Inspection on 30/10/06 for The Vale

This inspection was carried out on 30th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 25/05/06

The Vale 27/09/05

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 Eamonn Kelly Key Unannounced Inspection 30th October 2006 08:00 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 The Vale DS0000061139.V317926.R01.S.doc Version 5.2 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. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Vale Address 191 Willington Street Maidstone Kent ME15 8ED 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) 01622 762332 Charing Vale Ltd Post Vacant Care Home 28 Category(ies) of Dementia - over 65 years of age (28) registration, with number of places The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th September 2006 Brief Description of the Service: The Vale Residential Home is registered to accommodate up to 28 older people with dementia. The home is one of some 18 residential homes operated by Charing Healthcare Ltd. Service users at the home have significant levels of dementia, sensory impairments and/or physical disabilities associated with advancing years. Service user’s bedrooms are on 3 floors. The 2nd floor is accessible by stairs and a passenger lift. The 3rd floor is accessible only by further stairs and stair lifts. There are 3 bedrooms on this floor. Overall, there are 17 single and 5 shared bedrooms (and 5 bedrooms have an en-suite facility). The garden is suitable for use by frail older people and has a concrete ramp to assist access by wheelchair users. The current scale of charges are £480-£550 per week. Additional charges are contained in the Service User’s Guide and personal contract provided to each service user. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report has been compiled following an unannounced inspection on 25/05/06, a further inspection on 29/09/06 and receipt of information from Social Services Department and others relating to concerns for the safety and health of service users at the home. The report of the inspection visit in May 2006 contained a summary of the assessment of the extent to which National Minimum Standards for Care Homes for Older People had been met. Shortfalls were identified within that report in relation to the level of personal, health and social care at the home. In the light of more recent events including information arising from implementation of Local Authority adult protection procedures, this quality rating for this home has been adjusted accordingly. Charing Healthcare’s area manager (Mrs Belinda Watson) has responded to the request by the commission for improvements to be made at the home and she has supplied details of actions to be taken or already taken. Additional concerns have been made known to the Commission since both unannounced inspections and the adult protection meeting. This report has been prepared following these concerns and the current rating of the level of care services has been amended. The success of the home in meeting its undertakings will be assessed to enable a decision on further regulatory action to be considered. What the service does well: What has improved since the last inspection? Charing Healthcare’s area manager has advised the Commission of the following improvements: 1. A new manager recently took up her post. An application for registration would be made in mid-November 2006. 2. Care staff numbers have been increased by one in the earlier part of the day. Consideration will be given to a similar increase in staffing levels in the later parts of the day. 3. Two new kitchen assistants, a laundry assistant and a weekend domestic assistant will commence employment on 30/10/06. A recently recruited weekend domestic worker will also provide weekday staff cover. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 6 4. A new house induction programme will immediately commence. All new staff will undergo this procedure before unsupervised duties are undertaken. 5. All mandatory subjects will be covered during the 3 months induction/probation. 6. The situation as to how the activities co-ordinator will be supported by external sources (hand & nail therapist, entertainers, library services, and hairdresser) will be reviewed and its impact evaluated. The activities co-ordinator will be attending an Age Concern workshop. 7. The home’s service user’s guide will be amended to ensure that all information is relevant and up-to-date and prospective service users are not misled by claims of service levels that do not exist. 8. External refurbishments are nearly complete. All bedrooms that have not been refurbished will be redecorated. 9. Improvements to shared bedrooms will be made for better privacy for service users. 10. Communal areas will be redecorated. 11. A new dishwasher has been purchased. 12. Training in mandatory subjects will be carried out for all staff. The topics regarded as mandatory are: infection control, H&S, fire prevention, first aid, POVA, moving & handling and COSHH. 13. Most members of care staff (50 ) are being assigned as “learners” to the NVQ in Care programme. 14. Shortfalls in food provision are being addressed. A further letter regarding this was sent to the area manager on 26 October 2006. 15. A visiting consultant is providing advice to care assistants and others at the home on working with service users who have dementia. Further urgent consideration will be given towards having all care assistants enrolled on a dementia care training course. The area manager’s report also outlined where other initiatives are underway: • • • • • More emphasis on avoiding service user isolation. Better staff supervision. Better training in medicines administration. Action to address service user fall rate more actively and appropriately and Improved care plan recording. A number of these improvements were planned or underway prior to the intervention by CSCI and Kent Social Services. Care staff will not be involved primarily with ancillary duties now that the home will consistently have additional domestic, laundry and kitchen staff. What they could do better: The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 7 Charing Healthcare’s area manager (Mrs Belinda Watson) has undertaken to progress a number of improvements at the home for the benefit of service users, staff and visitors. Examples have been highlighted in the past 2 months that indicated the need for significant improvements in the following areas: (a) (b) (c) (d) (e) (f) The claims made to prospective service users in pre-admission documents. Management of the home. Training and development of staff. Staffing levels. Refurbishment of all common areas and bedrooms. Menus and food provided. Care managers are assessing how service users are individually being supported at the home. The outcome of these assessments will be taken into account in the next CSCI inspection. The requirements shown in this report are those that were contained in a letter to the owner of Charing Healthcare on 5th October 2006. These will be acknowledged as being met when the home implements all its undertakings. The proposed improvements by Charing Healthcare were contained in the area manager’s letter dated 22 October 2006 and subsequent discussions to clarify particular aspects. 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 summary of this inspection report can be made available in other formats on request. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 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 The Vale DS0000061139.V317926.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 6. Quality on this outcome area is poor. This judgement was made using available evidence including a visit to the service. It is also based on events following two recent inspections of the service. Service users and their representatives have access to written information and other support needed in making a decision if the home can meet their needs. Service users would be better supported if this information were more accurate and up-to-date. EVIDENCE: Prospective service users receive a full assessment by the manager (generally with a care manager’s assistance and a psycho-geriatrician’s report) prior to admission. Pre-admission information is more fully recorded now than previously. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 10 The pre-admission written information provided to prospective service users and their families is not up-to-date and is potentially misleading. This is because the claims made in the current service user’s guide in respect of support levels for service users are not actually delivered in practice. The home accepts service users for longer-term support or periods of respite care. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality on this outcome area is poor. This judgement was made using available evidence including a visit to the service. It is also based on events following two recent inspections of the service. The significant support needs of service users are not being adequately met. EVIDENCE: Care plan records have been improved. This is to enable service user’s health and personal/social support needs to be identified, met at all times and reviewed regularly with records explaining all aspects of this at any given time. The new records have not yet been extended to all service users. District nurses visit a number of service users twice a week to attend to pressure sores and problems with skin deterioration. Information from a social services case conference indicates that adequate support in this area is not always available to service users. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 12 A quarter of service users took their meals in their bedroom during the inspection visit in May 2006. More than half were spending most of their time in their bedroom during the September 2006 inspection (a reason given was that an infection outbreak was affecting staff and service users). In keeping with the home’s claims in it’s service user guide, the home is seeking to ensure that most service users are assisted to dress and then have meals in the dining room and receive more appropriate staff assistance. There is also additional thought being put into improving the ambiance of the dining room (ie. provision of linen tablecloths and serviettes and menu cards) at mealtimes. Menu cards for each day would show the choices available that day (which during the last inspections were limited). Information provided to the commission indicates that there is dissatisfaction with aspects of how food is provided to service users and the quality of meals. Charing Healthcare’s area manager is aware of these concerns and has undertaken to address them. The home’s medication trainer discussed medicine administration procedures by phone with the commission. The trainer has agreed with the area manager that the training procedure would be altered to include a significant element of competency testing. With the wide variation in the levels of service users’ physical infirmity, mental health support needs and sensory impairments together with the dispersed nature of the premises and access difficulties, four care assistants worked hard to cope effectively in meeting resident’s support needs. Since the inspection visits, the area manager has agreed to increase staffing levels to improve the comfort, safety and general support for service users. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality on this outcome area is poor. This judgement was made using available evidence including a visit to the service. It is also based on events following two recent inspections of the service. Service users maintain good contact with friends and relatives. They exercise control over their own lives insofar as their health allows and they receive support in maintaining good lifestyles. They would benefit from more assistance in this respect. EVIDENCE: Many service users stay mostly in their bedrooms. The home is addressing how best to assist service users have their meals in the dining room and to get dressed for such “outings” and be helped from their bedrooms. Service users on the 2nd floor are isolated to a considerable extent. Increased efforts and specific staff skills would need to be utilised to enable these service users to have a better lifestyle (currently it is claimed that service users prefer their current routines). The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 14 Since March 2006 when the activities organiser took up her appointment, there have been progress in assisting service users develop their enjoyment of daily life. The availability of 20 hours a week is a good start. The extreme pressures on staff in such a dispersed premises in meeting the assessed and changing needs of service users are alleviated only partially by such therapeutic support. A record book is maintained that details the activities service users are encouraged to take an active part in. Visitors said at a previous inspection visit that they are made welcome. The home has a good supply of books, newspapers and magazines available. Following two inspection visits, the commission has received information from a number of sources including Social Services about alleged shortfalls in the quality of food provided and the way it is presented. Charing Healthcare’s area manager is assessing how best to improve this important aspect of service user support. Some of the concerns arose from the failure of service users to recover more quickly from pressure sores. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality on this outcome area is poor. This judgement was made using available evidence including a visit to the service. It is also based on events following two recent inspections of the service. Service users are not receiving sufficient support that ensures they are not subject to abuse. EVIDENCE: At 2 previous inspections of the home, visitors and service users said that members of staff listen to concerns and complaints and take these seriously. Service users spoke openly about how they had no hesitation in making their views known. A copy of the local authority adult protection policy was available at the home. Members of staff met on that occasion were aware through experience and training of the risks to vulnerable people from various forms of abuse. Since the inspection visits, the commission has received a number of reports about possible neglect of service users, lack of adequate management and poor training and support of staff. Social services have conducted enquiries into aspects of support being given to service users. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 16 Charing Healthcare’s area manager has advised the commission about how the home is taking immediate steps to prevent possible further abuse of service users and these initiatives will be continued thereafter. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. Quality on this outcome area is adequate. This judgement was made using available evidence including a visit to this service. It is also based on events following two recent inspections of the service. The premises are suitable for the provision of support for older people. The safety and comfort of service users is being improved by external and internal refurbishment. EVIDENCE: The premises comprise bedrooms on the ground, first and second floors. The first floor is reachable by stairs and a passenger lift. Access to the third floor is more difficult as there is no passenger lift and service users use 2 stair lifts. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 18 Five bedrooms have en-suite facilities. There are 17 single and 5 shared bedrooms. One shared bedroom has an “en-suite” facility that does not comprise a WC. Shared bedrooms are currently under refurbishment to improve their decoration and to install sufficient facilities for the promotion of privacy for their occupants. Much of the external refurbishment has recently been completed. The maintenance schedule also includes the provision of a suitable lock on all bedroom doors that service users have the choice of using at any time. There are car-parking facilities at the side of the premises. The garden is suitable for use by frail older people. The gardener also maintains the gardens of other homes owned by the company. Water temperatures are taken regularly and recorded to guard against accidental burns (and temperature controllers are fitted). There were no persistent odours generally evident during the 2 previous inspection visits. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality on this outcome area is poor. This judgement was using available evidence including a visit to this service. It is also based on events following two recent inspections of the service. Service users are not adequately benefiting from provision by the home of sufficient numbers of staff and by the provision of adequate levels of training. EVIDENCE: Discussions have taken place between Charing Healthcare’s area manager and the commission about the pressure on staff to meet the support needs of service users in premises dispersed over a large area. Concern has also been expressed at a Kent Social Services case conference. The lack of suitable ancillary staff also meant that members of care staff were responsible for many ancillary tasks. Infection control failures are likely to have led to a serious outbreak of illness amongst staff and service users. The outbreak was eventually effectively controlled. The area manager has undertaken to address staffing problems. Staff files previously checked indicated that application forms are completed by all new staff, two written references are taken up, CRB (criminal record The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 20 bureau) checks are taken up and an induction procedure is followed. It has subsequently been identified that the induction procedures were not effective. Examples of supervision records were seen. These indicated that the manager discussed aspects of good and poor practice with staff regularly. The procedure also led to agreement on the types of support and training needed by staff. The levels of staff training have been identified as insufficient in meeting the specialist needs of service users. The area manager has undertaken to improve all aspects of staff training. This includes the acceleration in the rate of staff achieving NVQ Level 2 in Care, mandatory training of all care and support staff and specialist training for all care staff in dementia care. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38. Quality on this outcome area is poor. This judgement was made using available evidence including a visit to the service. It is also based on events following two recent inspections of the service. Service users do not have the benefit of living in a residential home that is well conducted EVIDENCE: Over the previous 18 months, Charing Healthcare has assured the commission that improvements requested had either been implemented or under active consideration. These assurances have not been met and there has been a long period of unstable management. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 22 The area manager has provided definite undertakings to make a series of improvements that contribute to service user’s comfort and safety. The CSCI survey received a mixed response from service users and their supporters. These responses were contained in more detail in the May 2006 inspection report. Some concerns were expressed about the levels of staffing and the availability of staff when called upon. Other information received since then by the commission has confirmed that problems persist which adversely affects the comfort and safety of service users. Care managers have reported that there is a high incidence of falls by service users with the relevant care plan stating “fall not witnessed”. The area manager is addressing how best to provide an effective framework to meet the support needs of vulnerable older people. The improvements in using care plan records have been a useful development at the home. Social services care managers and the Adult Protection Co-ordinator have been involved in a series of activities to protect service users. The shortfalls in support levels for service users identified over the past few months have led to the conclusion that the home has not been conducted in the best interests of service users. In written information provided by the manager to the Commission prior to May 2006 inspection, a declaration was made that all safety checks have been made and all necessary safety and maintenance certificates and checks are in place and up-to-date. Service users or their families or advocates are expected to be responsible for service user’s financial and legal matters. The home provides advice to a service user in obtaining independent advice if circumstances required this. Supplementary invoices are sent service user’s representatives to cover costs incurred each month for items not covered by the fee. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 23 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 1 x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 1 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 x 18 1 2 x x x x x x 3 STAFFING Standard No Score 27 1 28 1 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 x 1 x 3 x x 3 The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP31 Regulation 8 & 10 Requirement A manager must be appointed to run the home and the manager must be registered with the Commission. The registered provider shall appoint an individual to manage the care home... Timescale for action 01/12/06 At the inspection visit on 29/09/06, the area manager and general manager stated that a new manager would begin work on 16/10/06 and an application for registration would be made to the CSCI Regional Registration Team within 4 weeks of the manager taking up the appointment. 2. OP27 18 The response from service users 01/12/06 and their representatives indicated that improvement is needed to provide the necessary levels of staff and skill mix. This is due to the heavy dependency needs of service users and the dispersed nature of accommodation within the home. The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 25 The registered person shall, having regard to the size of the care home..ensure that at all times suitably qualified..persons are working at the home in such numbers... At the inspection on 29/10/06, the area manager and general manager stated that, with immediate effect, the number of care assistants on duty would be changed from 4:4:3 to 5:4:3 (am/pm/night) with an increase to 5:5:3 under further consideration because of the complexity of the premises and very high dependency levels of service users. A kitchen assistant, weekend domestic worker and laundry assistant would be employed. The need for an additional activities organiser would be reviewed. The need for an additional weekday domestic worker must be considered to cover for holidays and other absences (the current Service User’s Guide wrongly claims that 3 such staff are employed). 3. OP23 16 & 23 The schedule of repairs and maintenance is acknowledged. This should include the upkeep of individual bedrooms and particularly shared bedrooms for the promotion of privacy and safety for service users. The registered person shall provide facilities and services.. 01/02/07 At the inspection on 29/10/06, the area manager and general manager stated that the programme of internal refurbishment would carry on from the external repair The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 26 programme now underway. Carpets would be replaced and all common areas and bedrooms would be substantially upgraded. A dishwashing machine would be immediately installed to take this chore from care assistants who are already overburdened. 4. OP28 18 & 19 A staff training and development 01/01/07 programme must be put into place to enable members of staff to support service users who have dementia and other very high dependency needs. This requires that all members of staff undertake training appropriate to the tasks they undertake. All care assistants must receive appropriate training in a range of disciplines recognised as mandatory. This includes induction training, moving and handling and updates, first aid (so that at least one member of every shift is first aid trained), COSHH, fire safety and medication administration. Members of care staff must be registered on a course leading to NVQ Level 2 in Care and assisted in completing this qualification. As the home is registered to provide professional support for people with dementia, care assistants should be assisted in undertaking an appropriate additional qualification. The commission does not specify the type of course to be chosen but the VRC (Level 2) in dementia care is likely to be suitable. This is needed to support any claim by the owner that it is a specialist home caring professionally for people with DS0000061139.V317926.R01.S.doc Version 5.2 Page 27 The Vale advanced support needs including dementia-type illnesses. The registered person shall…ensure that…persons employed receive…training appropriate to the work they are to perform…. A person is not fit to work at a care home unless…he/she has the qualifications suitable to the work he/she is to perform and the skills and experience necessary for such work. An undertaking to this effect was given at the previous inspection visit in May 2005. However, this manager left the home on the following week to take up employment in another of Charing Healthcare’s homes and the undertaking was set aside by the home. 5. OP15 16 (2) (i) Service users must receive food that is well cooked and presented in a suitable way. The provision of meals is important because service users have few other advantages in their lives and because the intake of solids and fluids is of optimum importance to service users for prevention of infection and recovery. The area manager is aware of the concerns and has taken steps to improve the situation for service users (eg. better meal planning, menus and choices for service users). The company’s catering manager will be involved in improving this aspect of service provision and development. The registered person shall provide…food…as may reasonably The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 28 30/11/06 required by service users. 6. OP1 4, 5 & 6. Prospective service users and 30/11/06 their representatives must be provided with a Service User’s Guide that accurately describes the facilities and services provided by the home. In view of the extensive misleading information contained in the current guide copies of the revised document must be given to all prospective service users and their supporters. In due course, a copy of the new guide should be provided to all existing service users or their representatives. The registered person shall produce a written guide to the home…. The registered person shall keep under review and…revise the service user’s guide…and notify service users of any such revision within 28 days. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Vale DS0000061139.V317926.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000061139.V317926.R01.S.doc Version 5.2 Page 30 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!