Inspection on 02/05/07 for Valley Lodge Nursing Home

This inspection was carried out on 2nd May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 but made no statutory requirements on the home.

Other inspections for this house

Valley Lodge Nursing Home 03/05/06

Valley Lodge Nursing Home 18/01/06

Valley Lodge Nursing Home 22/08/05

Valley Lodge Nursing Home 21/03/05

Valley Lodge Nursing Home 23/09/04

Valley Lodge Nursing Home 08/03/04

Valley Lodge Nursing Home 18/09/03

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Valley Lodge Nursing Home Bakewell Road Darley Dale Derbyshire DE4 3BN Lead Inspector Judith Beckett Key Unannounced Inspection 2nd May 2007 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 Valley Lodge Nursing Home DS0000002094.V338401.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. Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Valley Lodge Nursing Home Address Bakewell Road Darley Dale Derbyshire DE4 3BN 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) 01629 583447 www.ashmere.co.uk Ashmere Care Group Vacancy 1 Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd May 2006 Brief Description of the Service: Valley Lodge is a care home registered to provide accommodation and personal care with nursing for up to 33 older people. The home is located in the village of Darley Dale around a half mile from Matlock town centre off a main bus / transport route. Accommodation is provided on 2 floors with a large lounge on the ground floor and a smaller quieter lounge also. A communal dining area is also on the ground floor. Catering, laundry, domestic and maintenance services are centrally provided. The home is set in accessible and attractive well-maintained grounds with car parking space provided. On the day of the inspection the manger stated the fees range from £417.15£635 per week. This is fully inclusive and no extras are added. Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the visit, an analysis was undertaken from information gathered over the last year. This included survey forms sent to residents and other key people such as relatives. This inspection was unannounced and took place over four hours. Only a limited number of the National Minimum Standards were examined at this inspection (with emphasis on the ‘key standards’), and follow up of the previous requirements and recommendations from the last inspection. The main method of inspection used was called case tracking which involved selecting 4 residents and tracking the care they receive, through discussing this with them and checking their records kept by the home. The Inspector spoke to 4 residents, 4 members of staff the acting manager and the Area Manager. The majority of the residents at Valley Lodge had difficulties in expressing themselves in words and were unable to contribute directly to the inspection. They were however observed throughout this visit as to how well their needs were being met by staff. Six service user questionnaires were received prior to the visit. Inspection methods used included a tour of the building, the examination of records such as care plans, staffing rotas, training records, medication systems and staff files. What the service does well: What has improved since the last inspection? Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 Page 6 Since the inspection on the 3rd & 4th May 2006 and an addition inspection visit on the 17th July 2006 to follow up concerns over a number of complaints there has now been compliance to many of the requirements made at these inspections. The inspector recognised the effort that the registered person, area manager and acting manager had made to achieve the compliance. The manager left last September and the area manager has been assisting at the home. The deputy was appointed to acting manager in March and CSCI are awaiting her application. Both care staff and trained staff have been recruited. Staff moral has improved and they are working more as a team. The format for the care plans has been changed and all trained staff are involved in care planning. The acting manager has supernumerary time, which enables her to do the initial patient assessments. Also the staff have received supervision and appraisal and training in Adult Protection, Fire and Moving and Handling, the shortfalls in staff records have received attention and quality monitoring by the manager has occurred. What they could do better: The acting manager stated that more work is to be carried out on the residents care plans so that they will continue to improve .She stated qualified staff would be given more training on this. The Registered Provider must ensure that application is made to the CSCI for manager registration. A phased programme needs to be carried out to fit suitable locks to all bedroom doors in accordance with documented risk assessments. New double glazed units are to be installed where condensation is obscuring the residents view. Please contact the provider for advice of actions taken in response to this Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3and 6 Quality in this outcome area is ‘Good’. This judgement has been made using available evidence including a visit to this service. Prospective residents’ needs were being fully assessed before admission so that care is provided in a way that meets individual needs and expectations. EVIDENCE: Two residents care plans were examined as part of the case tracking process. These indicated that full assessment information had been obtained prior to these residents being admitted to the home. This had been carried out by the acting manager. This included a nursing assessment and / or a community care assessment. The homes own assessment tool had been completed and provided comprehensive information about the person’s needs. The level and content of the assessment information was generally to a good standard. Residents are reassessed if they go into hospital prior to re-admission. A requirement made in respect of this at the previous inspection has therefore been met. Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 Page 10 A new Statement of purpose was now in place, which was satisfactory. The manager advised the inspector that the home did not admit service users requiring intermediate care. Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9, &10 Quality in this outcome area is ‘Adequate’. This judgement has been made using available evidence including a visit to this service. Residents’ health, personal and social care needs were being well set out in individual plans of care although these were not all being reviewed regularly. EVIDENCE: New care plans were being implemented .On examination of the two care plans of the two service users who were being case tracked, the plans were drawn up using information from the assessment and admission document. The inspector found that one care plan had not been re-evaluated on a monthly basis. Care plans indicated that residents and relatives had been involved and consulted in the completion of care plans. Risk assessments were included within the documentation and included moving and handling and pressure area risk assessments but again some of these had not been reviewed regularly. The daily records were detailed and indicated where changes had occurred in the identified needs and care of the resident, however this was not always Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 Page 12 reflected in the care plan. Discussions surrounding having the daily records with the care plans took place as this would help to ensure the care plans were working documents. Residents considered that staff were friendly and caring in their approach. One resident commented ‘they are always happy and make me laugh’ Residents who were able to express their views said that they felt their privacy and dignity was respected. Arrangements were in place for residents to access the optician, chiropodist and dentist as required. Medication Administration Charts (MAR charts) were examined for all the residents. These were generally in good order with the exception of the following: • There was one omission of a signature on the MAR charts. Photographs were now in place for all of the residents. A list of staff initials and signatures for those staff who administered medication were now in place. Letters from relatives were seen which indicated positive comments surrounding the care of a resident who had died. They spoke of the resident being ‘kept comfortable and dignified’. Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is ‘Good’. This judgement has been made using available evidence including a visit to this service. Residents were being provided with a range of satisfying activities and were able to maintain contact with relatives and the local community. The home provides an appealing and well balanced diet. EVIDENCE: Individual lifestyle preferences and preferred routines, including likes and dislikes were recorded in the 2 residents care plans examined. A programme of activities was in place individual participation was recorded daily in resident’s notes, although some gaps were noted. An entertainer was visiting during the afternoon of the inspection and photographs from previous events were seen, some being displayed in the entrance hall. The Acting Manager said that residents are offered one or two trips out per month. Residents are asked about the activities programme on a regular basis and also at resident and relative meetings. One resident said Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 Page 14 that he enjoyed the activities provided by the Home and he could exercise choice as to whether he participated. A clothes party was planned, as was a garden party for July. An open visiting policy was in operation. Information regarding advocacy services was available and a system was in place for the administration of personal monies. The service users had a choice of meal. The manager said that after breakfast, the cook asked each service user what was their choice for the main meal of the day. Several residents spoke positively about the quality of food provided by the Home. One resident reported that the food was of ‘good quality and quantity’. One service user informed the inspector that ‘There was a choice of meals and if you didn’t like it when it was presented, they would change it for you’. Another commented that the meals were ‘very good, ample portions and a good variety’ There were menus displayed for the day’s meals on the dining tables. Tables were set with cloths and individual serviettes. The environmental health officer had visited on 21/11/06 and a satisfactory report had been received. Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents felt confident that any complaints they had would be listened to. They were being protected from abuse as all staff had received appropriate training on this subject. EVIDENCE: A well-worded complaints procedure was displayed in the entrance hall. The Home’s complaints record had seven entries for 2006 and indicated that matters had been addressed to a satisfactory conclusion. Four had been substantiated and all had been responded to within 28 days. Two Adult Protection investigations had taken place during the last year. A series of complaints were received by the Commission last summer these were investigated and since September no areas of concern have been raised. It is acknowledged that a lot of work has been put into the home to remedy many of the concerns raised. One case-tracked resident stated that he had no concerns about the service he receives but would feel able to talk to any staff if he did have. All staff have attended Adult Protection Training given by Derbyshire County Council. Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,24,26 Quality in this outcome area is ‘Adequate’. This judgement has been made using available evidence including a visit to this service. Residents were living in a homely and generally well-maintained environment and had personalised bedrooms. There was need to improve Health and Safety matters in certain bathroom areas. EVIDENCE: Ongoing decoration was in progress with a planned programme of refurbishment. Upgrade of all bedrooms was to take place to include new bedding and curtains. Bedroom furniture was to be replaced to include lockable storage and the Area Manager said that risk assessments had not yet been completed regarding the implementation of suitable locks on bedroom doors. Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 Page 17 On touring the building the following shortfalls were found: Double-glazed units in the lounge, dining area and some bedrooms require Replacing as condensation restricts the views for the residents. Untidy and cluttered areas were noticed in communal areas. Ground floor bathroom 8 was cluttered and untidy with two hoists and a linen trolley. The sluice was generally tidy. The Acting Manager agreed that there were inadequate storage facilities in the Home. Discussions around using an unused room to use as storage took place. One new hoist had been purchased, as had a sling. The fire officer had visited and new smoke seals to doors are to be fitted by the end of June, these were being done. Every fire door was to be fitted with a self closer; more time had been allowed for this procedure. One resident commented that the home ‘smells lovely and the cleaners work very hard’. The home was also clean and generally odour free. Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs were being met by satisfactory levels of staffing and a generally well-qualified staff group. Residents were fully protected by the Home’s staff recruitment procedures. Staff received a full training programme to provide them with all the skills to do their jobs. EVIDENCE: The staffing rota for week commencing 24 April was examined. This showed that minimum staffing levels – one to five nursing and one to eight residential were being maintained. On some days there were four care staff on duty. The home aimed to have two trained staff on duty in order to enable the acting manager supernumerary time for her management duties. The occupancy at the time of inspection was 22 service users, 2 were in hospital. 3 were assessed as requiring personal care and 19 as having nursing needs. 2 staff were performing kitchen duties and 2 were housekeeping. A fulltime handyman is employed to carry out maintenance and decorating. There were no staff vacancies within the home at present. Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 Page 19 One service user said that ‘Staff are very responsive to the bell at night, when I ring, they come.’ Staff training records showed that all staff training was up to date. At the previous inspection it was agreed that the manager would be able to evidence that the staff training had been organised for 2006/07. Regarding National Vocational Qualification (NVQ) training, the manager provided evidence that 12 staff had obtained their NVQ level 2 or above. She went onto explain that 4 staff planned to start the NVQ level3. On discussing the training with the staff, the inspector was informed that, ‘the training had increased significantly this year’. There was a previous requirement to have accurate staff files, which contained the necessary information. On examination of the staff files at this inspection, those sampled contained all the required information. Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,38 Quality in this outcome area is ‘Adequate’. This judgement has been made using available evidence including a visit to this service. Residents were living in a Home run and managed by a person who is fit to be in charge – although not registered for this Home – and with a good management approach. The Home was being run in the best interests of residents, with their financial interests safeguarded and their health and safety generally promoted. EVIDENCE: The Acting Manager was well experienced and had been found ‘fit’ to be a registered manager at another care home. However, since accepting the post Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 Page 21 she has not applied to the Commission for registration as manager of this Home. She was in the process of completing the NVQ 4 manager’s award, as is the deputy manager at the home. The Acting Manager said she felt supported by her General Manager who visits weekly and was satisfied there were clear lines of accountability within the Home. The Acting Manager stated that a Residents and Relatives Meeting was due and minutes from the last meeting indicated that a good range of issues had been discussed. She added that, although the meetings tended to be poorly attended by residents they do have plenty of opportunity to informally share their thoughts with their key worker and other staff. Some completed residents, relatives and staff questionnaires were seen and the Acting Manager described improvements made following this feedback. Monthly Quality Audit visits to the Home by an Area Manager are made and documented as are visits made by the registered owner. The Home was holding only three residents’ personal money. The Acting Manager stated that as fees included all services very little money is kept within the home. The records were examined and appeared correct. The Acting Manager described a satisfactory system of bi-monthly supervision of all care staff with a yearly appraisal for care and senior staff and twice yearly appraisal for kitchen and housekeeping staff. The homes handyman keeps all of the maintenance records, which were seen to be satisfactory. Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 Page 22 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 2 8 3 9 2 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 2 X X X X 3 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 2 3 3 3 3 3 X 3 Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP19 Regulation 23 4 (c) 1 Requirement The requirements of the local fire service must be complied with to make sure the residents are safe. Suitable provision is made for storage, to prevent bathrooms and public areas becoming cluttered therefore creating health & safety hazards. New double glazed units must be installed in windows, which are obscured by condensation An application must be made to the CSCI for manager registration. Timescale for action 2. OP22 23 (l) 01/01/08 01/07/07 3. 4. OP24 OP31 23 2(b) 9 01/09/07 01/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Care plans should be reviewed in consultation with residents or their representative and evidence of this DS0000002094.V338401.R01.S.doc Version 5.2 Page 24 Valley Lodge Nursing Home recorded on file. 2. 3. 4. 5. OP7 OP8 OP19 OP21 Documented risk assessments for service users should be regularly reviewed. Regular quality checks of care planning documentation should be made. Suitable storage facilities should be found to reduce clutter in the areas identified in this report. Items stored in bathroom 8 should be moved to ensure that anyone using the WC can gain access to the wash hand basin in there. Suitable locks should be provided to residents’ bedroom doors, which they may actively choose to use and in consultation with them and in accordance with risk assessed needs. (Previous requirement from 08.09.03) All bedrooms should be provided with lockable storage space. 6. OP24 7. OP24 Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Valley Lodge Nursing Home DS0000002094.V338401.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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