Inspection on 27/09/05 for The Vale

This inspection was carried out on 27th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Vale 09/09/08

The Vale 06/07/07

The Vale 30/10/06

The Vale 25/05/06

The Vale 14/01/05

The Vale 26/08/04

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

CARE HOMES FOR OLDER PEOPLE The Vale 191 Willington Street Maidstone Kent ME15 8ED Lead Inspector Debbie Sullivan Announced 27 September 2005 10:00 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 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. The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Vale Address 191 Willington Street Maidstone Kent ME15 8ED 01622 762332 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Charing Vale Ltd Vacant CRH Care Home 28 Category(ies) of DE (E) Over 65- (28) registration, with number of places The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18 May 2005 Brief Description of the Service: The Vale is located on the outskirts of Maidstone and provides residential care for 28 older people, it is owned by Charing Vale Limited.The home has recently become registered to take older people with dementia. The service occupies a large detached property on the outskirts of Maidstone. Accomodation is provided on three floors, there is access to the first floor via a shaft lift and to the third floor via a stair lift. There is a safe and secure garden at the rear of the property. Public transport routes nearby provide access to the town centre. The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken by inspectors Debbie Sullivan (lead) and Ann Block. The inspection lasted six and a half hours, information was provided by the acting manager throughout the day and the Clinical Standards Manager who was present for part of the day. The acting manager had been in post since 12.9.2005 and had become familiar with the daily routines of the service. The inspection focussed on deficits in the service that had been identified at the last inspection in May 2005 and concerns that were newly highlighted. Due to this there was limited opportunity to speak with staff or residents. The Clinical Standards Manager had been in post for two months and had begun a programme of improvement to the service that was being implemented by the acting manager. Some documentation was looked at and information was also gained from comment cards and the pre inspection questionnaire What the service does well: Revised clear written information is available to prospective residents and their relatives regarding the service. Care staff have received training in dementia and more dementia - specific training is scheduled for October 2005. Care staff are spoken well of by residents and present as competent in their work. Staff enjoy working at the home and say it has a friendly atmosphere. There is a good understanding of adult protection policies and procedures. Action is being taken to improve the environment and quality of life of the residents. The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 8 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 standard(s) 1,2,3,4 and 5. Prospective residents or others acting on their behalf have access to information to enable them to make an informed choice about moving into the home. EVIDENCE: The home’s ‘Statement of Purpose and Service Users’ guides have been fully revised as the home is now registered to take older people with dementia. The manager undertakes an assessment of prospective residents and if a place is offered, confirmation is given in writing. A resident spoken with said that their relative had been able to visit the home on their behalf to assess its suitability. At the time of the inspection there were four vacancies for residents and the acting manager was planning to assess applicants shortly. Residents are given a statement of terms and conditions within the home. The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 9 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 standard(s) 7,8,9 and 10. The care plan format requires revision to include more information. Medication procedures do not fully protect the privacy and welfare of residents. Privacy in double bedrooms is not guaranteed. EVIDENCE: Discussion with the Acting Manager and Clinical Standards Manager took place regarding care plans; it was acknowledged that care plans required revision to include more information and that there should be evidence of reviews. Currently residents or their relatives do not sign care plans. Care plans are kept in a small filing cabinet in the hallway area; the cabinet is not large enough to hold all the files so some were on top of it and if left unattended could have been accessed by someone unauthorised to do so. A larger cabinet is to be purchased. A District Nurse was present for part of the morning and was attending to residents in their own rooms. Double bedrooms do not allow for personal care to be delivered discreetly or for privacy as there is no fixed track curtaining; folding screens were seen in some double rooms that looked clinical in appearance and were unstable. An item of clothing belonging to another resident was found in one resident’s wardrobe. The home has a room in which visitors can be received privately. The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 10 A resident spoken with stated that staff were respectful and throughout the inspection whilst there was limited interaction of staff with residents, that observed was appropriate. Procedures for some aspects of the storage and administration of medication have recently been improved; after the lunchtime medication round the MAR sheet file was left unattended on top of the drugs trolley that had been tethered in the hallway which is the area entered by visitors. The drugs fridge temperature had not been recorded on a number of days throughout September. A pharmacy inspection is to be requested and is welcomed by the home. The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 11 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 standard(s) 12,13,14 and 15. The routines in the home are flexible in some respects; opportunities for further choice and control to be exercised are continuing to be identified and measures taken to address them. Mealtime choices and routines and a review of the location of bedrooms in relation to assessed abilities and needs are a priority. EVIDENCE: The home does not have a programme of activities although it will be recruiting an Activities Coordinator to work four days per week. Very few activities were available to residents apart from watching TV, accessing the garden or talking with staff. Staff and residents spoke of residents receiving visitors although one resident said that their elderly visitors were no longer able to come as their bedroom was reached by a short flight of steps up and one down which those with mobility difficulties could not manage. Residents spoken with mainly were happy with their rooms; one felt very isolated due to the location of their bedroom and several bedrooms at the end of corridors up steps or on the third floor are quite remote from the comings and goings of the home and could be very isolating. The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 12 Information was displayed on a notice board of monthly visits to the home by a local Vicar. Bedrooms clearly included items that residents had brought from previous accommodation and were personalised to varying degrees. The degree of choice and control that residents have over their daily lives is improving with plans to review menus and provide pictorial menus so that choice of meal can be more informed. More substantial snacks will be offered in the afternoon; residents will be risk assessed regarding choice of having their doors open or closed, consultation has taken place with the fire officer over this. Flexibility has improved regarding time to get up in the morning. Residents can choose whether to take meals in their rooms or in the dining areas; again access to the dining room is limited for some, due to the location of bedrooms and stairs. Lunch was partially observed. Residents confirmed that a choice of main meal had been offered. The menu is varied; Meals were plated up and residents did not have the opportunity to state preferences regarding the vegetables. Care staff took meals to bedrooms and the dining room but no staff were evident for some time in the dining room and when present were bringing the meal or clearing away. No help was given to those needing assistance or encouragement with their meal. Aprons were available for residents who may spill food but these were not being used and had been left stained from previous wearing in a basket near the tables, they were not name tagged. The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 13 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 standard(s) 16 and 18. The homes’ policies and procedures have not always served to protect residents as fully as they could, whilst adult protection awareness is good. Procedures and recording must be improved upon to increase the safety of residents. EVIDENCE: The home has a complaints procedure that is available to residents and their representatives. The procedure is displayed in the home and has been updated since the last inspection. One resident spoken with said they had “no complaints”. There is an adult protection procedure in place and a number of care staff had received adult protection training in May 2005. CRB and POVA checks take place on new staff, the home is pro active in raising any adult protection concerns and just before the inspection had informed social services of a concern regarding risk to one resident from another. Measures had been taken at the home to minimise the risk. POVA referrals would be made if needs be. Shortfalls in record keeping in staff files, financial records, staff training records and lack of confidentiality in some record keeping has left gaps in the protection from abuse afforded to residents. These omissions are recognised and improvements in record keeping and the security of records is being addressed. The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 14 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 standard(s) 19,20,21,22,23,24,25 and 26. Residents would benefit greatly from improvements to the environment throughout the home. The current cleaning regime does not protect resident’s health and the use of some facilities is restricted by lack of repair. EVIDENCE: A programme of repair and refurbishment is due to be implemented at the home. The general décor was shabby and unwelcoming in places with worn and chipped paintwork, torn and very worn carpeting and areas requiring cleaning. Access to the garden had been improved and areas made safe for residents to walk around; the garden is well maintained and secure. None of the bedrooms have en - suite facilities; throughout the home seven toilets and five bathrooms are provided for residents. A toilet on the third floor was out of use, the other available toilet for the two residents on that floor was situated in the bathroom, which was being shared by two staff members being very temporarily accommodated in a room registered for a resident. The lock The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 15 on the bathroom was unsuitable and the bathroom shabby and unclean. A fire door leading to steep stairs had been left partially open next to the bathroom. Another bathroom was not in use to damaged flooring and a bath hoist base was exposed with unsafe rusting workings, which could be a hazard. None of doors to the out of order facilities were locked. Toilets and bathrooms were only cleaned every other day and rubbish bins, which could contain material that could cause toxic conditions emptied at the end of the daytime shift before 8 pm. Plastic gloves were seen hanging out of one full bin. Throughout the home there was evidence of specialist equipment being available and grab rails are in place in areas accessed by residents. The stair lift to the third floor negotiates two short flights of stairs and does not reach the very top stair so is not easily and safely accessible. It is recommended the home review it’s use of floor three for residents as well as the use of shared rooms that do not allow for privacy. It was unclear how much choice residents were given over sharing a room. All aspects regarding the concerns over environment were discussed with the Acting Manager and Clinical Standards Manager; measures to improve the environment will be put in place prior to major refurbishment, such as repainting woodwork and the appointment of an additional cleaner. A maintenance man is employed and window restrictors were being fitted in the dining room. The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30. Recruitment policies and procedures can be improved upon and the retention of staffing records be made more secure. Recording and tracking of training has not been adequate leaving residents and staff vulnerable. A greater skill mix of staff will more adequately meet residents’ needs. EVIDENCE: Recruitment was taking place to improve the skill mix of staff in the home; a second cleaner, activities coordinator; flexi member of care staff and a kitchen assistant are to be employed. Residents spoken with were complimentary about carers. Sufficient care staff were on duty during the inspection although were often not in evidence due to the layout and corridors of the building. Response to a call bell was swift and staff observed and spoken with presented as competent and enjoyed working at the home. A rota was displayed in the hallway with the full names of care staff. Training records could only be accessed that cover a fairly recent period and whilst training certificates could be seen on staff files it was not possible to get an overall view on which staff had been trained on some areas of work. An induction book was in staff files seen but was blank or had been filled in inconsistently. No records were available to identify how many staff had completed NVQ training. The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 17 All care staff had taken part in specific dementia awareness training due to the change in registration and a number had been on medication, adult protection, COSHH, fire training and moving and handling courses this year. Further dementia specific training is scheduled for October 2005. Recruitment procedures were established and a corporate reference request form used. This does not ask for dates of previous employment or ask for clarification of which referee is personal and which employment. Staffing files seen lacked some pieces of information and the information was sometimes not secured in the file and could easily be lost. Files were kept locked in the Manager’s office. The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,36,37 and 38. The home has not been run in the best interests of residents and staff have not been properly supervised or supported. Some records are not accessible or have not been securely stored. The health, safety and welfare of residents have not been fully protected. The home is working towards improving the overall standards. EVIDENCE: An Acting Manager supported by the Clinical Standards Manager was running the home; the Acting Manager had experience of running a care home and felt the staff were of a high standard. As there were new temporary management arrangements it was not possible to gain a true picture of the ethos of the home, although staff said it was a very friendly place to work and a resident stated, “we are looked after well”. The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 19 The atmosphere was somewhat subdued as no activities were taking place and a number of residents were in their rooms. Care staff are being supported to interact more socially with residents and encourage activity. No staff supervision records could be located and staff had not received formal supervision for an unspecified period. No staff meetings were taking place. A development plan for the home is in place and monitoring takes place by the use of visitor surveys with forms available on the desk in the hallway. Some policies and procedures need to be revisited and the safety and welfare of residents enhanced by better safe working practices in relation to infection control. Residents care plans and MAR sheets must be stored more confidentially; this includes old records, which were found in an unlocked filing cabinet near residents’ rooms. The property was secure with the use of keypads on outside doors and fencing around the garden. Fire alarms are tested weekly and visits from the fire officer, Environmental health officer and Health and Safety department have taken place this year. The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 2 COMPLAINTS AND PROTECTION 1 3 2 2 2 2 3 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 2 2 2 3 x 2 2 2 The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 21 Yes Are there any outstanding requirements from the last inspection? 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 OP7 Regulation 15(2) Timescale for action The registered person shall Action plan prepare a written plan as to how to be the service users needs in received by respect of health and welfare are CSCI by to be met and keep the service the end of users plan under review. In November that care plans must be reviewed 2005 and revised to contain full information on needs. The registered person shall Action plan ensure that care plans are kept to be received by securely within the home In that care plan files must be kept CSCI by confidentialy in a lockable space the end of and not unnattended at any time November in a public area. 2005. The registered person shall Action plan make arrangements for the to be recording, handling, safekeeping, received by safe admimistration and disposal CSCI by the end of of medicines received into the care home In that medication November 2005. A record sheets must be kept securely when not in use and the pharmacy recording of drug fridge visit has temperatures must be done been daily. requested by the home to fully review policies Version 1.30 Page 22 Requirement 2. OP7 17(1)(b) 3. OP9 13(2) The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc 4. OP10 OP 24 12(4)(a) 16(2)(c) 5. OP12 16(2)(m)( n) The registered provider shall make suitable arrangements to ensure that the care home is conducted in a manner which protects the privacy and dignity of service users. In that double rooms must have screening provided and residents own clothes only are available for t hem to wear. The registered person shall consult service users about the programme of activities arranged and provide facilities for recreation and make arrangements for them to engage in local,social and community activities In that consultation must take place regarding the develpment of an activities programme and it be implemented. and procedures . Action plan to be received by CSCI by the end of November 2005. 6. OP15 12(1)(a) 7. OP19 23(2)(a)( b)(c)(d)(e )(f)(n) The registered person shall ensure that the care home is conducted so as to promote the and make proper provision for the health and welfare of service users . In that those needing help or encouragement with meals be provided with suitable assistance at mealtimes. The registered person shall having regard to the number and needs of the service users ensure that the physical design and layout of the premises meet the needs of service users, the premises are of sound construction and kept in a good Action plan to be received by CSCI by the end of November . The Clinical Standards Manager advised on the inspection that an activities coordinator will be recruited. Action plan to be received by CSCI by the end of November 2005. Action plan to be received by CSCI by the end of November 2005. A schedule Page 23 The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 8. OP22 23(2)(n) 9. OP26 13(3)23(1 )(d) state of repair,adequate private and communal accomodation is provided ,equipment is maintained in good working order and the size and layout of rooms occupied by service users are suitable to their needs. In that a review be undertaken of each service users bedroom location to ensure that it is suitable in respect of choice, mobility, access to other areas of the home,access for visitors, isolation is avoided and double rooms offer private space. Maintenance and repair throughout the building is needed and must include repair to out of order bathrooms and toilets and bathroom equipment,repainting of chipped and cracked paintwork and replacement of torn carpeting The registered person shall ensure that suitable adaptations are made, and such support, equipment and facilities, including passenger lifts are provided. In that the stair lift to the third floor be repaired or replaced so that it reaches the top stair. The registered person shall make suitable arrangements to prevent infection,toxic conditions and the spread of infection. All parts of the care home are kept clean. In that the cleaning routine must be improved throughout the home and toilets and bathrooms cleaned daily. Waste bins in toilets and bathrooms must not be left to overflow and be emptied before late in the evening. The registered person shall for repair and refubishme nt has been drawn up by Charing Vale Ltd and will be forwarded to the commissio n. Action plan to be received by CSCI by the end of November 2005. The home is taking measures to address this by empoloying a second cleaner. Action plan to be received by CSCI by the end of November 2005. Informatio Page 24 10. The Vale OP28 18(1)(a) H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 11. OP30 18(1)( c ) 12. OP36 18(2) ensure that at all times suitably qualified,competant and experienced staff are working in the care home. In that a record of those staff that have completed NVQ training is maintained . No record was available to clarify if the target of 50 NVQ qualified staff in 2005 will be reached. The registered person shall ensure that the persons employed receive training appropriate to the work they are to perform. In that all newly employed staff must have induction training which is recorded and proper records maintained of training undertaken and due. The registered person shall ensure that persons working at the care home are appropriately supervised. In that a programme of formal supervision for all staff must be implemented. n and action plan to be received by CSCI by the end of November 2005. Action plan to be received by CSCI by the end of November 2005. 13. OP37 17(1)(b) 14. The Vale OP38 13(4)( c ) Action plan to be received by CSCI by the end of November 2005. Implement ation to be undertaken as soon as possible. The registered person shall Action plan ensure that the records relating to be to service users are kept received by securely in the care home. In CSCI by that care plans are MAR sheets the end of be kept securely when not in use November and any archived records be kept 2005. confidentially and not in an During the unlocked accessable cabinet. inspection measures were agreed to improve confidential ity. The registered person shall Action plan Version 1.30 Page 25 H56-H06 S61139 The Vale V251811 270905 Stage 4.doc ensure that unnecessary risks to the health and safety of service users are identified and and so far as possible eliminated. In that the unstable filing cabinet on the third floor landing be removed, the fire exit door at the top of a flight of stairs on floor 3 must not be left ajar, hazardous tears in carpets must be made safe, cakes of soap left in an assisted bathroom and the staff toilet must be removed, the bathrooms containing the exposed hoist base and with an unsafe floor must be made inaccessable to residents. to be received by CSCI by the end of November 2005. Action to remove these risks was discussed and agreed during the inspection. A programme of refurbishm ent has been developed by Charing Vale Ltd. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. The Vale Refer to Standard 7 10 15 23 29 29 Good Practice Recommendations It is strongly recommended that residents or their representatives agree and sign care plans. It is very strongly recommended that the use of double rooms be reviewed and the recording of choice over moving to a double room be recorded. It is strongly recommended that aprons used to protect residents clothes at mealtimes be individually name tagged and washed when soiled. It is strongly recommended that the use of the thrid floor for resident accomodation be reviewed due the access limitations and isolated location. It is strongly recommended that the coorporate forms used for reference requests state whether referees are personal or employment and ask for dates of employment. It is recommended that original CRB disclosure forms not H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 26 7. 8. 9. 37 be kept at head office the reference number only needs to be available. It is recommended that the use of the resident register be reviewed as more than one name is on each sheet. It is very strongly recommended that staff not be accomodated on the premises in registered rooms and share bathroom facilities. It is recommended that if staff do shopping for residents clear accounting records are put into place and agreement is given by a manager. The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone, Kent 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 The Vale H56-H06 S61139 The Vale V251811 270905 Stage 4.doc Version 1.30 Page 28 - 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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