Inspection on 15/11/05 for Loose Valley Nursing Home

This inspection was carried out on 15th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Loose Valley Nursing Home 16/09/08

Loose Valley Nursing Home 16/10/06

Loose Valley Nursing Home 29/06/05

Loose Valley Nursing Home 09/03/05

Loose Valley Nursing Home 26/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Loose Valley Nursing Home 15 Linton Road Loose Maidstone Kent ME15 0AG Lead Inspector Debbie Sullivan Announced Inspection 15th November 2005 09:30 X10015.doc Version 1.40 Page 1 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 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 Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Loose Valley Nursing Home Address 15 Linton Road Loose Maidstone Kent ME15 0AG 01622 745959 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Nellsar Limited Mrs Kathryn Louise Garner Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (34), Terminally ill (5) of places Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registration is restricted to caring for older people which can include up to five people with a terminal illness. 29th June 2005 Date of last inspection Brief Description of the service: Loose Valley Nursing Home is situated a short distance outside the centre of Maidstone, it is on a main transport route with a good bus service. The home is set in attractive grounds overlooking the Loose valley; some bedrooms have views of the grounds and surrounding countryside. The home is registered to provide nursing care for 39 older people, 5 of whom may have a terminal illness. There are seven double and twenty-three single rooms. Accommodation is on two floors; a shaft lift provides access to the upper level. There is a main lounge, a conservatory and dining room. Registered General Nurses are on duty at all times complimented by care assistants, a chef, kitchen, domestic and laundry staff, a maintenance operative, an activities coordinator and fitness instructor. Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place from 9.30 am until 3.45 pm. During the inspection time was spent with the home’s manager, nursing sister, care assistants, the chef, laundry assistant and maintenance operative. Residents were spoken with individually and during lunch and the afternoon exercise session. Views were sought from visiting relatives, documentation read and the daily routines of the home observed. The area operations manager for Nellsar was present at the start of the inspection. The pre inspection questionnaire completed by the manager provided comprehensive information and a number of comment cards were received from service users, relatives and visitors, G.P’s and other professionals. Throughout the day staff were pleasant and helpful and demonstrated commitment to providing a good quality service. Some statements on comment cards and made during the inspection were; From residents, “I like it very much” “Carers work very hard” “ I am well looked after” “Food is always nice” “As good as you’ll get” From relatives, “Senior staff give confidence” “I am happy with the care” “Staff are getting to know my relative’s needs well” From health care and other professionals, “The home is always helpful, will follow instructions and maintains a high standard of care” “I would advise any patient needing a nursing home to consider Loose Valley seriously.” “Excellent home” What the service does well: Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 6 The admission process is thorough and well documented. The personal and health care given to residents is of a high standard and there are good relationships with other professionals. Emphasis is put upon maintaining good nutrition by assessing, recording and reviewing the dietary needs and preferences of residents. The home provides a homely environment that is well decorated and maintained. The staff team is well trained and supported and staff enjoy working at the home. The home is well organised and managed. What has improved since the last inspection? What they could do better: Indexing and sectioning of care plans would enable information to be more easily accessible. The form used on care plans titled “for the completion of support staff” needs to be renamed so that is clear it is for the use of outside professionals only. The good practice of double-checking of medication record sheets needs to always be in place. Please contact the provider for advice of actions taken in response to this Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5. Prospective residents and their relatives have access to written information about the home and are able to visit so that an informed choice can be made. Needs are thoroughly assessed before admission. EVIDENCE: The home has a Statement of Purpose and a Service User’s Guide, which were displayed in the reception area; a written contract is provided when a resident moves in. The needs of prospective residents are thoroughly assessed and documented by the manager of the home and a senior member of the nursing staff, to establish if the home can meet needs. Visits to view the service are welcomed. Relatives of two fairly newly admitted residents said that they had visited before making a choice and one family had viewed several homes before deciding upon Loose valley. One relative had chosen to view the home as they had heard good reports of the service. They all felt that the right decision had been made. The home does not offer intermediate care. Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11. The health and personal care needs of residents are well met and documented. Residents are treated with dignity and privacy is respected. Staff manage terminal illness with sensitivity. EVIDENCE: Care plans read gave very comprehensive information regarding health and personal care needs, some background on the resident and information on personal interests. Sectioning and indexing care plans would help information to be accessed more easily. Complex health needs were especially well documented, with risk assessments in place. Residents or their relatives had signed care plans and other forms of agreement, such as that agreeing to the use of bedrails. Specialist professionals are contacted when necessary and their input is recorded on a specific form; one form showed that at least five specialist health professionals such as a Parkinson’s Disease nurse and a dietician were involved in consultation over a resident’s care needs. A doctor visits the home on a weekly basis. Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 11 Residents are encouraged to mobilise as far as possible and emphasis is put upon maintaining physical ability, an additional weekly exercise session has been started. No residents were self - medicating although they are provided with lockable space in their rooms to facilitate this if required. Medication is stored correctly and administered by trained nurses. MAR sheets had been filled in correctly with the exception of one gap two weeks prior to the inspection. There is a system in place whereby nurses double check MAR sheets; this one omission would be investigated. Residents and relatives spoken with were complimentary regarding the support and care given by nursing and care staff and during the inspection staff were observed to treat residents with dignity, to respect privacy and showed a genuine personal interest in the well being and comfort of residents in their care. Screening to ensure privacy is available in double rooms and agreement to share a room was signed by residents or relatives. The home is registered to take residents who are terminally ill, the needs of those at the end of their lives are met sensitively and staff are provided with specialist training on care of the dying. Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Residents are encouraged to make choices about their daily lives and to maintain contacts and interests. Meals are well cooked with plenty of choice and special dietary needs are catered for. EVIDENCE: The personal interests of residents are recorded on their care plans and contact with friends and relatives is encouraged and supported. Several residents received visitors during the inspection and others spoke of expecting visitors or of keeping in telephone contact with family. Relatives spoken with said they could visit at any time and were always made welcome. Residents are able to make daily choices, for example in terms of choosing areas of the home to access, activities to participate in, time to get up and go to bed and meals. Those who did not need to stay in bed for health reasons were either spending time in their rooms, the conservatory or lounge. One resident was hoping to go out for a drive with a relative. Residents manage their finances if they choose to and if necessary the support of an advocate is requested. Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 13 A programme of activities is available which includes exercise sessions, bingo, quizzes and outings. Entertainers visit the home regularly and religious services are held of various denominations. The weekly exercise class provided by a physiotherapist was observed; it was well attended and residents enjoyed taking part, those with only a little movement were able to join in. The chef sees each resident on admission to establish any dietary needs or preferences and these are regularly reviewed. Residents make a daily choice from two main lunchtime and evening meals; other alternatives can be provided on request. Residents are regularly consulted over the five-week menu and any less popular meals are removed. The lunchtime meal was well cooked and presented; residents spoken with all liked the food. One resident was celebrating a birthday; a cake had been made for the occasion and iced with their name on. Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17 and 18. Residents can feel confident that any concerns or complaints will be taken seriously. Residents are protected from abuse by the homes’ recruitment procedures and staff receive adult protection training. EVIDENCE: The home has a complaints procedure; there had been two complaints since the last inspection, both had been properly addressed and documented with a record of thorough feedback to the complainant. Staff spoken with were aware of the procedure and would feel confident in reporting any complaints to the manager or senior staff. Residents and relatives said that they would also be happy to refer any complaints to senior staff and felt they would be addressed and listened to. Solicitors, relatives and an advocacy service support the legal rights of residents when necessary. An adult protection policy is in place and all staff receive adult protection training; care staff were aware of adult protection issues and all staff are CRB and POVA checked before commencing employment. Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26. Residents live in a safe, clean, homely and well-maintained environment. Individual rooms are personalised and meet needs. Facilities and equipment are in place to help maximise independence. EVIDENCE: The home occupies an older style building that has been extended; it is well decorated, maintained and homely, any minor repairs are dealt with promptly, as evidenced in the maintenance book. The lounge, dining room and conservatory offer communal areas for residents, the conservatory is popular as it is light and spacious with views of the garden and used for activity sessions. Individual rooms vary in size and the environment they offer depending upon which part of the building they are in; a number of bedrooms were seen, all were cleaned to a high standard and residents had personalised them to varying degrees. One bedroom had an odour that was caused by the current health needs of the resident, this was being addressed with the GP and senior Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 16 staff felt treatment would alleviate any further problems. Residents spoken with liked their rooms and relatives who had viewed and chosen rooms were very satisfied. One resident especially liked the view from their window of the grounds. Residents access the upper floor via a shaft lift and the grounds are now safer for them to use as uneven paving stones in the path around the building have been replaced. Some rooms have en suite facilities and sufficient toilets and bathrooms are available for communal use, a shower room was being fitted on the ground floor. Throughout the building equipment for communal or individual use was in evidence and rooms are equipped with call bells. Radiators are guarded or have low temperature surfaces. Systems are in place in the laundry room to prevent infection and there are three sluicing areas. Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. The needs of residents are met by a well - trained and supported staff group who are competent to undertake their specific roles. Recruitment procedures serve to protect residents. EVIDENCE: The needs of residents are met by a mix of care, nursing and ancillary staff. Qualified nursing staff are always on duty, with a nurse and three carers on waking duty night duty. Two agency staff were being employed at the time of the inspection with recruitment for permanent staff to replace them underway. A twilight carer is on duty in the evenings. Care staff spoken with felt that they were busy but had time to spend individually or in activities with residents especially in the afternoons and that the staffing compliment was appropriate. All staff observed were supporting residents in a confident, competent and assured manner. Some staffing files were inspected, including those of fairly newly recruited staff. Files included a checklist of recruitment documents, including CRB, POVA checks, documents to verify personal information, references, an induction pack and booklet and training information. Care and other staff said that a lot of training is available, including mandatory training such as health and safety and first aid and on topics specific to the needs of residents such as epilepsy and dementia. Training due included that on fire procedures and hearing loss. Care staff said they were well supported in the initial stages of their employment and were not expected to work alone Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 18 until they felt confident to do so. Staff spoken with were positive about working at the home and enjoyed working there. The training file showed clear tracking of the courses staff had been on and were due to take, training needs are identified in supervision meetings. The home is actively working towards achieving the target 50 of care staff being NVQ trained. Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 and 38. The home is well managed and run in the best interests of residents and staff. The health, safety and welfare of residents are protected by safe working procedures and practices. EVIDENCE: The registered manager is well qualified and experienced in running the home. Comments made by residents, relatives and staff were complimentary about the way the home was run and it was clear that staff benefit from clear leadership and good support which reflects upon the quality of service offered to residents. The atmosphere in the home was open and inclusive and staff were cheerful. A valid insurance certificate was displayed and regular investment in the home is made, an example being that on the day of the inspection a washing machine had broken down and was to be immediately replaced. Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 20 The home does not manage any residents’ finances; an administrator manages the invoicing of fees for the home. Currently when the administrator is not on duty there is no access to some financial records. Staff receive regular supervision and appraisal and staff meetings are held, staff confirmed that issues they raise at meetings are addressed. Records are kept safely and securely in the managers’ office and the reception area. Evidence of safe working practices was seen during the inspection and fire records were read. Weekly testing of fire alarms takes place and a fire practice was held in September 2005 that was responded to swiftly, a record of participants was recorded. Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement “The registered person shall make arrangements for the recording, safekeeping, safe administration, and disposal of medicines received into the care home”. In that there should be no gaps on MAR sheets. The manager and nursing sister discussed immediate plans to ensure no gaps are left in future. “The registered person shall ensure that the records referred to in paragraph 2 are at all times available for inspection in the care home”. In that a record of charges to residents, including extra charges for additional services must be available for inspection. Timescale for action 16/11/05 2 OP35 17(3)(b) Sch. 4(8) 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 23 No. 1 2 Refer to Standard OP7 OP7 Good Practice Recommendations It is recommended that care plans are indexed and sectioned so that information can be more easily accessed. It is recommended that the care plan document titled “support staff only”, be renamed so that it is clear it is for the use of outside professionals. Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Loose Valley Nursing Home DS0000060403.V253389.R01.S.doc Version 5.0 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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