CARE HOMES FOR OLDER PEOPLE
Valewood House Bell Vale Lane Haslemere Surrey GU27 3DJ Lead Inspector
Mrs G Davis Announced Wednesday, 24 August 2005, 10.00am, V237507 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 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. Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Valewood House Address Bell Vale Lane, Haslemere, Surrey, GU27 3DJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01428 644670 Valewood House Nursing Home Limited Mrs Shirley Ann Houghton Care home 40 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (MD) - 40 Both of places Mental Disorder, excluding learning disability or dementia - over 65 years of age (MD(E)) - 40 Both Dementia - over 65 years of age (DE(E)) - 40 Both Dementia (DE) - 40 Both Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Only service users over 40 years of age in the DE and MD category may be admitted. Date of last inspection 06/01/05 Brief Description of the Service: Valewood is a care home with nursing providing personal care and accommodation for up to 40 service users in the categories of DE and MD It is privately owned by Valewood House Nursing Home Limited. (Org) The registered manager is Mrs S. Houghton Located on the outskirts of Haslemere, the home is a large country house which has been extended to provide additional accommodation.It has 32 single bedrooms, and 4 shared bedrooms. There are comfortable sitting and dining areas, domestic in character and a passenger lift provides access to the first floor. The home was registered in July2002, and is a large detached property, set some distance from the road. There is generous parking to the front of the property and extensive well established grounds which have been landscaped to provide safe seating and walkways by the lake. The home has 32 single bedrooms, and 4 shared bedrooms. There is a passenger lift and comfortable sitting and dining areas, domestic in character. Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the first of the two inspections (minimum) that an inspector must make in a year. On this occasion this inspection was announced and took place over one day in August 2005. The aim of this inspection was to find out how the home cared for the residents and whether sufficient staff members were available to provide a safe and stimulating environment for the residents. Surveys for residents/their representatives and other visitors were provided to the home before the inspection date, three from relatives were returned plus one from a visiting professional and they were unanimous in their comments regarding the care provided by Valewood House. “ We are very satisfied with the level of care provided at Valewood House – it is very professional whilst retaining a very personal touch”. The content from the questionnaires, plus information contained in the preinspection questionnaire has been used to inform this report as well as information gained through speaking to residents and staff members, observation of practice and scrutiny of records, policies and procedures. There were no visitors on the day of inspection. Observation of the body language of those residents who were unable to give the inspector verbal opinions confirmed that they were content and comfortable with their surroundings. On occasions the inspector witnessed sensitive and discreet interaction of staff members with several individuals who were agitated, helping them to regain confidence and calm. A tour of the home took place. Staff and care records were inspected as well as the Home’s Statement of Purpose, Service Users Guide and some of the Policies and Procedures. The home was appropriately staffed and rotas indicated that sufficient staff numbers provided a safe environment and opportunities for the residents to enjoy the facilities offered by the beautiful and extensive grounds and the town of Haslemere nearby. The décor and fabric of the home was attractive and well maintained and the building offered a variety of areas for residents to sit and relax in. There have been no complaints made to the Commission for Social Care Inspection regarding the home. There were no requirements or recommendations arising from this inspection. Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 6 What the service does well: What has improved since the last inspection?
A Dovecot and wild bird feeder has been placed outside the conservatory providing interest for those residents who are chair bound. Use has been made this summer of a Beach Hut at West Wittering and small parties of residents have enjoyed this facility throughout the summer. Other day trips to places of interest have been arranged.
Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 7 The activity programme has been expanded to introduce some activities to help boost the confidence of some of the residents by rehabilitating forgotten skills. Pets have been introduced into the home and the therapeutic effect of this has been evident. A new and more comprehensive system of care planning has been introduced and these provide holistic and informative guidelines for the staff team. The home continues to introduce training topics that are service related and the staff group will increase their knowledge of the needs of those who have nursing and mental health needs. This has led to the residents enjoying a calm environment where timely and sensitive intervention by staff members has converted potentially challenging situations into a manageable ones. A monthly audit of accidents and falls has been introduced with the resultant decrease in falls by more than half. Extensive work on the grounds including the introduction of a level and safe lakeside walk further enhances the beautiful surrounding gardens. 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. Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1.2.3.4.5.6. All prospective residents, or their representatives, have a number of opportunities to make an informed choice about whether they want to live at Valewood House and have their needs thoroughly assessed prior to admission by a senior member of staff. Those that choose to live at the home have a written contract/statement of terms and conditions with the home that they or their representative has agreed to. Intermediate care is not provided by the home. EVIDENCE: The home provides a comprehensive Statement of Purpose and Service User Guide to all prospective residents, their families and their Care Managers. Everybody concerned with the prospective resident is encouraged to visit as often as they like and a four-week trial period is used to allow the new resident to settle in and make sure that they are happy with the situation. A review of the placement takes place after six weeks and where possible the resident or their representative is fully involved and contributes to any changes to the care plan that might be made. A contract for each individual was available. Most of the residents were unable to speak to the inspector about their experiences on admission because their disability precluded it.
Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 10 Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7.8.10.11. Where possible residents or their relatives/representatives are involved with the drawing up of their care plans, which contain detailed information of how the care and health needs of the residents should be met. From evidence gathered it would appear that the staff group respect the privacy and dignity of the people living at Valewood House. EVIDENCE: Where residents are not able to be involved with the drawing up of their care plans, then the residents relative or advocate is involved. Relatives confirmed that they were informed of any change in their relatives care. The care plans have recently been updated to a more comprehensive model of recording and they included up to date information regarding the residents’ current health status. Some had been reviewed on a monthly basis others had not and the Inspector recommended that a uniform approach of regular review be adopted. The Service Users guide contains information regarding the respect that the resident can expect and other training for staff members reinforces this. Helping the multicultural staff group to understand the differing perceptions of what is meant by respect has become an essential element of supervision. From observations made on the day the Inspector concluded that the staff group treated the residents with respect in all aspects of their care.
Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 12 There is an open approach to the death of residents and other residents are included in the bereavement process. Families are always given the opportunity to participate in the final nursing of residents if they choose. Medication was not examined on this occasion. Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12.13.15. The residents are provided with the opportunity to follow their chosen lifestyle at all times. Where the resident is unable to make those choices and decisions for themselves, family or representatives are consulted to make sure that the person has as much control over their lives as possible. A wholesome and balanced diet is provided EVIDENCE: All preferences and interests are recorded on the care plans. The inspector witnessed staff members helping the residents to make choices that were within their capacities One resident told the inspector “ everyone is very kind and nice here” and relatives were complimentary about the staff group and the care that their relatives received. Staff members carry out activities with the residents and these vary between quiz games, bingo and one to one activities. Regular days out to places of interest are arranged and this summer use has been made of a beach hut on the coast The inspector was able to observe members of staff interacting with the residents and witnessed some sensitive management of potentially difficult behaviour. The inspector joined the residents for lunch and enjoyed a tasty meal. During the meal the inspector was able to observe the care staff carrying out their duties in a discreet and dignified manner.
Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 14 Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16.18. The residents or their representatives are sure that they can trust the home to protect them as far as possible from bad practice and unacceptable behaviour from others. EVIDENCE: Due to their disability most of the residents would be unable to complain. The home has policies and procedures in place to ensure that action is taken if a resident or their representative was worried and a complaint book is provided to record any issue that might arise. Those that were able to converse with the Inspector were knowledgeable about how to complain. The home has clear instructions for staff members as to what to do if abuse of a resident is suspected and the members of staff that were spoken to in depth were knowledgeable about the procedure to take and had received training. The recruitment files examined showed that all the checks to ensure proper security screening on all applicants had been carried out. Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19.20.21.23.24.26. The home is a comfortable, pleasant and well-maintained building, which is decorated and furnished to a high standard. As well as a choice of communal day space it provides each resident with a room that has been furnished to meet their wishes and needs. Regular maintenance makes sure that the environment is safe EVIDENCE: During the course of the inspection the majority of rooms were visited to make sure that the environment was safe and comfortable for people who live there. There was an adequate number of washing and toilet facilities, which contained the required specialist equipment to promote independence. It was seen that many residents had brought personal possessions into the home, including small items of furniture, ornaments and photographs. There are a number of communal spaces for people to use and a variety of safe outdoor sitting areas and walkways available in the extensive grounds. Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 17 On the day of inspection, Valewood House was clean, and free from offensive odours. Risk assessments regarding the safety of the building were in place. Policies and procedures were available for staff about the control of infection, and the safe disposal of clinical waste. Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27.28.29.30. Valewood House has an adequate number of staff members with appropriate training and skills to provide competent care to the residents at all times. EVIDENCE: A random selection of staff files was looked at including the most recently appointed member of staff. All the required security checks had been carried out and evidence of identity and qualifications and supervision notes were also on file. Appropriate induction training had been undertaken with the newest member of staff. The home employs a high number of trained staff and continues to encourage further in-house training in service related topics by the remaining staff members. The home employs a high number of trained staff and continues to encourage further in-house training Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31.32.33.35.36.37. The home is run in a manner that offers protection to all aspects of the residents’ interests. EVIDENCE: The registered manager has achieved the Registered Manager’s award and is a Registered Mental Nurse. She has all the skills and competence to discharge her responsibilities fully. Other senior managers in the home support her. The registered provider completes a Regulation 26 report monthly and a copy is provided to the Commission for Social Care Inspection. Residents are consulted on a one to one basis and their suggestions are acted upon e.g. at the request of the residents’ a monthly ‘take away’ is purchased. There are good management systems with comprehensive policies and procedures in place to provide protection to the residents and guidance to staff members on how to carry out their duties; records were found to be accurate and up to date. In particular the individual care plans contained vital
Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 20 information regarding the residents’ health and welfare needs and promote a uniform approach to the care and protection of the residents. Formal supervision is carried out with the staff group every 12-14wks and the outcomes recorded. Risk assessments are undertaken and the health, safety and welfare of the residents is promoted and protected by the practice of the home. Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 4 3 x 3 3 x x STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 4 3 x 3 3 3 4 Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 22 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 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 Good Practice Recommendations Valewood House H60-H11 S24233 Valewood V237507 240805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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