Inspection on 19/01/07 for Vale House

This inspection was carried out on 19th January 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 House 28/12/05

Vale House 15/08/05

Vale House 16/12/04

Vale House 13/08/04

Vale House 18/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Vale House The Botley Alzheimer`s Home West Way, Botley Road Botley Oxford OX2 9UD Lead Inspector Kate Harrison Unannounced Inspection 19th January 2007 10.30 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 House DS0000027187.V321043.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 House DS0000027187.V321043.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Vale House Address The Botley Alzheimer`s Home West Way, Botley Road Botley Oxford OX2 9UD 01865 794096 01865 794095 valehouse@botleyah.freeserve.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) The Botley Alzheimers Home Patricia O`Leary Care Home 20 Category(ies) of Dementia (20), Mental disorder, excluding registration, with number learning disability or dementia (20), Old age, of places not falling within any other category (20) Vale House DS0000027187.V321043.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. On admission persons should be aged 60 years and over. In addition, there are 4 day care places available. Date of last inspection 28/12/05 Brief Description of the Service: The Botley Alzheimers Home (known as Vale House) is registered to provide care for up to twenty male and female service users, aged 60 years and over, suffering with severe dementia. The home is also registered to provide day care for up to four service users with dementia, but this service is not provided at present. Vale House is a registered charity and is managed by a voluntary Board of Directors. Accommodation is provided on the ground and first floors, and there are sixteen single bedrooms and two double rooms. Bedrooms do not have en-suite facilities but all rooms have washbasins. There are two bathrooms, one shower room and seven toilets. A communal lounge/dining room is situated on the ground floor. A second sitting room has been opened up to provide access to a comfortable area called the family room. Access to this room was previously from outside. A link corridor has been opened up to allow access from within the home. Leading off this room is a small paved area of garden with borders planted with shrubs and herbaceous plants. This provides a small secure outdoor space for service users. The home is situated on the outskirts of Oxford and is on a regular bus route to and from Oxford. The weekly charge is £757.50, and there are no extra charges for services such as chiropody or hairdressing. Vale House DS0000027187.V321043.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 10.30 hours and was in the service for 5.5 hours. This inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that CSCI has received about the home since the last inspection. The inspector saw all areas of the home and looked at records and documents relating to the care of the residents. The inspector asked the views of the residents, relatives and health and social care professionals about the home through questionnaires (comment cards) that the Commission had sent out. 11 individuals replied to the Commission’s comment cards and their views are reflected in this report. The inspector met several residents on the day, and also spoke to relatives and staff, including the registered manager, the chef and some of the home’s volunteers and housekeeping staff. Relatives who replied via the Commission’s comment cards or who spoke to the inspector praised the qualities of the staff and the management of the home. The management is ‘excellent’, ‘care and support is wonderful’, and ‘I salute a home with staff who really do care’, were some of the comments received. Equality and diversity matters are addressed well within the home, and this is due to the home’s philosophy of addressing the needs of the individual, be they residents or staff. What the service does well: The home has a history of providing good care, and at this inspection visit the care of residents is at a high standard. Each is treated as an individual, with a life history that is generally known by the staff. The managers and staff continually reflect on how to improve life for the residents, and staff work well as a team. Relatives see the work of the family support worker as ‘so valuable’, because the family support worker keeps contact with the family from the admission process and throughout the resident’s stay at the home. Relatives commented that the home’s staff are ‘focussed and attentive’ and are always ‘looking for ways to support residents and relatives’. Several of the staff team have been at the home for many years and through the practice of working in pairs, they share their skills and knowledge with less experienced staff on a daily basis. The home’s practice of mentoring staff encourages staff members to gain confidence and contributes to the stable staff team. Vale House DS0000027187.V321043.R01.S.doc Version 5.2 Page 6 The home’s group of volunteers contributes to the residents’ good quality of life. The home is run in the residents’ best interests, through the strong leadership provided by the managers. 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 House DS0000027187.V321043.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 House DS0000027187.V321043.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): 3 and 6. The home does not provide intermediate care. Quality in this outcome area is excellent. The prospective resident’s needs are fully assessed before admission, and the family support worker helps the prospective resident and the family adjust to the changing situation. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector saw the admission records for two residents. One was admitted for a short stay of a few weeks and the other was admitted as a long term resident. The registered manager or her deputy had visited the prospective residents to carry out an assessment and had gained all the necessary information from the family and from the documents supplied by the Social and Health Care Department of the local county council. The information included details about the individual’s physical and emotional needs. The admission process for those needing respite care is the same as for long-term care, and includes update letters about subsequent admissions. Vale House DS0000027187.V321043.R01.S.doc Version 5.2 Page 9 The home’s family support worker, a qualified social worker, visits the family before admission, and relatives said that these visits and her subsequent contact were ‘very comprehensive and satisfactory’. Other families said that they had visited several times before admission and one relative said that it was the “happiness of the residents’” observed during a visit that helped them decide to choose Vale House for their relative. Vale House DS0000027187.V321043.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 excellent. Respect for the residents is shown in all aspects of life at the home, and the high quality of the care provided meets the needs of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector saw the care plans for two individuals and noted that risk assessments are carried out for key topics, such as nutrition, moving and transferring individuals, and falling. Information from the assessments is used to decide how care should be carried out, and details are used in the individual’s care plan. All personal care is carried out in private and respect for the residents is the key element of the home’s ethos. The residents’ physical and emotional needs are taken into account, and the ‘Thinking Ahead’ plan helps relatives to avoid some of the shock associated with the death of a family member. Attention is given to the social needs of the residents and the social care plan is linked to the individual’s life history, so that staff can use the information to engage meaningfully each day with the residents. The inspector witnessed instances during the day when this approach was used to effect, as staff members knew the residents well and were able to anticipate needs and Vale House DS0000027187.V321043.R01.S.doc Version 5.2 Page 11 intervene skilfully to diffuse and avert difficult situations. Reviews of the individual’s care are carried out regularly and relatives are encouraged to attend. Relatives said that ‘staff are always very helpful’, ‘care and support is wonderful’ and ‘staff really do drive forward any medical support needed’. The home has policies and procedures to guide staff members to manage medication. Medication is supplied by a national pharmacy and is held securely. The inspector checked the medication for two residents and found that it was appropriately stored and recorded. Controlled drugs are also well managed. Vale House DS0000027187.V321043.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 excellent. Daily life is organised around the preferences of the residents, and their social needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Daily life at the home is managed according to the individual’s preferences on the day. Staff members and volunteer provide activities on a daily basis, and half of those who responded to the Commission’s comment cards said that there are ‘always’ activities arranged that their relatives could take part in. Some relatives said that some individuals could not take part in the group activities, but liked the one to one sessions the carers provided. On the day of the inspection visit, the inspector noted that carers responded to the needs of the residents by spending several short periods of time with them individually, and using their knowledge of the resident’s interests to pass time meaningfully together. Another relative commented on the value of the music sessions. Singing sessions and interactive music sessions are provided, and one relative said that mail-shots of activities at the home are posted to her, and are displayed in the home. Residents are valued for their contribution to the life of the home and are encouraged to express their personality. The home has a visiting policy and Vale House DS0000027187.V321043.R01.S.doc Version 5.2 Page 13 families are encouraged to visit, and one relative told the inspector that she is always welcome at the home. The family support worker also acts as the family contact person, and visitors know that they can contact the manager or her deputy if they need to. One member of staff is skilled at adapting clothes to meet the changing needs of individual residents and this is a valuable service for families and residents. The home’s chef has been at the home for several years and has an efficient system of receiving information about the nutritional and dietary needs of the residents. Nutritional supplements are available, as are fresh meat, fish and vegetables. The lunch and evening mealtime are organised at set times but individuals can eat when they want to. Members of the home’s volunteers help out at lunchtime and provide valuable support for the home’s staff. One relative commented: ‘it is fantastic that (my relative) can eat when he feels hungry’, and another said that the food is ‘very nutritious’. Vale House DS0000027187.V321043.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. Complaints are taken seriously and residents are safeguarded from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an appropriate complaints policy and procedure, and the procedure is prominently displayed at the entrance area. The inspector saw the home’s complaints record book and noted that complaints are recorded, that action is taken to address the issues, and complainants are informed of the outcome. The staff members understand that few of the residents would be able to make a complaint on their own behalf, and communication with the family is seen as important to quickly address any identified issues. No complainant has approached the Commission with concerns about the home since the last inspection. The home has policies and procedures to safeguard the residents, and all the staff members have received training in the protection of vulnerable adults. Update training is also provided so that all the staff members are knowledgeable about current procedures. Vale House DS0000027187.V321043.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. The residents live in a safe, clean and well-maintained environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a development plan that includes the long-term goal of finding more suitable premises, including more outdoor space for the residents. This would allow for better facilities for the residents and improved services for people with dementia. The present environment lacks outdoor space, although a small area is used to good effect. General maintenance is carried out regularly and staff members record the issues needing attention. The home’s housekeeping team works over the full week and training is provided on safety issues. The laundry area has recently been redecorated and good systems are in place to prevent the spread of infection, such as colour coding of refuse bags and the use of disinfectant hand gel. Vale House DS0000027187.V321043.R01.S.doc Version 5.2 Page 16 Vale House DS0000027187.V321043.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. Residents are cared for by sufficient knowledgeable and competent staff members and the recruitment procedures are generally good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s staff rota shows that a registered nurse is always on duty over the twenty-four hours, and that sufficient carers are available to meet the needs of the residents. The home meets the national minimum standard of having 50 of the carers qualified to National Vocational Qualification Level 2 in Care, and there are three assessors for the programme at the home. The deputy manager is responsible for staff training and the home’s induction programme for new staff members meets the Skills for Care standards, and is adapted to meet the needs of the home. Training and updating courses are available for the home’s nurses, and all mandatory training such as fire safety, moving and handling residents and food hygiene is provided. Training for staff on the care of people with dementia happens on several levels, and uses different media such as video and discussion and distance learning. Reflective practice is encouraged so that learning is continuous and is based on practice in the home. The inspector spoke to some carers and understood that staff members are highly motivated, due mainly to the high level of mentorship and training provided at the home. Staff work in pairs and this benefits both the resident and the carers. Relatives described the staff as ‘exceptional staff’ providing Vale House DS0000027187.V321043.R01.S.doc Version 5.2 Page 18 ‘loving care’ and one family said they are ‘extremely lucky’ to have their relative at Vale House. The inspector saw three staff files to check the home’s recruitment procedures. Emphasis is placed on getting the right person for the job rather than simply filling a vacancy, and all the home’s volunteers undergo the recruitment process. The home’s application forms were appropriately completed, and Enhanced Criminal Record Bureau (CRB) clearance were available for the new members of staff. The inspector noted that a reference for one individual was addressed ‘To Whom It May Concern’, and another telephone interview with a referee was not followed up with a written reference. The inspector understood that written references as confirmation were expected from the referees for the individual at the time of application, but these had not arrived. Another individual’s check against the Protection of Vulnerable Adults List, though requested had not arrived at the appropriate time, though an enhanced CRB and satisfactory references were available. When these issues were brought to the attention of the manager she quickly took action to address them. The inspector recommends that the home uses a checklist or other system to make sure that all the information requested about individuals working at the home is available to the home at the appropriate time. The home values diversity in the staff members and staff of all abilities are encouraged to achieve their best. Vale House DS0000027187.V321043.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 and 38. Quality in this outcome area is excellent. The management team offers focussed clear leadership to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has worked at the home for sixteen years, since the home began, and has extensive management and nursing experience. The deputy manager has also been at the home for many years and is a nurse with a keen interest in staff training. Relatives described the running of the home as ‘dedicated professional management’, and ‘a fantastic management’. The home’s quality assurance system includes a questionnaire to relatives and family meetings to discuss how the interests of the residents are met. The family support worker meets with the directors regularly to report on issues Vale House DS0000027187.V321043.R01.S.doc Version 5.2 Page 20 arising with families, as does the registered manager. The home produces a regular newsletter for relatives, staff and residents. The home does not manage residents’ financial affairs, and the families usually manage financial matters on behalf of their relative. The home has a health and safety policy statement and provides training for staff on health and safety topics. Contracts are in place to make sure that all the health and safety checks are in place, and a fire risk assessment has been carried out to identify how to improve fire safety at the home. Vale House DS0000027187.V321043.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 X X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 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 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Vale House DS0000027187.V321043.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. 1. Refer to Standard OP29 Good Practice Recommendations The inspector recommends that the home uses a checklist or other system to make sure that all the information required by law about individuals working at the home is appropriately acquired. Vale House DS0000027187.V321043.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 House DS0000027187.V321043.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. 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