provide person-centred details about how people wished to be cared for at the end of their lives. Care plans only noted whether a person had a ReSPECT form in place, without further information about what was important to them, such as individual preferences, religious considerations, or wishes. This lack of personalised planning meant people may not receive dignified care and support towards the end of their life. without dignity, or being supported in a way that did not met their needs. People and relative feedback told us that wishes were not always documented. One relative shared, “[Person] is now deemed to be in palliative care and they have mentioned regarding views on end-of-life care but I don't think it's been documented.” Another said, “We have discussed ‘do not resuscitate’ with [Person] but there has been no formal documenting of this as far as I know.”