Inspection on 04/06/07 for Vale Court Care Home

This inspection was carried out on 4th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Vale Court Care Home 27/11/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Vale Court Care Home 9b Chester Road Whitby Ellesmere Port Wirral CH65 9BD Lead Inspector Wendy Smith Unannounced Inspection 9:00 4th June 2007 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 Court Care Home DS0000068319.V333397.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 Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Vale Court Care Home Address 9b Chester Road Whitby Ellesmere Port Wirral CH65 9BD 0151 3564827 0151 3564280 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) Four Seasons (No 3) Limited Christina Narracott Care Home 56 Category(ies) of Old age, not falling within any other category registration, with number Physical disability of places Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 56 service users in the following categories: Old age not falling within any other category (OP) Physical disability (PD) Date of last inspection 1st February 2007 Brief Description of the Service: Vale Court is a modern purpose-built two-storey nursing home situated in the Whitby area of Ellesmere Port and close to the town centre. It is set in its own grounds behind local shops. There is easy access to local amenities and the home is convenient for public transport. The home provides care for older people and for younger adults with a physical disability. The home’s weekly fee is from £390.35 to £550, not including the Registered Nurse Care Contribution. Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on 4th June 2007. Three inspectors carried out the visit, one being a pharmacist inspector who was checking whether requirements about the handling of medicines made at previous visits had been addressed. On the same morning, representatives from Cheshire County Council and Western Cheshire Primary Care Trust were holding a meeting at the home to review whether the concerns that they had about the service had been addressed. One of the inspectors attended this meeting. A tour of the building, including communal areas and some bedrooms, was completed. A sample of records was looked at and time was spent in conversation with the home manager, the regional manager, residents, staff and visitors. Forty people were living at the home, five of whom were under 65 years of age. Some of the information contained in this report is taken from the preinspection questionnaire that was completed by the home manager. Commission for Social Care Inspection comments cards were provided for residents, visitors and visiting professionals to give their views of the home. Five of these were completed and returned. What the service does well: People interested in coming to live at Vale Court have a full assessment to ensure that their care needs can be met. Residents’ care needs are assessed and recorded in their care plans so that staff know what care they need. Social activities are provided four afternoons a week and an activities noticeboard provides details of the programme for each month. The manager keeps a written record of all complaints received. The records showed that this includes verbal complaints as well as more formal complaints. Action taken to investigate and address complaints is also logged. Residents have a comfortable, safe, clean and well maintained environment to live in. There is a full team of care staff and nurses led by two unit managers and this ensures continuity of care for the people who live at the home. Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 6 Quality assurance and monitoring systems have been used to good effect to identify where the service needs to improve. Progress has been monitored and reviewed to ensure that there is continuous improvement. Regular health and safety checks are made and recorded to ensure that equipment is always safe for use. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People interested in coming to live at Vale Court have a full assessment to ensure that their care needs can be met. EVIDENCE: Since the last inspection the home’s statement of purpose and service user guide have been updated and there is a copy of the service user guide in each bedroom to give information to the resident and their visitors. A further update is needed to include details of the new management structure within the home, which has only been in place since mid-April 2007. Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 9 Information about two new residents, one on each of the units, was looked at. The care folders for both contained a preadmission assessment. This document is very lengthy and comprehensive and had not been completed in full for either person, but did contain basic information about their needs. The care plan for the resident on the ground floor contained a full assessment from the person’s social worker. The resident on the first floor had been admitted from hospital. Not all of the equipment she needed was in place on admission because the hospital staff had not provided enough information about what was needed. Information provided by the home manager indicated that seven people living at the home had dementia. All of these people had significant medical conditions and were not presenting any difficulties in meeting their needs. Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 10 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ care needs are assessed and recorded in their care plans so that staff know what care they need. The management of residents’ medicines has improved greatly to ensure that they always receive what has been prescribed by their doctor. EVIDENCE: A sample of care plans was looked at on both floors of the home. In general the standard of recording had improved considerably since the last Commission for Social Care Inspection visit. A new resident on the first floor had a full and detailed care plan but there were some inconsistencies, for example it was unclear whether she needed the assistance of two or three staff when care was being given. Two different weights had been recorded on two different pages on the same date. An instruction to ‘reposition regularly’ was not specific enough to tell the staff how often this should be done. Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 11 The new resident on the ground floor also had a full and detailed care plan. The pressure sore risk assessment identified that she was at very high risk of developing pressure damage to her skin but there was no care plan to instruct staff what action needed to be taken to prevent this from happening. This was discussed with the unit manager. He considered that the score was too high and did not accurately reflect the person’s condition, however he agreed that whenever a high pressure sore risk score is recorded this should always trigger a care plan. Three other care plans looked at were completed to a good standard and had been reviewed and evaluated regularly. The recording of wound care had improved to accurately chart the progress of healing. Some of the photographs were not very clear, but staff now have a new camera that is better. One of the nurses has qualification in tissue viability, advice can also be accessed from a tissue viability nurse specialist through the resident’s GP and district nurse. The continence advisor said that she had been very impressed with the way that things had been moving forward at the home. She has two excellent continence link carers and has given a lot of advice and information to staff. She was disappointed that a recent complaint about the home referred to continence care. On investigation she found that the wrong product was being used for the person. The lead nurse assessor said that she had also noted recent improvements at Vale Court. One resident spoken with said that she was very happy with the attitude of the home’s staff. During a stay in hospital she felt embarrassed about a weight problem, but she feels much more comfortable at Vale Court and staff are very understanding. Staff are caring and they listen to you. Another resident said that she can have a good laugh with the staff. A Commission for Social Care Inspection pharmacist inspected the medicines because of longstanding serious concerns about the accuracy of medicine administration and recording. Since the last visit all staff have received medication training and supervision. A rigorous audit process has supported a great improvement in medicines management. All medicines are stored properly and are dated when opened to be sure that they are still fit to take. All records to do with medicines are clear with a complete audit trail that shows that the medicines have been given correctly. Where medical readings are needed, like blood sugar levels for people with diabetes and pulse for those on certain heart tablets, these are clearly kept with the medication record. Where residents have a machine to measure their blood sugar they have a record of regularly recalibrating the machine to be sure it is working properly. Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 12 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to exercise choices in daily living and social activities are provided regularly in the home. EVIDENCE: Social activities are provided four afternoons a week and an activities noticeboard provides details of the programme for each month. A copy of this is also given to residents in their rooms. The activities organiser keeps a record of what has taken place. The activities organiser said how much she enjoys her job and looks on the residents as my friends. She spends some one to one time with residents who prefer to stay in their own rooms. She was organising a fundraising fete for ‘Action on Elder Abuse’ and hoped to raise awareness as well as money. She said that she has funds to buy whatever is needed for activities. A resident spoken with said that the staff had made her recent birthday a special day. The activities organiser was planning another birthday party that week following a request from a resident’s daughter. A musical entertainer had been booked. Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 13 Two of the comments cards received before the inspection contained negative comments about the standard of food. This was discussed with the home manager. She explained that the chef had been dismissed and the assistant chef was on long-term sick leave. The home was now using an agency chef who was excellent. Three residents spoken with on the first floor said that they were happy with the meals provided and one spoke of recent improvements. Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 14 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives can be confident that their complaints will be addressed and that they are protected from abuse. EVIDENCE: The manager keeps a written record of all complaints received. The records showed that this includes verbal complaints as well as more formal complaints. Action taken to investigate and address complaints is also logged. A recent complaint about the care of a resident is being investigated by the local authority and a past complaint, also being investigated by the local authority, has not yet been resolved. Staff training records showed that training about the protection of vulnerable adults has been provided for nearly all of the staff within the last year and the training programme showed that this will continue until everyone has attended. The company has a whistle-blowing policy and a help-line number for staff. The arrangements for dealing with calls to this number were reviewed following concerns expressed by staff. Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 15 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have a comfortable, safe, clean and well maintained environment to live in. EVIDENCE: The home was purpose built and is light and spacious. All residents have a single bedroom of adequate size with en-suite facilities. There is a satisfactory number of lounges, dining rooms and bathrooms that are furnished and equipped to meet the needs of the people who live at the home. On the day of the visit the standard of cleanliness was good, and professional visitors who attended a meeting said that they were pleased with higher standards of cleanliness. A number of issues about the environment that were raised by residents and visitors in a recent satisfaction survey have been addressed. Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 16 The manager and the regional manager are carrying out a clinical equipment audit. This will identify whether the home has all of the equipment needed for the care of the people currently living at the home. The room that was previously used by the activities organiser has been designated as a nurses’ office. This will be put into use as soon as the telephone line is fitted and will provide a more private place for staff to be able to speak with visitors and do their written work. Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 17 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Enough nurses and care staff are provided to meet residents’ needs. EVIDENCE: The home employs 12 nurses and the records showed that they all have current registration with the Nursing and Midwifery Council. There are 26 care staff, of whom seven have a national vocational qualification in care, three are currently working towards a qualification and another three are waiting to start. No agency nurses or care staff have been required in recent weeks. From 13th April 2007 the organisation of the home has changed so that there is a unit manager for each floor. One of the unit managers is a nurse who was already employed at the home, the other unit manager is a new member of staff and he is completing his induction. Both were on duty on the day of the visit and were very helpful and enthusiastic about their new role. In four of the comments cards received from residents and visitors, people considered that there were not always enough staff. On the day of the visit there were plenty of staff. The ground floor had a nurse and three care assistants to look after 16 residents. The first floor had two nurses and three care assistants for 24 residents. The home manager was also on duty. Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 18 On the first floor a high number of residents needed the assistance of two staff to provide their care and a hoist to transfer them. The pre-inspection questionnaire completed by the manager indicated that 34 residents need a wheelchair for mobility and 38 residents need help with toileting. Residents were transferred from wheelchairs to armchairs, and to the dining room for their lunch. This appeared unhurried and good humoured. Call bells were all answered within a reasonable time. Staffing levels will need to be closely monitored as and when occupancy increases to ensure that these standards are maintained. The personnel files for two recently recruited staff were looked at. These contained all of the required information including two references and a Criminal Records Bureau disclosure. The home manager has discovered that a significant number of staff who have worked at the home for a length of time do not have a Criminal Records Bureau disclosure. She is working to address this and most have now been applied for. Over recent weeks a great deal of training has been provided for staff to ensure that they are all up to date with important health and safety related practices. The new company trainer spent four weeks at the home and one of the home’s nurses now has responsibility for ensuring that staff receive the appropriate training. A training matrix charts the progress towards all staff completing the basic training. This showed that all of the care staff and nurses have attended moving and handling training within the last six months, and all except six have attended fire awareness training in last six months. A training plan is in place for the rest of the year. Staff spoken with confirmed that they had received training and found it useful. A number of staff had also been to training events provided by the Primary Care Trust. Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 19 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Quality assurance processes have been implemented to very good effect to ensure that the home is run in the best interest of service users and to promote their health and safety. EVIDENCE: Since the visit on 30th May 2007 the home manager has completed the ‘fit person’ process and will be registered by the Commission for Social Care Inspection as manager of this service. She has started working towards the registered manager award. The improvements that have taken place across all areas of the home over recent months demonstrate the hard work and commitment that she has put in, with support from the regional manager. Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 20 Four Seasons has recently carried out a satisfaction survey of residents and their relatives. Following this an action plan was written which addresses all negative comments received and details any remedial action needed. A ‘Team Audit’ covering all aspects of the service has been carried out. This was a very lengthy and detailed process and has identified areas where improvements can be made. Following the last Commission for Social Care Inspection visit an improvement plan was agreed and this has been put into practice and reviewed. The improvements to the management of residents’ medicines shows that very rigorous monitoring has been taking place. There are satisfactory arrangements for residents to be able to keep small quantities of personal spending money in a dedicated bank account. Detailed individual records are available. The home’s maintenance person carries out daily, weekly and monthly checks of all plant and equipment. All of these are very neatly recorded and show where any action has been required. Information provided by the manager showed that equipment is tested and serviced by outside contractors as often as needed. There was evidence of regular fire drills being held. Thirteen residents were using bedrails. These are audited monthly by the regional manager. Staff have been issued with a red laminated card which is an aide-memoir about how bedrails must be fitted. Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 21 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 X 3 X X N/A 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 4 Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Vale Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Court Care Home DS0000068319.V333397.R01.S.doc Version 5.2 Page 24 - 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!