Inspection on 20/06/07 for The Vale Care Centre

This inspection was carried out on 20th June 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Vale Care Centre 10/11/06

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 Susan Richards Unannounced Inspection 20th June 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Vale, The Care Centre DS0000002096.V339586.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.V339586.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 valethe@schealthcare.co.uk 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.V339586.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Vale Care Centre is able to accomodate 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 10th November 2006 Date of last inspection Brief Description of the Service: The Vale provides accommodation, personal and nursing care for up to 40 older persons, either male or female, although also has agreement to accommodate three people who are physically disabled included within the total of 40. The home is purpose built over two floors and is located within the community of Bolsover, approximately 12 miles to the north east of Chesterfield town centre and within a short distance of junction 29 of then Ml motorway. There is a choice of lounge and dining space on each floor and all bedrooms are single occupancy, some having en suite facilities. There are a range of aids and equipment and also environmental adaptations to assist those with disabilities, including level access, suitable bathing and toilet facilities, a shaft lift, emergency call system, handrails and grab rails and moving and handling equipment /hoists. Kitchen and laundry facilities are centralised. There is level access to an outside garden to the rear of the home, which provides seating and is well maintained having a green house, lawn and patio areas and planting. People who live at the home is provided with twenty-four hour care and support from a team of nursing, care and hotel services staff, currently led by an acting manager. An activities co-ordinator is also employed. People who wish can access the most recently published inspection report, which is openly displayed in the main reception area, along with other key information about the home. The range of fees per week as at 09 April 2007 is as follows: Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 5 £325.50 – £545.15 per week for those who fees are paid via local authority funding arrangements and, £400.00 - £599 per week for those who are privately funded. The actual fee charged in determined in accordance with individual’s assessed needs and whether or not nursing care is provided. There are additional charge for hair dressing, private chiropody, transport and personal toiletries, which are as per vendor. Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. For the purposes of this inspection we have taken into account the relevant information the Commission holds about the service, the previous key inspection report of 10 November 2006, a pre-inspection questionnaire (AQAA) completed by the registered persons for the purposes of this inspection. During our visit to the home, case tracking was used as part of our methodology. This included three people whose care and service provision was more closely examined. Discussions were held with them and with staff about their care and the services they receive and their care plans and associated care records were examined. Their private and communal accommodation was also inspected. Discussions were also held with the relatives/representatives of some people accommodated. What the service does well: People live in a safe, clean and comfortable environment, which suits their needs. People’s needs are effectively assessed, in consultation with them and their health and personal care needs are well met in accordance with their lifestyle preferences and risk assessed needs. People are provided with a good standard of food, which accords with their preferences and assessed needs. Mealtimes are well organised and people receive the support and assistance they require from staff who do this in a sensitive manner. People know how to complain and there are effective management systems and arrangements in place to promote people’s protection from abuse. People are well supported from a staff team, who are usually recruited, inducted and trained effectively. The health, safety and welfare of people who live at the home and the staff employed there are overall, well promoted and protected. Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Ensure that people receive accurate and key information about the home and its services. This should also be made available in alternative formats to promote equal opportunity of access for those people who may have sight difficulties. Take action to develop people’s opportunities and choice in relation to leisure and social activities, including outings and community access in order to best promote their individual expectations and preferences. Ensure more prompt attention to the maintenance and repair of equipment in the home (bathing and boiler systems), in order to benefit the people who live there. Always ensure that no staff member commences their employment without the proof and confirmation of their fitness to do so. Implement an evidenced based approach to determining staffing levels, which accounts for people’s dependency care needs in order to promote the best interests of people who live at the home and the staff employed there. Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 8 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.V339586.R01.S.doc Version 5.2 Page 9 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.V339586.R01.S.doc Version 5.2 Page 10 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): NMS 1, 3 & 6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People’s needs are effectively assessed, in consultation with them. The providers stated intent regarding the review of information provided for people about the home, may better inform the majority, although its availability in standard format only may not best promote equal opportunity for access for those with sight difficulties. EVIDENCE: There were 34 persons accommodated. All are British white with Christian beliefs or non-religious. Eighteen people receive nursing care and there are also five people admitted under the category of physical disability (PD). The Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 11 home’s certificate of registration has agreed conditions for three people under the category of PD. This was discussed with the manager and the operations manager who had recently notified the Commission of this issue and who advised that a registration application is to be submitted. Information is provided for people about the home in standard format by way of a written guide. This was examined, together with the home’s statement of purpose. The manager advised that the guide and statement of purpose are currently under review with the aim of providing more accurate and key information, including change of manager details. The existing documents do not contain all relevant information as is required, including the range of needs the home intends to meet, terms and conditions and fees charged and what they cover and information re/access to last key inspection report. Case tracking was undertaken in respect of 3 people, two admitted under the category PD and one older person (OP). Individual’s written needs assessment information, including that relating to risk was fairly comprehensive and detailed in accordance with recognised professional guidance. For one person, their dietary preferences were not recorded. However, discussion with staff confirmed that they were conversant with these. Records of reviews of these were also properly maintained. For one person, (category PD) their nutritional risk assessment review indicated a need for a referral to the dietician given their risk scoring which was very high. There was no written record as to whether this had been undertaken. However, discussions with that person and also with the acting manager advised that this referral had recently been made. Pre-admission assessment records and placement review records were provided for each person case tracked. T People case tracked (or where relevant, their relative) said that key staff consulted with them about their needs regularly. The relative of another person accommodated, category PD who visits daily and represents her husband stated the same. The home does not provide for intermediate care. Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 12 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): NMS 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. People’s health care needs are effectively met in consultation with them. EVIDENCE: The written care plan and associated health care records of those people case tracked were examined and discussions were held with them about their care and their involvement in their care planning. Care plans were formulated in accordance with individual’s risk assessed needs and had regularly recorded reviews. They were reflective of recognised clinical guidance, including that relating to the care of older persons, as relevant for one of them. Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 13 Inputs from and access to outside healthcare professionals were well accounted for, including that relating to specialist and routine health care screening. People spoken were positive about the care and support they received and said that staff were professional, patient, worked hard and were conversant with their care needs. They said they were consulted about their care plans, which were signed by them or their representative where they were unable. They said that their preferred routines were upheld as far as reasonably possible. Discussions were also held with a relative who said that the care was to a good standard and that they are regularly consulted and involved in care reviews in accordance with their role as representative. Systems for the management and administration of medicines were examined via case tracking. Key information was accessible to staff in respect of medicines, including relevant policy and procedural guidance, nursing practise standards guidance and specific medicines information. Discussions were held with people case tracked and also staff about the arrangements for their medicines. Since the previous inspection the Commission has received written notification regarding a medicines error, including details of action taken by the home. This was discussed with the manager and the ongoing arrangements were examined in respect of this and are appropriately managed. The overall arrangements for individual’s medicines were also discussed with those people case tracked and were to their satisfaction. Systems for ordering, storage, administration and disposal of medicines were also in accordance with good practise, including that relating to controlled medicines. All bedrooms have lockable storage provided in the event of any person wishing to manage their own medicines. Although at the time of the inspection there was no person who did so, relevant policy and procedural guidance including a recorded risk assessment were in place in event of this. Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 14 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): NMS 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. The recent employment of an activities co-ordinator and further developments planned, should better enable people to access activities, which accord with their preferences and needs. People are provided with a good standard of food, which accords with their preferences and assessed needs. EVIDENCE: Since the previous inspection an activities co-ordinator has been employed for 20 hrs per week usually planned to provide four hours daily Monday to Friday. Information regarding activities is displayed in the home and recorded social profiles and social care plans are in place for each person case tracked. Discussions were held with those people who confirmed that they were always consulted regarding their social care and daily living routines and received support in accordance with their wishes. Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 15 Photographs of people engaging in various activities and celebrations were displayed in the home. There are also monthly meetings held by ‘Friends of Vale,’ which is a registered charity, who support fund raising activities for residents. The minutes of their meetings are displayed and a monthly newsletter is also circulated. The manager and a visitor to the home advised that there were plans to seek an independent chair for the meetings held by the Friends of the Vale. General discussions with relatives and other residents indicate that a choice of activities are organised in the home, although this was sometimes difficult due to staff availability, particularly at weekends. Care staff felt that people’s dependencies and personal care requirements impacted on their ability to provide activities in the absence of the activities co-ordinator, particularly at weekends. The manager also confirmed that a key improvement aim for the home is to develop activities further, particularly access to the local community and outings for people and also to establish residents meetings on a regular basis. All people spoken with said that the food is generally good. Lunches were served during the inspection and were well presented and of good quality and quantity. Tables were attractively set and people chose whether to eat in their own rooms or in the dining rooms. Staff assisted those people who required both sensitively and safely, although they expressed some difficulties in terms of managing this given staff availability. Aids to assist people with eating and drinking are provided for each person, as necessary, including plate guards and assisted drinking vessels and food is prepared in consistency in accordance with individual’s risk assessed needs. Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 16 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): NMS 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to complain and are now more confident that any complaints or concerns they may raise will be taken seriously. The systems and arrangements in place promote people’s protection from abuse. EVIDENCE: Discussions were held with manager about complaints received over last twelve months. The manager advised that she had re-established a record for complaints since coming into post. The home’s complaints procedure is openly displayed and information is also provided about how to complain in the service guide (see also choice of home section of this report re information formats). Many people spoken with (residents, relatives and staff) said they knew how to complain, although indicated that they had experienced some difficulties Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 17 over the last year in getting any concerns they may have raised to be taken seriously or acted upon by the previous manager. However, all felt this situation to have resolved and expressed confidence that they are now listened to and any concerns or complaints they may have are taken seriously. The arrangements for staff instruction and training in respect of abuse awareness and safeguarding vulnerable adults were discussed with the manager and staff and are satisfactory. The administrator advised of a recent review of company policy regarding residents’ finances and the management and handling of their monies in the home. Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 18 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): NMS 19, 21 & 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People live in a safe, clean and comfortable environment, which suits their needs, although more prompt attention to the maintenance and repair of equipment in the home would be to their benefit. EVIDENCE: The private and communal facilities accessed by people case tracked were inspected. All areas seen were clean, comfortable, well furnished and decorated and free from hazards, although one person recently admitted to the home, did not have an emergency call buzzer extension. Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 19 People spoken with said that they were comfortable in the home and felt it was clean and well decorated and furnished. Bedrooms seen were personalised. All windows seen at first floor level had suitable window restrictors, provision of which had been reviewed since the previous key inspection and following a reported serious incident in the home. Since our previous inspection of the home, the Health and Safety Executive have made a recommendation, that summer temperatures are reviewed at the home and consideration given as to whether other measures should be taken to reduce the effects of heat. At the time of the inspection, although there was no excessive outdoor temperature, the home was very warm. Two visitors requested a fan in the ground floor small lounge due to this. This was discussed with the manager who confirmed that fans were available, although was not aware of any plans for further measures. At our previous inspection a requirement was made regarding the need to repair two assisted baths by 31/01/06. One of these had been repaired (bathroom 15). The new acting manager had obtained a quote for the repair of the other, which is the Parker bath on the first floor and assured that this would soon be undertaken and an extended timescale from the previous report was therefore agreed. We hand tested the hot water in bathroom 15 by running the water for around two minutes, which ran cold. The manager advised that it took around ten minutes for the hot water to run through, as a new pump is required for the boiler. The separate shower on the first floor is also in need of repair and was reported to have been out of action for a considerable time. We spoke with one person who resided at the home out in the garden, which is well maintained, with patio and seating areas, together with planting and a greenhouse. People said they could easily access the garden, which they enjoyed. One person, case tracked said they enjoyed time spent planting in the greenhouse. Aids to orientation were noted around the home, including picture signing to assist those with confusion. Bedroom doors all have doorknockers. The manager had introduced a monthly maintenance plan, a kitchen action plan and a home action plan and there is a maintenance person employed fulltime at the home. Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 20 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): NMS 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. People’s needs are met from a staff team who are usually recruited, inducted and trained effectively. However, the implementation of an evidenced based approach to determining staffing levels, which accounts for people’s dependency care needs would be in the better interests of people who live at the home and the staff employed there. EVIDENCE: The staff files of four of most recent staff starters were inspected and discussions were held with the manager and staff about the arrangements for their recruitment, induction, training and deployment. Staff turnover was also discussed, which was high over the preceding 12 months. Three of the staff files examined contained satisfactory information in respect of their employment and recruitment. The fourth concerned a registered nurse, who had commenced their employment as a bank nurse in the home on Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 21 01 December 2006 working one night per week as the nurse in charge. There is no confirmed POVA/CRB for this person. A copy of their CRB application was seen in their personal file. This was recorded as having been checked and sent. However, it was in complete. This was raised a serious concern with the manager during the inspection, and also in writing following the inspection with the registered provider. The manager and administrator took immediate and suitable action to ensure the safety of people in the home. Four other staff files were randomly selected and all of these had confirmed POVA/CRB checks for each staff member. Staff files also contained information regarding training and induction. At the last inspection we made a requirement that evidence must be in place that a structured induction has been undertaken for each new staff member. The manager had introduced an induction record, which was completed for the most recent staff starter and was satisfactory. Out of twenty-one care staff employed – 11 have achieved at least NVQ level 2 and eighteen are working towards this. One is working towards an NVQ level 3 and three further had recently signed to do these, with a further 1 waiting to sign up. Therefore there are almost 50 of staff who have achieved at least NVQ level 2, with further undertaking these. The pre-inspection information provided by the manager detailed a barrier to improvement being that funded higher NVQ training is not available for senior staff but is for under 25 year olds. This was discussed with her with reference to Skills for Care National Minimum Data Set (NMDS) and funding provided through them in respect of that stated above. The manager said that the NMDS was received by the home and would be completed by her and submitted to Skills for Care. The arrangements for other staff training are satisfactory including that relating to safe working practises, which is organised on a continuous rolling programme, including fire, M & H, infection control, COSHH, food hygiene, first aid and POVA training. Other training undertaken included includes – dementia awareness, continence, challenging behaviour, pressure ulcer prevention. Monitoring and auditing of staff training is undertaken on monthly basis and training needs analysis and training plans is in place. A requirement was made at the previous key inspection of this service to ensure that care staffing is maintained at a level where people’s needs and welfare can be met and maintained. Staff felt that staffing arrangements had improved, including that the high staff turnover over the last twelve months had abated and that there was a more stable staff group. However, despite improvements, they felt that staffing levels were not always sufficient. This was discussed further with them. All Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 22 said that residents were safe and felt they received good basic personal and health care. However, that given the numbers and dependencies of people accommodated and the arrangements for staff deployment, this impacted on staff availability at meal times, for activities and social care (see also social care section of this report) and also at night time, when it was felt that people sometimes had to wait for attention. Staffing levels were confirmed with them as per the home’s duty rotas. People accommodated said that staff worked very hard to meet their personal and healthcare needs and felt that their basic care needs were being met. There was a total of thirty-four residents accommodated (including 18 nursing/5 physically disabled). Nursing and care staff deployment was as follows: 1 Registered Nurse and five care staff during the morning (8 am-2 pm. 1 Registered Nurse and four care staff during the afternoon (2 pm - 8pm). 1 Registered Nurse and two care staff on duty (8pm – 8 am). Activities co-ordinator 9.30 am to 1.30 pm daily Monday to Friday. Care staff felt that additional care were required, particularly during the afternoon and night shift to maintain consistency of care and to enable balanced deployment on each floor of the home, given people’s dependency needs. Staff did not feel that residents’ dependencies were being properly accounted for when determining staffing levels. Staff also said that they did not have time to provide activities for people or spend time with them when activities co-ordinator was not present, as they were too stretched providing personal and healthcare. They also said that often when a new staff member was being inducted they were part of those numbers and not additional to, which was very difficult to manage. Discussions were held with the manager about the arrangements for staff deployment and residents’ dependencies. Although all residents dependencies are individually assessed using a recorded assessment tool – as kept in their care files and reviewed monthly, this information is not used to inform staffing levels/deployment. The application of the residential forum tool was also discussed. The manager was aware of this staffing tool but had not accessed it. Some information was provided in the AQAA as completed by the manager about people’s overall dependency needs, which were discussed with the manger and staff at the inspection. Based on an assumption that there are no people accommodated with high dependency needs, 18 with medium dependency (as per 18 nursing accommodated) and 16 with low dependency (personal care only). The residential staffing forum tool indicates that there Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 23 should be a total of 613.54 care staff hours (ie not including registered nurses) with 166.96 overhead hrs which totals 780.50 hrs. Information given on the AQAA re care staff hours (not including registered nurse hours) currently provided per week totals 561.00. Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 24 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): NMS 31, 33, 35 & 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are now more confident that the home will be run in their best interests and the health, safety and welfare of residents and staff are overall, well promoted and protected. EVIDENCE: The acting manager has recently come into post. She was formerly the deputy manager at the home, although had left her employment there before returning to take up the post of manager. Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 25 During discussions with people accommodated and staff at the home, many were keen to point out their confidence in the manager. The manager is a registered general nurse who is currently undertaking the registered manager’s award. She advised that she had recently submitted her application for registered manager with the Commission. At time of the inspection visit, independent auditors were undertaking a full quality audit of the service in accordance with ISO 9000. The manager advised she had recently sent out service user satisfaction surveys to people (thirty one on total) and that to date there were twenty-one returns. The results are to be analysed. Quality monitoring surveys were not extended to outside stakeholders. During discussions with people case tracked they confirmed that they were regularly consulted about the care and services they received by way of the key worker system and individual care reviews. Some were aware that an operations manager representing the registered provider regularly visited the home. Reports of those visits were provided at the home for the manager and for inspection. Of the three people case tracked, one manages their finances. Two have support from their families. Safekeeping of personal monies by the home was undertaken for one of those. The arrangements for that person were examined, including safe and record keeping and were satisfactory. The arrangements and records of safekeeping for four a number of other people were randomly examined. These were generally satisfactory, although the arrangements for payments made on behalf individuals in respect of hair dressing and private chiropody were not always in accordance with the home’s policy and procedural guidance for residents finances. As detailed under the staffing section of this report, the arrangements for staff safe working practises were satisfactory. Comments made under the environment section of this report also apply here with regard to the hot water supply to bathrooms and the need for boiler repairs (pump) and also the recent review and provision of suitable window restrictors. Manager advised that since coming into post, she had implemented a kitchen action plan referring to the last report from the environmental health officer and outstanding items therein, which she stated were not addressed by previous registered manager. The cook also confirmed this. Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 26 All staff had also all been provided with the company’s ‘Risk of falls from heights’ policy, following a serious incident in July 2006 and receipt of the HSE report of their investigation relating to that incident in February 2007. During discussions with staff at they advised that they had been re-briefed and were provided with a copy of this policy. Information regarding the arrangements for the maintenance of equipment in the home were provided in the AQAA, except for the electrical hard wiring, although this was confirmed as satisfactory at the previous inspection of this service. Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 27 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X X 3 X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 2 X X 2 Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 28 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4, 5 Requirement Timescale for action 31/08/07 2. OP21 23 (2)(b) & (j) 3. OP27 18 1 (a) The revised statement of purpose and service user guide must be provided which accords with Schedule 1 and includes details of terms and conditions of accommodation provided and the amount and method of payment of fees. This is to ensure that people receive key and accurate information about the home. 20/08/07 NMS 38 also applies here. The home must be kept in a good state of repair and equipment provided at the care home for use by people must be maintained in good working order. In this instance the boiler (pump), the parker bath to the first floor and the separate shower. This is to ensure people’s health and safety, and that they live in a wellmaintained environment and have access to a range suitable washing facilities. Staffing levels and skill mix must 20/08/07 be appropriate to the assessed needs of people accommodated in order to ensure that the arrangements for staff DS0000002096.V339586.R01.S.doc Version 5.2 Vale, The Care Centre Page 29 4. OP29 19 (1)(a) & (b) deployment are based on good evidence and are in people’s best interests (both residents and staff). A person must not be employed 21/06/07 to work at the care home unless they are fit to do so and that satisfactory information and documents are obtained in respect of that person as specified under Schedule 2 of the Care Homes Regulations 2001. This is to promote the safety and protection of people accommodated at the home. 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 OP1 Good Practice Recommendations Key information provided for people about the home should be available in alternative formats to promote equal opportunity of access for those people who may have sight difficulties. OP13 also applies here. The home should further develop people’s opportunities and choice in relation to leisure and social activities, including outings and community access in order to best promote their individual expectations and preferences. Consider whether further action should be taken to reduce the effects of heat from environmental temperatures in the home. Payments made by the home on behalf of any person accommodated to an outside service provider must be in accordance with the home’s stated policy and procedural guidance concerned with the handling of people’s monies. This is to ensure the best protection of people (both residents and staff responsible for handling those monies). 2. OP12 3. 4. OP19 OP35 Vale, The Care Centre DS0000002096.V339586.R01.S.doc Version 5.2 Page 30 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.V339586.R01.S.doc Version 5.2 Page 31 - 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. 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