Inspection on 09/09/08 for The Vale

This inspection was carried out on 9th September 2008.

CSCI found this care home to be providing an Good service.

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

The Vale 06/07/07

The Vale 30/10/06

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 17/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Vale 191 Willington Street Maidstone Kent ME15 8ED     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wendy Mills     Date: 0 9 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: The Vale 191 Willington Street Maidstone Kent ME15 8ED 01622762332 Telephone number: Fax number: Email address: Provider web address: sally@charinghealthcare.co.uk Name of registered provider(s): Type of registration: Number of places registered: Charing Vale Ltd care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 28. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE). Date of last inspection Brief description of the care home Residents have significant levels of dementia, sensory impairments and/or physical disabilities associated with advancing years. Their bedrooms (18 single and 5 shared) are on ground, first and second floors. 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 is as follows Kent County Council: #402 per week. Other local authorities may pay different fees. Privately funded residents: #500-#550 per week. The Resident?s Guide contains information about services and facilities. Additional charges are made for hairdressing, chiropody, newspapers, private telephones and call costs, Freeview converters). 28 Over 65 0 Care Homes for Older People Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection was undertaken by Wendy Mills, link inspector, on behalf of the Commission for Social Care Inspection (CSCI). The inspection lasted seven hours. During this visit, time was spent talking to residents, staff and the registered manager, examining documentation and making a tour of the home. Feedback from health and social care professionals and relatives and supporters of the residents was considered and direct and indirect observation was used throughout the visit. This report is compiled using evidence gathered at this visit as well as information supplied to the CSCI prior to this visit, for example, feedback from health and social care professional or from information that the home has supplied such as notifications required under the regulations of the Care Standards Act. The evidence is then used to Care Homes for Older People Page 5 of 26 give the home a star rating. The outcome of this visit and the positive feedback received has resulted in the home being awards a 2 Star rating. This means that the home is judged as good. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Older People Page 7 of 26 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides the service users, their relatives and supporters with the information they need so that they can make an informed decision about their choice of home. Residents are properly assessed before a place at the home is offered. This ensures that only those people whose needs can be met are cared for in the home. Evidence: The home has a comprehensive Statement of Purpose and Service User Guide. These documents give good information about the home to any prospective service users and their supporters. The home also produces a monthly newsletter that gives very good information about the day-to-day activities in the home. The care plans of residents recently admitted to the home were examined. The Care Homes for Older People Page 10 of 26 Evidence: registered manager said that she undertakes an assessment of prospective residents and only those whose needs can be met are offered a place at the home. A sample of care plans was examined. There is a written plan of support for each service user. These are important documents. This is because they form one of the means by which the residents and their supporters can be tell that they will be supported in the manner of their choice. Also, the plans are a source of reference information for the care workers who need to ensure that they assist people in a consistent and appropriate manner. Since the last inspection a great deal of work has been done to develop the care planning process. All care plans have been completely revised and changed to focus on person centred care. Much old documentation has been archived so that paperwork is much better organised and easier for staff to use. The home does not provide intermediate care. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home promotes the health and well being of the residents and respects their privacy and dignity. Evidence: Since the last inspection a great deal of work has been done to develop the care planning process. All care plans have been completely revised and changed to focus on person centred care. Much old documentation has been archived so that paperwork is much better organised and easier for staff to use. The care plans now also contain a next of kin sheet for participation and agreement to change for those residents who are no longer able to make appropriate decisions. The care plans show that the home monitors the health and well-being of the residents very well. All residents are registered with local general practitioners (GPs) and the advice of other health and social care professionals, such as district nurses and care managers, is sought and followed. Care Homes for Older People Page 12 of 26 Evidence: The policies and procedures for promoting equality and diversity in the home have been revised to ensure that the need to value the diverse backgrounds and wishes of individual residents are now incorporated into the care planning process. The likes and dislikes of individual residents are noted in their care plans. Residents and/or their relatives are asked if they would like to complete life histories so that a little more is known about them. This information can then be used as a basis for decision-making should a time comes when a resident is no longer able to make their own decisions. Staff receive training in equality and diversity to help them understand the ways and means by which they can identify specific needs and to treat people with equitably. Staff also receive training in specialist areas such as dementia and diabetes to help them understand the care needs of people suffering from these conditions. There are sound policies and procedures for the management and administration of medicines in the home. Medicines are stored safely and securely. A senior carer takes the main responsibility for monitoring medicines in the home and ensures that prescriptions are processed quickly. The registered manager oversees all aspects of medicines in the home and carries out spot checks to make sure policies and procedures are being followed. There have been recent audits of all aspects of medication, including a check on those medicines prescribed for used when required (PRN). There are clear polices in place to ensure that the residents are treated with respect and dignity at all times. The need to respect privacy and dignity is actively promoted and staff receive training in this during their induction training. Throughout the visit, direct and indirect observation showed that staff treated the residents with the utmost kindness and respect. They were seen to knock on doors, speak gently and address the residents in a respectful way and to encourage, but not force, participation in activities around the home. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home values equality and diversity and provides a wide choice of activities and healthy and appetising meals. This enhances the lives of the residents and helps them stay as independent as possible. Evidence: The home values and promotes equality and diversity and provides a wide range of opportunities that help maintain the independence of each resident. Since the last inspection the home has appointed an activities co-ordinator. This has made a significant difference to the daily life in the home. There is now a good choice of activities and all staff are encouraged to support activities within the home. The staff have a good understanding of the ways in which residents can be encouraged to participate. For example, some residents like to take part in tasks such as laying the tables but prefer not to take part in more organised activities such as music and movement. Some residents were observed to participate in preparation for lunch by folding serviettes whilst others joined in games and exercises. A few residents made it clear that they did not want to join in any activities and their choice was respected. Care Homes for Older People Page 14 of 26 Evidence: A significant improvement in activities since the last inspection is the development of sensory boxes. The boxes contain a variety of familiar things such as rice, garden mint and cornflakes. Residents have to try to identify the objects by using senses such as touch and smell. The sensory games have been a great success and have helped residents maintain the use their senses. Since the last inspection the home has created a reminiscence room in the small, quiet lounge. This room is also available for private entertainment for residents, such as family lunches and tea parties as well as for daily use. Visitors are welcomed at any reasonable time and relatives say they are made to feel a valued part of the life of the home. The home now produces a monthly newsletter that tells residents, and their families latest news about the home and any planned activities. The most recent newsletters told of celebrations of birthdays and a golden wedding, a successful garden fete, entertainers who visited the home and a number of outings, including a trip on the River Medway. The activities co-ordinator is commended for the work she has put in and for the way in which she has made such a significant improvement in activities both within and outside the home and the high quality of the newsletter she produces. Religious and cultural needs are catered for. A local vicar visits the home and arrangements would be made for other religious leaders to visit if the need arose. The home has a pleasant dining area. Residents can choose where to eat their meals although most prefer to use the dining area. There is a varied and nutritious menu and there was plenty of locally purchased fresh produce in the home on the day of inspection. Conversation with the cook showed that she is able to change menus to suit the needs of residents and can cater for special diets. The main meal is taken at midday. This was sampled and found to be appetising and well cooked. Residents, who were able, said that they enjoyed their meals. Direct and indirect observation showed that support was to those who needed help with eating in a discrete and unhurried way. Since the last inspection the home has introduced review sheets for families and professionals to note food and other preferences through observation. This information is then recorded in the care plan and the home makes sure that food that a resident dislikes is not offered. Care Homes for Older People Page 15 of 26 Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has sound policies and procedures for managing concerns, complaints and safeguarding issues. Staff clearly understand these processes and act accordingly. This means that the home does all it can to protect the residents from harm. Evidence: The home has sound procedures for handing complaints, concerns and safeguarding issues. The complaints procedure is contained in the Statement of Purpose and the Service User Guide and is also displayed in the entrance to the home. Discussion with the registered manager showed that concern is dealt with immediately and resolved the satisfaction of all concerned. Discussion with staff and inspection of training records showed that all staff receive training in the Protection of Vulnerable Adults (POVA). It is clear that they have a good understanding of safeguarding issues and would be prepared to report any concerns to the manager. They said that the manager is easy to talk to and can be relied upon to act on concerns. Discussion with the registered manager showed that she has a very good understanding of safeguarding. She maintains good relationships with health and social care professionals and seeks their advice appropriately when faced with complex safeguarding dilemmas. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is clean and well maintained. This gives the residents a pleasant and homely place in which to live. Evidence: The home is clean and well maintained and there is a welcoming atmosphere. This gives the residents a pleasant and homely place in which to live. The home has a very warm and welcoming atmosphere. It is well maintained, clean and has no offensive odours. A laundry assistant, a maintenance person and cleaning staff are employed. There are sound infection control measures in place. There is plenty of communal space with a large conservatory, sitting and dining areas as well as a small, quiet lounge referred to as the parlour. Since the last inspection there have been further improvements to the environment. The parlour has been redecorated and furnished in a 1940/1950.s style. Books, magazines and ornaments in this room prompt reminiscences. This provides a peaceful room that promotes conversation about past times. It is a pleasant room where residents and their relatives can spend time away from the busier atmosphere of the other communal areas. In addition, fourteen bedrooms have been redecorated. Care Homes for Older People Page 18 of 26 Evidence: Outside there is a well maintained and enclosed garden where residents can participate in a number of activities, including gardening. In the past months the home has held a garden party and a strawberry tea in the garden. On the day of inspection several residents were enjoying spending time walking in the garden. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels, staff training, staff recruitment procedures and staff morale are all good. This means that the residents are cared for by a well qualified and cheerful staff team. Evidence: Staffing levels, staff training and staff morale are all good. This means that the residents are cares for by a well qualified and cheerful staff team. On the day of inspection there were good staffing levels and staff rosters showed that the appropriate number of care staff are placed on each shift. In addition the home employs a maintenance person, a laundry assistant, a cook, kitchen assistants and cleaners. The home is commended for the staffing levels. Inspection of a sample of staff files showed that a good level of training both in statutory and specialist areas is going on. Staff have received training in equality and diversity, diabetic awareness, managing bereavement, therapeutic activities and dementia. All staff have received training in the procedures for safeguarding vulnerable people. The National Vocational Qualification (NVQ) at level two, is held by eight members of staff and two more will complete this very soon. One member of staff is studying for the NVQ at level four and eleven now hold the VRQ in dementia. Care Homes for Older People Page 20 of 26 Evidence: All kitchen staff hold a three-year, level two award in food safety in catering. Staff spoken to say that they enjoy working in the home and that they receive plenty of training and support to enable them to do their jobs. Direct and indirect observation showed that staff were kind and caring towards the residents and offered support, when needed, in a discrete and gentle manner. The home has sound policies and procedures for the recruitment of staff. Inspection of a sample of staff files showed that appropriate pre-employment checks had been made, including Criminal Records Bureau (CRB), Protection of Vulnerable Adults (POVA) and written and verbal references. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed; the views of the residents and their supporters are listened to and acted upon. This means that the home is run in the best interests of the residents. Evidence: Since her appointment, the manager, Ms Sally Sharpe has provided strong and proactive leadership for the home. She has ensured that all the requirements from the last inspection have been met and that further improvements have been made. She is well qualified and has over twenty years experience of working in care settings. Staff said that Sally is a very supportive manager and that she listens and acts upon their ideas and concerns. Good arrangements for staff supervision are in place and staff confirmed that they receive enough supervision to help them do their jobs. Discussion with Ms Sharpe showed her to be knowledgeable about best practice in care Care Homes for Older People Page 22 of 26 Evidence: and to be very aware of the needs of people with dementia. She communicates effectively and appropriately with the Commission. Direct and indirect observation showed that she understands the needs of the residents and communicates well with staff. Her office is well organised and tidy and records are stored securely. She was able to put her hand to all documentation requested during this visit. The home carries out regular health and safety audits and records these properly. No health and safety hazards were noted during a tour of the home. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!