Inspection on 10/11/06 for The Vale Care Centre

This inspection was carried out on 10th November 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Vale Care Centre 20/06/07

The Vale Care Centre 18/01/06

The Vale Care Centre 04/02/05

The Vale Care Centre 18/08/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Vale, The Care Centre Castle Lane Bolsover Chesterfield Derbyshire S44 6PS Lead Inspector Angela Kennedy Key Unannounced Inspection 10:30 10th November 2006 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 Vale, The Care Centre DS0000002096.V315739.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. Vale, The Care Centre DS0000002096.V315739.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Vale, The Care Centre Address Castle Lane Bolsover Chesterfield Derbyshire S44 6PS 01246 824252 01246 241020 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) Southern Cross Care Homes Limited Vacant Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (3) of places Vale, The Care Centre DS0000002096.V315739.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Vale Care Centre is able to accommodate an additional 3 named service users under the category of PD The maximum number of persons accommodated within Vale Care Centre is 40 No one falling within category OP may admitted into Vale Care Centre where there are 40 persons within the category of OP already admitted 18th January 2006 Date of last inspection Brief Description of the Service: The home is, a 40-bedded establishment, purpose built and is of modern appearance. It is located within the community of Bolsover. The home has provision for nursing and personal care. It consists of lounge / diners and separate lounges, with all bedrooms being single occupancy. Further details are listed above. The fees for The Vale per week, as at the 2nd October 2006 were: Nursing: Low Mid High £387.15 £ 430.15 £480.15 Residential Low £308.50 Mid £ 322.55 High £ 340.10 Vale, The Care Centre DS0000002096.V315739.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced key inspection, which means that the Vale was assessed against all of the key national minimum standards. The inspection included a thematic enquiry as part of a national pilot scheme. This consisted of asking a number of standardised questions to a sample of residents. The acting manager was informed and the agreement of the resident was sought before asking a set of questions about the care they received. The inspection lasted approximately six hours and the following areas were assessed: Three residents care files looking at their care plans, risk assessments and other relevant information that related to the care and support they received. These three residents were spoken with regarding their views of the service and the care provided. Two staff files looking at recruitment records and training undertaken. These two members of staff were spoken with regarding their opinions of the support and training they received. An additional member of staff was also spoken with and a prospective relative. A partial tour of the building was undertaken to assess the condition and maintenance of the building. Other records were looked at relating to staffing levels, staff training, medication practices, how the service manages complaints, the meals provided, the activities available to residents and records relating to the servicing of equipment and fire safety practices. Throughout the inspection the acting manager was available to provide any documents required and answer any questions. What the service does well: Vale, The Care Centre DS0000002096.V315739.R01.S.doc Version 5.2 Page 6 The care plans and risk assessments in place were good and clearly instructed staff as to the care and support required to meet the resident’s needs. All documentation relating to individual needs was regularly reviewed to ensure any changing needs were identified and met. Training provided to staff was ongoing and this ensured that staff were kept up to date with training, and training needs were met to ensure residents were cared for by staff who had the skills and knowledge required. A positive rapport was observed between the staff and the residents. What has improved since the last inspection? What they could do better: In general The Vale provided a good standard of care. However the recent staff turn over and staffing levels had impacted on both staff and residents, as discussions with both staff and residents demonstrated. During the tour of the building it was noted that two baths were in need of repair, it was stated that these repairs had been ongoing for some time due to the incorrect assessment of the parts required. One member of staff was said to be working under the supervision of senior staff whilst awaiting a satisfactory criminal records bureau check. This member of staff did have a POVA first check in place but there was no evidence on the staff rota to demonstrate the senior member of staff they were working with each day. Vale, The Care Centre DS0000002096.V315739.R01.S.doc Version 5.2 Page 7 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. Vale, The Care Centre DS0000002096.V315739.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 Vale, The Care Centre DS0000002096.V315739.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): 1,2,3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s have the information they need to make an informed choice about The Vale and written contracts of residency were in place. Resident’s needs were assessed before moving into The Vale to ensure their needs could be met. EVIDENCE: Although the Service User Guide was not looked at during this inspection, one resident was asked if they had an up to date copy of the service user guide, as one of the questions asked as part of the thematic enquiry. (See summary of report for further information regarding this) Vale, The Care Centre DS0000002096.V315739.R01.S.doc Version 5.2 Page 10 The resident spoken with confirmed that they did have an up to date copy of the service user guide. As part of the thematic enquiry this resident who was asked if they had a written contract or statement of terms and conditions. They stated that they did have a contract but they were unsure if the contract had changed since they came to live at The Vale. Three residents files were seen and all had contracts in place regarding the terms and conditions of their residency. All of the three residents files seen had a needs assessment in place that had been undertaken prior to admission. This assessment had looked at all the areas of need and demonstrated that resident’s needs were appropriately assessed to ensure their needs could be met. The resident taking part in the thematic enquiry was asked if anyone had talked to them before they moved into The Vale about what their care needs were. The resident said they had been assessed and spoken with about their care needs before they moved into The Vale. Vale, The Care Centre DS0000002096.V315739.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 in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s health, personal and social care needs were set out within an individual plan of care and residents were treated with dignity and respect. Medication practices in place ensured the safety of residents was maintained. EVIDENCE: The care plans seen within the three residents files looked at were of a good standard and clearly instructed staff of the support and care required to ensure resident’s needs were met regarding their health, personal and social care needs. Each resident had a key worker who was responsible for ensuring their care plans were reviewed and kept up to date. Vale, The Care Centre DS0000002096.V315739.R01.S.doc Version 5.2 Page 12 All care plans had been assessed on a monthly basis to ensure any changing needs were identified and addressed. Two of the residents had signed in agreement of their care plans, one resident had declined to sign but on discussion with this resident it was confirmed that they were happy with the support and care provided but due to related health issues had declined to sign any documents. Risk assessments seen were detailed, regularly reviewed and again provided clear instruction to staff regarding any risks and the appropriate action required. Various risks assessments were seen these included; wound assessments, pressure area care, dependency, moving and handling, nutrition, continence, falls, diet, mobility and activity. The medication practices used at The Vale were good. No errors were noted on the medication administration records and all medication was stored correctly. Residents spoken with were very complimentary regarding the care and support they received from the staff team and confirmed that staff treated them with respect and dignity. A public telephone was available for residents use and residents were able to have their own telephone line within their private accommodation if they wished. It was noted that residents were addressed by their preferred name and this was recorded within their care files. Vale, The Care Centre DS0000002096.V315739.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 in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Activities although limited were available and residents were able to maintain contact with family and friends and were encouraged to maintain choice and control over their lives. The meals provided were varied and nutritious in content. EVIDENCE: There is no longer an activities co-ordinator in post at The Vale, however the acting manager did say that this post had been recently advertised. Discussions with the residents suggested that activities used to be good but due to low staffing levels had deteriorated. No activities were observed taking place on the day of inspection. Vale, The Care Centre DS0000002096.V315739.R01.S.doc Version 5.2 Page 14 An activity notice board was on display within the entrance area that stated the outside entertainment planned. This included visits from the Salvation Army and a local men’s choir. Also on display were memory cards written by some of the residents regarding their lives, which were to be used to make a memory book. A rota showing the activities for each day were displayed, the activities included; bingo, games, chair based exercises, baking and crafts, manicures and hand massages, reminiscing and reading. Visiting times at The Vale were open and residents were able to receive their visitors within their private accommodation or within the communal areas as they chose. Residents were able to bring their personal possessions into The Vale and an inventory was kept within resident’s files. Set menus were provided however it was confirmed by both residents and staff that alternative meals were always made available if required. Resident’s comments regarding the quality of the meals provided were positive. Vale, The Care Centre DS0000002096.V315739.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 in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were confident that any concerns they had would be listened to and acted upon and the practices and procedures in place demonstrated that residents’ were protected from abuse. EVIDENCE: The complaints log was seen and evidence was in place to demonstrate that all complaints had been dealt with satisfactorily. The commission were made aware by the service, of concerns that had been raised regarding a possible adult protection issues. This issue had been dealt with appropriately and investigated by the local authority as required. Vale, The Care Centre DS0000002096.V315739.R01.S.doc Version 5.2 Page 16 Staff received training in Safeguarding Adults from the provider and the acting manager confirmed that she had undertaken multi disciplinary safeguarding adults training. No Safeguarding Adults referrals or investigations were being undertaken at the time of inspection. The resident taking part in the thematic enquiry was asked if they had received written information that told them how to make a complaint, they stated that they had and felt that they had all the information they required to raise any concerns they had about their care. Vale, The Care Centre DS0000002096.V315739.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, 21,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable environment that is generally well maintained with good standards of hygiene in place. EVIDENCE: A partial tour of the building was undertaken mainly looking at bathrooms, communal areas, laundry and some bedrooms. One bathroom on the ground floor was out of order as the bath was in need of repair; this left only one bath available on the ground floor. It was stated that some residents had to be escorted to the first floor for their bath. Vale, The Care Centre DS0000002096.V315739.R01.S.doc Version 5.2 Page 18 The Parker bath on the first floor although still in use also required minor repairs due to a leak at the front area of the bath. The manager stated that repairs had been ongoing whilst the nature of the repairs required was determined. The laundry area was seen and provided sufficient equipment to ensure residents clothing and linen could be laundered appropriately. Washing machines were able to meet disinfection standards. The communal areas were seen and provided sufficient lighting and heating. Comfortable armchairs were provided for residents use. Bedrooms that were seen provided all of the required furniture and equipment and were decorated to a good standard. Vale, The Care Centre DS0000002096.V315739.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 in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff had the skills, training and competency required to their job, however the staffing levels available did not demonstrate that all of the residents needs could be met. Residents were supported and protected by the homes recruitment policy and practice. EVIDENCE: Two members of staff were spoken with to determine their views of the care provided, the support given by their manager and senior staff, and the training provided. One of the members of staff spoken with had recently commenced employment at The Vale. Discussions took place regarding the induction Vale, The Care Centre DS0000002096.V315739.R01.S.doc Version 5.2 Page 20 training he had received. This member of staff confirmed that mandatory training had taken place such as Moving and Handling, Health and Safety and Care of Substances Hazardous to Health. However there was no evidence in place to demonstrate that this member of staff had received any in house induction training or that they were being supervised. Although this member of staff had been employed for one month there was no written contract of employment available within their personal files. These issues were discussed with the acting manager. The other member of staff spoken with had worked at The Vale for several years and had undertaken mandatory training as and when required such as moving and handling, food hygiene, fire safety and infection control. Both members of staff discussed concerns they had regarding staff shortages and both confirmed that they had worked additional hours to cover shifts. A prospective residents relative who had visited The Vale on several occasions was also spoken with and expressed concerns regarding the staffing levels. This relative stated that staffing had been an issue at the home as several members of staff had left over the last few months and this had left staff shortages. This relative also said that the staff employed at the home demonstrated a caring attitude towards residents. The rotas over a three-week period were looked and demonstrated that one qualified member of staff was on duty from 8am to 8pm with five care staff throughout the day, and one qualified nurse was on duty throughout the night with three care staff. The acting manager stated that at present staffing hours were down by 90 hours a week, which meant that staff were being asked to cover additional shifts. It was confirmed that three new staff had been appointed and were waiting for satisfactory clearance checks to be sent. Both members of staff had the required recruitment documentation in place within their personal files. However one of the staff did not have a Criminal Records Bureau check in place but did have a satisfactory POVA first check in place, which allowed them to work under supervision. As stated above there was no written evidence to demonstrate that this member of staff was working under the supervision of a senior member of staff. Although the member of staff in question stated that he had shadowed senior staff. The acting manager confirmed that 50 of the care staff team had achieved their National Vocational Qualification in care at level 2 or above. Vale, The Care Centre DS0000002096.V315739.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 in this outcome area is good. This judgement has been made using available evidence including a visit to this service The service is run in the best interests of resident’s and their financial interests safeguarded and health and safety are promoted and protected by the safe working practices of the home. EVIDENCE: The acting manager had applied for registration with the commission for social care inspection and had the training and knowledge required to manage the service. The staff spoken with had varying opinions regarding the management approach of the acting manager, however the issues discussed did not impact Vale, The Care Centre DS0000002096.V315739.R01.S.doc Version 5.2 Page 22 on the health and welfare of the residents. The acting manager was aware of these issues and stated that they were being addressed. Effective quality monitoring systems were in place at The Vale, this included reports of the monthly visits undertaken by the provider and monthly audits on medication and accidents. Training audits were also undertaken monthly to provide the statistics of staff training undertaken. The financial transaction records were seen for residents whose money was kept for them by the service. Clear written records were in place that recorded all transactions. It was noted that not all transactions had two signatures in place and as a matter of good practice; to protect both residents and staff, it is advised that two signatures are provided at each transaction when handling resident’s monies. Some of the safe working practices undertaken at The Vale were assessed and were satisfactory, this included valid certificates of inspection for the Fire Alarm system and nurse call system, service certificates for lifts and the sluicing machine, a valid Gas Safety record, valid portable electrical equipment tests and valid water chlorination certificate. Training in Control of Substances Hazardous to Health had also been undertaken in September 2006. Vale, The Care Centre DS0000002096.V315739.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 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 2 X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Vale, The Care Centre DS0000002096.V315739.R01.S.doc Version 5.2 Page 24 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 2 Standard OP12 OP21 Regulation 16 (n) 23 (2) (j) Requirement Activities must be arranged in consultation with residents and provided on a regular basis The two baths requiring repair must be repaired to ensure adequate bathing facilities are available to residents. Staffing levels must ensure residents needs can be met and their welfare maintained. For new staff who commence employment with a satisfactory POVA first check in place (whilst awaiting a satisfactory CRB check) evidence must be in place to demonstrate that a nominated member of staff who is appropriately qualified and experienced is appointed on duty at the same time as the new worker to supervise the new worker, and ensure that new worker does not escort residents away from the building unless accompanied by the nominated member of staff. A record of the Terms and Conditions of employment must be in place within all staff files DS0000002096.V315739.R01.S.doc Timescale for action 31/01/07 31/12/06 3 4 OP27 OP29 18 1 (a) 19 (11) (a) (b) (c) 18/12/06 30/11/06 5 OP29 17 (2) Schedule 4(6)(d)(e) 30/11/06 Vale, The Care Centre Version 5.2 Page 25 6 OP30 18 (c) (i) Evidence must be in place to demonstrate that all new staff undertake structured induction training. 30/11/06 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 Refer to Standard OP35 Good Practice Recommendations Records relating to residents financial transactions should have two signatures in place at each transaction. Vale, The Care Centre DS0000002096.V315739.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Vale, The Care Centre DS0000002096.V315739.R01.S.doc Version 5.2 Page 27 - 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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