Inspection on 25/03/06 for Valley House

This inspection was carried out on 25th March 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Valley House 06/09/06

Valley House 19/07/05

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 Valley House Elham Valley Road Barham Canterbury Kent CT4 6LN Lead Inspector Nicki Dawson Unannounced Inspection 25 March 2006 10:10 th Valley House DS0000023287.V279562.R01.S.doc Version 5.1 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 Valley House DS0000023287.V279562.R01.S.doc Version 5.1 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 Adults 18-65. 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. Valley House DS0000023287.V279562.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Valley House Address 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) Valley House Elham Valley Road Barham Canterbury Kent CT4 6LN 01227 832230 Family Investment (Five) Limited Vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Valley House DS0000023287.V279562.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th July 2005 Brief Description of the Service: Valley House provides residential care for up to 8 adults with a learning disability. It is situated in the beautiful rural setting of Elham Valley vineyards. 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. Parking is available near to the home. The home is owned and managed by Family Investment Limited. The families of residents buy shares in the company. Family Investment Limited also operate a pottery and tearoom on the same site. The home manager, Annette Norton, has previously worked for the organisation and has been in post for six months. The home is on two floors. It has recently been extended to provide two additional en-suite rooms. It has eight single rooms, and seven have en-suite shower 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 DS0000023287.V279562.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on Saturday 25th March at 10.10am and took 5 hours. The inspector spoke with all six residents who live at the home and joined some of them for lunch. The inspector looked around the main areas of the home and a number of residents’ bedrooms. Time was also spend looking at a records kept by the home. What the service does well: What has improved since the last inspection? What they could do better: If there is a fire in the home staff need to know what to do and the fire needs to be prevented from spreading. This can be done by staff taking part in regular fire drills and fireguards being fitted to residents’ bedroom doors. Not all medicines given to residents are recorded. Although there is no evidence that any mistakes have been made, this can potentially happen without clear records being kept. Residents care plans need to be changed so that they contain all the information that is needed, in a clear way, so staff can easily follow them. Residents who may want to move to Valley House are not given information about what it is like to live at the home, in a way that they can understand. This information should be written in a document called a ‘service user guide’. It is disappointing that after 4 years of the National Minimum Standards, this basic information is still not available. Valley House DS0000023287.V279562.R01.S.doc Version 5.1 Page 6 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 DS0000023287.V279562.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Valley House DS0000023287.V279562.R01.S.doc Version 5.1 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 the following standard(s): 1 and 5 Prospective residents do not have all the information they need to make an informed choice about where to live. EVIDENCE: The home has produced a ‘statement of purpose’ that sets out the aims, objectives and philosophy of the home, together with the services and facilities provided for residents. The home is also required to produce a ‘service user’s guide’, which clearly sets out for residents, the services and facilities that they can expect if they move to the home. The home has produced this guide in a draft format only and existing and potential residents have not been given a copy. Individual contracts clearly set out the terms and conditions that residents expect when they move into the home. It is recommended that in addition, each contract contain the resident’s room number and the amount of fees payable. Currently, residents’ contracts state that the fee level is available from the directors of the company. Valley House DS0000023287.V279562.R01.S.doc Version 5.1 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 the following standard(s): 6, 8 and 9 Residents care plans do not contain all their care needs, which means that staff may be unclear as to how to support a particular resident. Residents are consulted on all aspects of life in the home. EVIDENCE: Residents care plans do not give a comprehensive account of the individual needs of each resident. Some information was out of date, some goals had not been properly reviewed and the support needs of some residents were omitted. Assessments of potential risks to residents had been identified, but not all had a clear strategy in place to reduce the potential risk to the resident. The manager agreed that the plans needed further development. The member of staff on duty said that resident’s care plans were easy to use and understand. Residents were aware of their plan of care and are involved in a monthly review of their care needs. Residents said that they could make their views know about how the home is run at regular residents meetings. The items for discussion at each meeting are recorded on the resident’s notice board. . Valley House DS0000023287.V279562.R01.S.doc Version 5.1 Page 10 Valley House DS0000023287.V279562.R01.S.doc Version 5.1 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 the following standard(s): 11, 12, 13, 14 and 17 Residents are given opportunities to live fulfilling lives. EVIDENCE: Staff encourage residents to participate in their share of the household tasks and to be as independent as possible. Each resident is allocated one day at home a week to attend to their household tasks. Family Investment has developed a range of day opportunities for the residents. There is a pottery, vineyard and teashop in the area surrounding the home and a workshop situated in Barham. The residents are actively involved in these activities and said that they were pleased with their activity programmes. They explained that if they were not happy with an activity they could change to one that they prefer. Some residents also take part in work opportunities in the community. Residents have opportunities to participate in a range of leisure activities, including the Special Olympics, watching cricket at Canterbury and going shopping. Residents said that they were looking forward to their planned holidays to Centre parks and Somerset. Valley House DS0000023287.V279562.R01.S.doc Version 5.1 Page 12 At mid-morning, staff asked the residents what they would like for lunch. The inspector joined some residents for lunch and a midmorning coffee break. These occasions were both relaxed and informal. The menu indicated that residents are given choices at mealtimes and that a well-balanced diet is provided. Valley House DS0000023287.V279562.R01.S.doc Version 5.1 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 the following standard(s): 19 and 20 Resident’s physical and emotional needs are met. Staff recording of the administration of medications is not clear and may potentially place residents at risk. EVIDENCE: Staff ensure that residents regularly access relevant health care professionals. All health care appointments and the outcomes are clearly recorded. Staff are aware of the healthcare needs of residents. Resident’s emotional needs are recognised and professional support accessed where appropriate. Selected aspects of the ordering, storage and administration of medications were inspected. The home has a comprehensive policy on the administration of medication. Generally the administration of medicines complied with the home’s procedures, with two exceptions. Records indicated that the medicines of one resident who self-medicates had not been checked. Also, it was recorded that one resident’s eye drops had not bee given for a number of days. The manager explained that this resident had been absent from the home on the majority of these occasions. Valley House DS0000023287.V279562.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: Valley House DS0000023287.V279562.R01.S.doc Version 5.1 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 the following standard(s): 24, 25, 26, 27 and 28 Residents live in a homely, comfortable, but potentially unsafe environment. 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 be accessed by public or house transport. 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. Rooms contain items that are important to the residents. The home has recently been extended to include two additional ensuite bedrooms. The residents moving to these rooms were very pleased with their accommodation. One downstairs room has been extended and an ensuite shower room has been added. This means that all but one resident’s room has ensuite shower facilities. Downstairs there is a large living room a dining room that has been extended, a kitchen and laundry area. The garden has been laid to lawn, with a seated area. Valley House DS0000023287.V279562.R01.S.doc Version 5.1 Page 16 At the last inspection the home was required to provide fireguards to resident’s bedroom doors. This was to prevent residents from wedging open fire doors, which is a potential hazard. It was therefore distressing to observe that residents were still wedging open fire doors, since one fireguard had broken and the two new rooms had yet to be fitted with fire guards. A requirement to take immediate action was made. Valley House DS0000023287.V279562.R01.S.doc Version 5.1 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 Competent staff supports residents. EVIDENCE: There have been a number of changes in the staff team recently. The majority of residents said that staff were good listeners. One resident said that staff, “do not always listen….and don’t always sort out problems”. Another said that staff did their “jobs properly” and were, “lovely and caring”. Staff on duty on the day of the inspection demonstrated that they were competent in undertaking their duties. Valley House DS0000023287.V279562.R01.S.doc Version 5.1 Page 18 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 40 and 42 Resident’s views about the quality of care at the home are regularly sought. Adequate measures to minimise the potential risk of fire have not been undertaken, which places residents at risk. EVIDENCE: The home uses various methods to gain the views of residents, staff and stakeholders about the quality of care provided at Valley House. Staff meetings are held and the home’s policy states that there are shareholders meetings and an annual general meeting. Residents said that their views were sought and listened to during regular meetings and in addition they had completed a quality service questionnaire. The manager said that these suggestions had been summarised and addressed in a plan of action. A selection of policies and procedures were sampled. Staff said that the homes policies and procedures were accessible and that they knew where to find a piece of information if it was required. Valley House DS0000023287.V279562.R01.S.doc Version 5.1 Page 19 The fire system is regularly maintained. However, staff have not participated in a fire drill for a period of eight months, to ensure that they are aware of evacuation procedures. As mentioned previously in this report, residents are being put at risk by wedging their bedroom doors open during the day, which are fire doors. A requirement was made to take immediate action. Valley House DS0000023287.V279562.R01.S.doc Version 5.1 Page 20 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 Standard No Score 1 2 2 X 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 X 28 3 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X 3 2 X LIFESTYLES Standard No Score 11 3 12 4 13 3 14 4 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 2 X X X 3 3 X 1 X Valley House DS0000023287.V279562.R01.S.doc Version 5.1 Page 21 YES 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. 2. Standard YA6 YA9 Regulation 15 (1) 13 4 c Requirement Care plans must contain sufficient detail to enable staff to meet residents needs Risk assessments should contain a detailed plan of the steps to follow to minimise the potential risk to the resident A record must be made on the MAR sheet when administrating all medications (previous timescale of 19/07/05 not met) Staff should regularly check the medicines of residents who selfadminister The practice of wedging open fire doors must cease immediately and fire guards be fitted. An immediate requirement was made on: - (previous timescale 19/07/06) Staff should participate in a fire drill twice in a year and their name should be recorded. An immediate requirement was made on: Timescale for action 25/05/06 25/05/06 3. YA20 13 (2) 01/04/06 4. 5. YA20 YA24YA42 13 (2) 23 4 (a) 01/04/06 29/03/06 6. YA42 23 4 (e) 29/03/06 Valley House DS0000023287.V279562.R01.S.doc Version 5.1 Page 22 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. 2. Refer to Standard YA5 YA22 Good Practice Recommendations Residents statement of terms and conditions should include the room number and amount of fees payable A copy of the complaints procedure should be posted on the residents notice board so that it is clearly visible Valley House DS0000023287.V279562.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Kent and Medway Area Office 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 DS0000023287.V279562.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!