Inspection on 07/11/06 for Valewood House

This inspection was carried out on 7th November 2006.

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 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

Valewood House 09/02/06

Valewood House 24/08/05

Valewood House 06/01/05

Valewood House 19/07/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOMES FOR OLDER PEOPLE Valewood House Bell Vale Lane Haslemere Surrey GU27 3DJ Lead Inspector Mr E McLeod Key Unannounced Inspection 7th November 2006 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 Valewood House DS0000024233.V314612.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. Valewood House DS0000024233.V314612.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Valewood House Address Bell Vale Lane Haslemere Surrey GU27 3DJ 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) 01428 644670 valewood@btconnect.com Valewood House Nursing Home Limited Mrs Shirley Ann Houghton Care Home 40 Category(ies) of Dementia (40), Dementia - over 65 years of age registration, with number (40), Mental disorder, excluding learning of places disability or dementia (40), Mental Disorder, excluding learning disability or dementia - over 65 years of age (40) Valewood House DS0000024233.V314612.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Only service users over 40 years of age in the DE and MD category may be admitted. 9th February 2006 Date of last inspection Brief Description of the Service: Valewood is a care home with nursing was registered in July2002 and provides 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, Valewood House is a large country house that has been extended to provide additional accommodation. The home is a large detached property, set some distance from the road. Inside there are comfortable sitting and dining areas, domestic in character and a passenger lift provides access to the first floor. It has 32 single bedrooms, and 4 shared bedrooms. There is generous parking space to the front of the property and extensive well-established grounds with a large lake, which have been landscaped to provide safe seating and walkways by the lake. Valewood House DS0000024233.V314612.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was arranged to update assessments of key standards from the National Minimum Standards for care homes for older people made at the previous inspection. The key unannounced inspection visit to the home was undertaken by one inspector on the 7th November 2006 from 10 a.m. until 3.20 p.m. The registered person had completed a pre-inspection questionnaire and information from this plus evidence from previous inspections has been used to inform the planning and inspection process, and this report. Evidence gained during the inspection visit also informs this report. On the day of the inspection visit, the inspector spoke with four residents, three staff, the registered manager, and the responsible individual, Mr Coleville. A partial tour of the premises was made. The inspector sampled four sets of admission records for residents, and four sets of care plans. Three sets of staff recruitment and training records were also sampled. The inspector observed a lunch setting, and interactions between staff and residents. A number of policies, procedures, and health and safety records were also sampled. The inspector would like to thank everyone who contributed to the inspection visit. What the service does well: Good care plans and arrangements for residents to access healthcare support are in place. The registered manager continues to update her knowledge and training, and the home is well managed and has a good atmosphere. Residents have a range of activities available, and contribute to the planning of social events in the home. Residents are supported to maintain contact with friends and relatives. The home provides good communal, bedroom, and bathroom facilities. Good arrangements are in place for staff training, staff supervision and support, and staff recruitment. Valewood House DS0000024233.V314612.R01.S.doc Version 5.2 Page 6 The home is being adequately staffed to ensure residents’ needs are being met. 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. Valewood House DS0000024233.V314612.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 Valewood House DS0000024233.V314612.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Good arrangements are in place for pre-admission assessments, visits, and trial stays. The quality of outcomes for residents in this section is good. The judgement has been made using available evidence, including a visit to the service. EVIDENCE: The range of fees is £544.25 per week to £740 per week. Four sets of admission records were sampled, all of which included preadmission and risk assessments. The registered manager Mrs Houghton advised that she visits prospective residents prior to a trial stay being agreed, and records of assessments carried out during those visits were seen. Valewood House DS0000024233.V314612.R01.S.doc Version 5.2 Page 9 Prospective residents have a six week trial stay before a decision is taken on formal admission. The home does not provide intermediate care. Valewood House DS0000024233.V314612.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Good care plans and arrangements for residents to access healthcare support are in place. Appropriate procedures are in place for the administration of medicines. The resident’s choice is being encouraged, and privacy and dignity supported. The quality of outcomes for residents in this section is good. The judgement has been made using available evidence, including a visit to the service. EVIDENCE: Four sets of care plans were sampled, and these included risk assessments and clear guidelines for staff on how the resident’s needs should be met and risks managed. A number of residents require a high level of physical care, and the inspector observed staff providing support with personal care, eating and drinking in a calm and respectful manner. Valewood House DS0000024233.V314612.R01.S.doc Version 5.2 Page 11 Staff were observed to be available and responsive to residents, and to be engaging residents in conversations and activities. Staff were seen to treat residents with respect, and staff interviewed felt that resident choice, privacy and dignity were important and were being prioritised. For example, residents are encouraged to help plan menus, activities and social occasions in the home. Residents’ meetings take place fortnightly, and records of these indicate that residents are being consulted about social events and day to day matters in the home, and are being encouraged to make their views known. Resident’s bedrooms are lockable, and residents can choose to hold a key. A tour of the premises indicated that some residents are choosing to hold keys. Care records seen show that residents are accessing the health services they are in need of. Care plans seen included Care Programme approach (CPA) reviews, which indicates that residents continue to be monitored by the local community mental health team. One resident said she had received good support from the home after recent surgery. The inspector sampled medication records. Staff advised the inspector that only trained nurses are administering medication. Manufacturers’ information on medicines administered is held in the home. Medicines are securely stored. Staff advised that residents’ medication is reviewed regularly at the CPA reviews and on other occasions when a resident receives a visit from their allocated psychiatrist. Each resident has a key worker, which is making more one to one support available to the individual resident. Valewood House DS0000024233.V314612.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Residents have opportunities to practice more independence, and to access community facilities. Residents have a range of activities available, and contribute to the planning of social events in the home. Residents are supported to maintain contact with friends and relatives. A good standard of meals is being provided for residents. The quality of outcomes for residents in this section is good. The judgement has been made using available evidence, including a visit to the service. EVIDENCE: Four meals per day are provided for residents, and during the inspection snacks such as fresh fruit and biscuits were also being provided. Residents said they enjoyed the meals provided, and alternatives to the main meals are Valewood House DS0000024233.V314612.R01.S.doc Version 5.2 Page 13 provided. Specialist diets such as vegetarian, vegan, and soft food are being provided. A lunch sitting was observed, and more frail residents were receiving help with eating where this was required. Fresh ingredients are being used in cooking, and menus seen indicated that meals are varied and nutritious. Activities provided in the home include bingo, gardening, quizzes, table games, aromatherapy and beauty sessions. The information board includes a programme of planned activities. Mrs Houghton advised how residents are encouraged to make choices about the activities available. Community facilities used by residents include a luncheon club, church, garden centres and shopping. An information board in the sitting room has information on local community facilities such as the library and clubs. Residents said there had been outings during the summer, and photographs from one of these outings were displayed in the sitting room. The most recent social event was a Halloween party, and residents are involved in planning Christmas events. During the inspection visit, staff were taking residents to attend medical appointments or activities in the community where this was requested, and a quiz session was being held in the afternoon which was well attended. Communal facilities include an outbuilding used by residents who wish to practice more independence, and this has facilities for cooking, doing individual laundry, and playing computer games. Care plans seen included support being provided to assist residents to maintain contact with relatives and friends. Valewood House DS0000024233.V314612.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 A complaints procedure is in place and accessible to residents, their friends and relatives. Arrangements are in place for the reporting of adult protection issues, and the home has recently reported allegations made to the relative authority and has acted to protect residents from harm. The quality of outcomes for residents in this section is good. The judgement has been made using available evidence, including a visit to the service. EVIDENCE: A complaints procedure is in place, and a copy of this is displayed on the notice board. The inspector noted that a recent residents’ meeting had provided information to residents on the complaints procedure. The complaints record was seen. Since the previous inspection, there has been one notified adult protection matter which has been investigated by local agencies who reported that “Valewood House have dealt with the allegations in a professional manner”. Staff are receiving training in the protection of vulnerable adults. Valewood House DS0000024233.V314612.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 26 The home provides good communal, bedroom, and bathroom facilities. The provider continues to improve the quality of the accommodation provided. The quality of outcomes for residents in this section is good. The judgement has been made using available evidence, including a visit to the service. EVIDENCE: A partial tour of the premises was made with registered manager Mrs Houghton. Improvements to the premises since the previous inspection include an upgrading of the patio area, and steps and features have been created to make the area around the lake more accessible to residents. Valewood House DS0000024233.V314612.R01.S.doc Version 5.2 Page 16 The home is being well maintained, and there is good natural light throughout the building. The premises are arranged to provide a comfortable living environment for residents. Mrs Houghton advised that carpeting of the lounge and stairs is due to be completed before Christmas, and there are plans to install a walk-in shower. The main communal areas are the sitting room, the conservatory, and the dining room, and an outbuilding used for craft work, cooking, and computer games. There are also a number of smaller rooms which can be used for meeting visitors more privately. Four of the bedrooms are shared, and none of the bedrooms seen have en suite facilities. There are however a good ratio of toilets, bathrooms, and shower rooms on the premises. Bedrooms visited had appropriate facilities, and have been individualised by the resident. The inspector found that hot water in hand basins in bedrooms and bathrooms did not benefit from temperature regulators, and hand testing indicated that hot water in these hand basins was too hot for the hand to be held under them more than briefly. A requirement concerning this has been made in relation to standard 38. Sluices and sluice washing facilities are provided. All areas of the home visited were clean and hygienic. Maintenance records were seen, and a system is in place for staff to advise the maintenance staff of problems identified, and for it to be recorded when the work is carried out. The grounds and gardens are being well maintained. Valewood House DS0000024233.V314612.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Good arrangements are in place for staff training, staff supervision and support, and staff recruitment. The home is being adequately staffed to ensure residents’ needs are being met. The quality of outcomes for residents in this section is good. The judgement has been made using available evidence, including a visit to the service. EVIDENCE: 6 first level nurses are employed, there are 17 care staff, and 8 ancillary staff. 6 care staff have the National Vocational Qualification (NVQ) in care at level 2 or above. Mrs Houghton advised that 3 care staff are presently undertaking NVQ training in care at level 2, and 2 care staff are doing the NVQ3 training in care. The inspector observed that staffing levels on the day of the inspection were adequate to ensure that residents were receiving the care they needed, staff were able to escort individual residents on social trips and medical appointments, spend individual time with residents and provide social activities for residents. Valewood House DS0000024233.V314612.R01.S.doc Version 5.2 Page 18 Staff training provided in the past 12 months has included abuse awareness, challenging behaviour, psychoses, manual handling, health and safety, fire safety, pressure care and catheter care. Planned training includes elder abuse, activities for today, and the ‘working with approach’ in mental health. Records are also being held to ensure that staff are working legally, and nursing staff update their registration. Staff interviewed said that there were arrangements in place for one to one supervision, and for staff meetings. Records for staff supervision were sampled. One resident said “they are very good people, the staff here”, and the inspector observed that residents find staff friendly and accessible, and that staff help maintain a good atmosphere in the home. Staff interviewed enjoy working in the home, and feel supported by the managers. Three sets of recruitment records for staff employed since the previous inspection were sampled, and these indicated that good recruitment procedures are being followed which is helping protect residents. Valewood House DS0000024233.V314612.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 38 The registered manager continues to update her knowledge and training, and the home is well managed and has a good atmosphere. Arrangements are in place to ensure safe working practices and a safe environment for residents. However, the provider needs to ensure that hot water provided to residents is controllable and within safe temperature limits. The provider needs to show that the views of residents, their friends and relatives, and stakeholders in the community are being sought on how the service is performing, and takes these views into consideration in the future development of the service. The quality of outcomes for residents in this section is good. The judgement has been made using available evidence, including a visit to the service. Valewood House DS0000024233.V314612.R01.S.doc Version 5.2 Page 20 EVIDENCE: The provider has advised the Commission of the most recent health and safety and service checks which have taken place. The inspector was advised of action taken to meet requirements made at the most recent fire and environmental health inspections. Accident records and records of environmental safety checks were seen. Fire training is provided for staff, and residents are also able to attend this. The inspector found that hot water in hand basins in bedrooms and bathrooms did not benefit from temperature regulators, and hand testing indicated that hot water in these hand basins was too hot for the hand to be held under them more than briefly. The inspector took the view that it was neither practical or safe for residents for wash hand basins to have such very hot water. The registered manager has continued to update her knowledge and training, in areas such as employment law and time management. The inspector found there to be a good atmosphere in the home. Arrangements are in place to monitor the quality of the service provided. Regular residents’ meetings are helping ensure that residents’ views influence the day to day running of the service. However, there was a lack of written evidence that the views of residents, their friends and relatives, and of stakeholders in the community are being sought on how the service is performing. No results for service user surveys have been published since the previous inspection. The provider has advised that each policy and procedure is reviewed every 6 months, and that staff have read and work to these policies and procedures. Valewood House DS0000024233.V314612.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 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 3 3 x X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X X X 2 Valewood House DS0000024233.V314612.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. 1 Standard OP33 Regulation 24 (1) (5) Requirement That the provider will establish and maintain a system for evaluating the quality of the services provided which provides for consultation with service users and their representatives. The registered manager shall ensure that hot water provided for the use of residents and staff is within safe temperature limits Timescale for action 26/03/07 2 OP38 16.2 (f) 26/02/07 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 Valewood House DS0000024233.V314612.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 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 Valewood House DS0000024233.V314612.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. 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