Inspection on 19/07/05 for Valley House

This inspection was carried out on 19th July 2005.

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

Valley House 06/09/06

Valley House 25/03/06

Valley House 16/10/04

Valley House 14/06/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Valley House Elham Valley Road Barham Canterbury Kent CT4 6LN Lead Inspector Nicki Dawson Announced 19/07/05 at 09:30 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Valley House Address Elham Valley Road Barham Canterbury Kent CT4 6LN 01227 832230 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) Family Investment (Five) Limited Miss Bernadette Riley CRH 6 Category(ies) of Care Home for people with Learning Disabilities. registration, with number of places Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 16th October 2004 Brief Description of the Service: Valley House provides residential care for 6 adults with a learning disability. It is situated in the beautiful rural setting of Elham Valley vineyards. Within the grounds is a purpose built pottery and a tea room. There are no amenities in the immediate area, but the small village of Barham is a few miles away. Buses provide links to Canterbury and Folkestone. There is ample parking space near the home. The home is owned and managed by Family Investment Limited, and the families of residents may buy shares in the company. Family Investment Limited also operate the pottery and tea room. The home is on two floors. It has six single rooms, and four have en-suite facilities. There is a bathroom with toilet and shower facilities on the second floor. The communal space consists of a main lounge and dinning room. Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection commenced at 9.30am and concluded at 6.30pm. The majority of this time was spent talking with residents and staff. Two support staff were interviewed and time was spent in the office looking at records and speaking with the registered manager. Residents showed the inspector around their home and one resident shared a meal with the inspector. The inspector received information about the service, from the registered manager, all of the residents and six relatives, prior to the inspection. The comments from residents and relatives were all positive about the service provided at Valley House. What the service does well: What has improved since the last inspection? What they could do better: The health and safety of residents has been put at risk by the practices of wedging open fire doors that must remain closed at all times; omitting to record all medication that is administered; and accommodating more residents than the home is registered to accommodate. The home takes the health and safety of residents seriously, and addressed all these matters immediately after the inspection took place. Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 6 Residents are able to express their concerns to staff, but need to be made aware of how to do this formally, via the complaints process. Staff are aware of aspects of controlling the spread of infection and the protection of vulnerable adults, but would benefit from formal training. The overall standard of the environment is high, but is let down by one piece of broken furniture and some missing bathroom tiles, in residents rooms. 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. Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3 and 4 A detailed assessment is undertaken of all prospective residents before a decision is made as to whether the placement will be permanent. When prospective residents are invited to come to the home for a trial visit, the home must ensure that it does not exceed the number of residents for whom it is registered to accommodate. EVIDENCE: Prospective residents complete an application form and then the registered owner and registered manager undertake a home visit. The prospective resident visits the home to have the opportunity to ‘test drive’ the home. During this time, a very detailed assessment is completed, including the views of relatives, professionals, staff and the residents already living in the home. By allowing prospective residents to stay overnight at the home, the home has exceeded the number of residents for which it is registered to accommodate. A statutory requirement was made for this practice to cease immediately. The staff team demonstrated that they are able to communicate with the residents and have a good understanding of the needs of adults with a learning disability. Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, and 8 Staff understand the individual needs of residents as set out in their individual plans of care. All residents should be involved in the care planning process. Residents are enabled to make choices and are involved in all aspects of life within the home. EVIDENCE: Resident’s individual plans contain information about their personal history, contact details, health, social behaviour, medication, and daily routine. Plans are currently being developed to ensure that the most current information is easily accessible. Residents know that staff write about them, but not everyone knows the content of this information. Some residents are aware that they have an individual plan of care. However, the care plan viewed did not contain the resident’s signature to show that they had agreed to the content of the plan. Staff were knowledgeable about the content of resident’s care plans. One member of staff stated that the most important part of their job was “listening to service users and giving them choices and guidance in that choice”. They were then able to demonstrate how this principle had been put into practice that morning. Staff added that resident choice was limited, particularly at the weekend, since there is only one member of staff on shift. This is especially limiting for residents who are not able to travel independently. Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 10 Residents have regular meetings where they come together to discuss their home life. Residents are encouraged to take responsibility for their own monies and clear records are kept of all financial transactions. Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 and 17 Residents lead active, busy lives at Valley House. Their responsibilities are acknowledged and their contribution to the community valued in the wide range of leisure, work and educational activities in which they participate. EVIDENCE: Household tasks are shared amongst the residents. One resident showed the inspector a book, containing a rota for all household tasks including, emptying the bins, cooking, and shopping. Residents undertake their household responsibilities on a set day each week. Family Investment has developed a range of day opportunities for the residents. There is a pottery, vineyard and tea shop in the area surrounding the home and a workshop situated in Barham. The residents are actively involved in these activities. One resident proudly showed the certificates of achievement that they had obtained from these day services and other college courses that they had attended. These included life skills, food hygiene and French conversation. Residents also have opportunities to participate in other leisure activities, which include the Special Olympics, watching cricket at Canterbury and a visit to the Kent County show. Photographs were viewed of a holiday that the male residents had recently enjoyed. Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 12 Staff said that residents were encouraged to invite friends around for a meal. Residents can use the residents’ telephone to remain in contact with friends and family. One resident buys the newspaper to keep in touch with important events. Residents explained that the person who is responsible for the cooking that day chooses the menu. Staff said that mealtimes were “like at home…. everyone gets together to talk about what they have done during the day”. The inspector joined a resident for lunch and a midmorning coffee break. These occasions were both relaxed and informal. The menu for the evening provided a well-balanced meal. Other meals provided at the home and alternatives that are available for residents are not recorded. Therefore, it could not be assessed whether the resident’s diet as a whole was satisfactory and nutritional. Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 20 and 21 The practices and procedures for the administration of medication are generally good, but need strengthening in identified areas to ensure the continued good health of residents. Staff deal sensitively with residents who are bereaved. EVIDENCE: Residents organise their own personal care and staff give guidance when needed. The recording, administration and disposal of medication was inspected and seen as in accordance with the homes policies and procedures. There were two exceptions. The recording of the administration of medication, for one day, in respect of one resident, had been omitted. This can potentially place the health of the resident at risk. The opening date of a bottle of eye drops, which has a short shelf life, had not been recorded. The registered manager immediately disposed of this medication and commenced a new bottle to prevent placing the resident’s health at risk. The staff interviewed demonstrated that they were competent in the administration of medication and first aid. Residents’ individual plans contain information about their spiritual needs and wishes after death. Residents who are bereaved “receive the most wonderful support and understanding from the staff at Valley house”, explained one relative. Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Discussion is encouraged and action taken to prevent the problems of residents from developing into formal complaints. Formal training would strengthen the staff’s awareness of how to safeguard residents from abuse. EVIDENCE: Residents said that staff were approachable and that they listened to their concerns. Staff maintained that ‘listening’ was the most important part of their job. The registered manager explained that she would address any complaint as a matter of urgency. The home’s complaint procedure is detailed in the ‘service user guide’, but omits the name, address and telephone number of the Care Standards Commission. Feedback obtained from relatives confirmed that they are aware of the complaints procedure. The registered manager agreed that residents and relatives would be more aware of the complaints procedure if it was posted on the notice board. Staff interviewed demonstrated that they would act appropriately if they suspected that a resident had suffered from abuse or neglect. The registered manager was aware of the protocols for informing other professionals if abuse was suspected. However, these protocols have not been included in the homes adult protection procedure and staff have not received structured training on adult protection. These actions would help ensure that residents are protected from abuse and neglect. There is a policy on whistle blowing and staff said that it was effective. Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25, 26, 27, 28 and 30 Valley House provides a clean, comfortable and homely environment for the residents who live there. Staff would benefit from training in infection control. EVIDENCE: Valley House is situated in a beautiful rural location and many of the upstairs rooms have views across the vineyard and surrounding countryside. The local amenities can only be accessed by public or house transport. One member of staff said that this could be quite isolating and restrictive, especially when there was only one member of staff on duty. Residents were delighted to give a tour of their home. Each resident has a single room. Bedrooms have been decorated according to individual tastes and to a good standard with two exceptions. The chest of draws in one room was broken and some tiles were missing from the bath front in one of the ensuites. Rooms contain items that are important to the residents. Four of the residents have en-suite rooms and the other two residents share a bathroom. Downstairs there is a large living room and a separate dining room, kitchen and laundry area. The garden has been laid to lawn, with a seated area. The home has been attractively decorated with hanging baskets, chosen by the residents. Building work is planned to extend the home to provide two Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 16 additional resident rooms. The current residents are very aware of the process and some of the impact that this will have on their daily lives. Valley House is clean throughout. Some staff are very knowledgeable about procedures for the controlling infection in the home and others had limited knowledge, but knew where to find the relevant information. Hence, the staff team would benefit from training in this area to ensure consistency in practice. Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, and 36 Residents are protected by the home’s recruitment practices. Staff understand and communicate well with the residents, both individually and as a team. EVIDENCE: Residents and relatives spoke highly of the staffs’ qualities. Residents said that staff listen to them and one relative commented that, “the staff do an excellent job”. An examination of personnel files showed that before an employee commences work at the home, a thorough recruitment and selection procedure is undertaken, including the necessary pre-employment checks. The staff team consists of the registered manger, a part time deputy manger, two full-time and three part-time support staff. Since the last inspection, one member of staff has left and the registered manager is due to leave shortly. One member of staff said, “it has been a hard year with staff changes”. There is a minimum of one staff on duty at all times. Staff said that this could be “frustrating”, especially at weekends, when residents have differing ideas about where they want to go and what they want to do. New staff work alongside current staff and receive in-house training, which meets the National Minimum Standards. The registered manager is developing a staff-training programme for all staff to ensure that they receive mandatory training. Three staff are in the process of completing NVQ Level 2. Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 18 Staff said staff meetings are held regularly and that they are an effective form of communication. In addition staff communicate the changing needs of the residents by writing in the handover sheets and communication book. Staff receive supervision and said that it was, “more frequent than it used to be”, and that this was “good”. The personnel files viewed indicated that the regularity of these meetings fluctuates between staff. However, staff stated that the registered manager was always available if needed. Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38, 42 and 43 The residents and staff benefit from the open and clear management approach in the home. The practice of wedging open designated fire doors has put the health, safety and welfare of residents at risk. EVIDENCE: Staff said that the registered manager was approachable and that the atmosphere in the home was of a “family feeling”. The registered manager communicated in a sensitive way with the residents during the inspection. An inspection of records revealed that maintenance of gas, electrical and fire fighting equipment had been undertaken. Two practices in the home, with regards to fire safety, put the health of residents at risk. The first is that no record has been made when staff participate in fire drills. The second is that residents are wedging their bedroom doors open, which are designated fire doors. A statutory requirement was made to cease this practice immediately. Staff demonstrated through discussion that they knew what to do if an accident took place. Valley House has a certificate of insurance and an annual report with accounts. Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 20 Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 2 x Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 3 3 x 2 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 2 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Valley House Score 3 x 2 3 Standard No 37 38 39 40 41 42 43 Score x 3 x x x 1 3 H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 22 NO 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 4 Regulation Care Homes Act 2000 section 24 17 (2) schedule 4 Requirement The registered person must cease the practice of accommodating potential residents over the number for which it is registered. The registered person must keep a record of food provided in sufficient detail to enable any person inspecting it to determine if the diet is satisfactory and nutritional The registered person must ensure that a record is made when administrating all medicaitions The registered person must ensure that the complaints procedure includes the name, address and telephone number of the commission. The registered person must commence staff training in adult protection ensure that the homes policy on adult protection includes the protocols for making a referral to social services The registered person must ensure that the chest of draws in one residents room and the tiles on the bath front in one residents en-suite bathroom is Timescale for action Immediate 2. 17 19/10/05 3. 20 13 Immediate 4. 22 22 19/10/05 5. 23 13 19/1/06 6. 26 23 (2) c 19/9/05 Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 23 reparied 7. 42 23 The registered person must ensure that when a fire drill is undertaken, that a record is made of all staff who participate. The registered person must ensure that fire doors are not wedged open. immediate 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 6 Good Practice Recommendations The registered person should ensure that all residents are involved in the care planning process and understand the content of important information that is written about them The registered person should post a copy of the complaints procedure on the residents notice board 2. 22 Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU 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 Valley House H56-H05 S23287 Valley House V229205 190705 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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