Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 22/08/05 for Valley Lodge Nursing Home

Also see our care home review for Valley Lodge Nursing Home for more information

This inspection was carried out on 22nd August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents considered that staff were caring in their approach and responded appropriately to their needs. Staff had a good understanding of residents needs and said that one of the best things about the home was that staff worked together to provide good care for residents. The staff team is reasonably well established and residents reported that staff were approachable. The environment is homely and comfortable and generally well maintained.

What has improved since the last inspection?

An acting manager has been appointed and the Provider is working to address the manager vacancy. An audit has been completed to address the required redecoration and refurbishment of the premises. A training and development plan has been developed and is beginning to be implemented.

What the care home could do better:

A full assessment of resident`s needs, preferences and abilities needs to be completed on admission. Care plans need to be reviewed, updated and all records completed in accordance with the regulations. A programme of renewal and redecoration must be implemented with timescales for completion. Qualified staffing levels must be maintained and clinical leadership within the home must be assured by a senior nurse.

CARE HOMES FOR OLDER PEOPLE Valley Lodge Nursing Home Bakewell Road Darley Dale Derbyshire DE4 3BN Lead Inspector Marie Bonynge Unannounced 22 August 2005 @ 10:00 am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Valley Lodge Nursing Home Address Bakewell Road Darley Dale Derbyshire DE4 3BN 01629 583447 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) Leyton Care Homes Vacancy CRH Care Home 33 Category(ies) of N Care home with nursing registration, with number of places Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21st March 2005 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 is set in accessible and attractive wellmaintained grounds with car parking space provided. Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over one day in August 2005. The Inspector spoke to residents, staff and the Acting Manager. Several residents had difficulties in expressing themselves in words and were unable to contribute directly to the inspection, however they were observed throughout this visit as to how well their needs were being met by staff. Records were examined included care plans, health records, staffing rotas and quality assurance systems. The home has made some progress towards meeting the requirements from the last inspection report although this has been limited in respect of the care planning documentation and a number of the requirements remain outstanding. What the service does well: What has improved since the last inspection? An acting manager has been appointed and the Provider is working to address the manager vacancy. An audit has been completed to address the required redecoration and refurbishment of the premises. A training and development plan has been developed and is beginning to be implemented. Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 6 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. Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 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 standard(s) 2 and 3 Deficits in the assessment process and assessment information cannot always assure residents that their needs will be fully met. EVIDENCE: Care plans and associated records were examined for three of the residents accommodated on this visit. Contracts / statements of terms and conditions were said to be in place for all residents and an example of the residents contract was seen. This did not specifically include the free nursing care element where a nursing contribution was to be paid in respect of nursing provided at the care home to the resident. Assessment information had been obtained for one resident prior to their admission but was not fully completed in two of the care plans. This was a requirement outstanding from the last inspection report and has been carried forward. The new documentation that was being introduced had not been incorporated into the care plans. There were therefore deficits in the level of information provided. Discussions with nursing staff and examination of the daily logs indicated that care staff were aware of the care needs of residents. Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 9 It was not clear from the documentation available that all of the residents’ health, personal and social care needs were being fully met. EVIDENCE: Discussions with residents indicated that they considered staff were friendly and caring in their approach and responded to their needs appropriately. Three care plans were examined that were variable in their content. The monthly weight of one resident had not been recorded consistently although the nutritional assessment and pressure sore assessment tool indicated that the resident was in a high risk category. One resident had a history of falls but no falls risk assessment had been completed. Discussions with staff and residents indicated that health care matters were attended to promptly and that GP referrals were timely. Examination of the communications book supported this. The Inspector was advised that work was ongoing to update and review the care plans although not all of them had been completed. Three requirements have been carried forward from the last inspection report. Medication systems were not examined on this occasion, however the temperatures of the Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 10 refrigerator for medication were now being recorded. This requirement has therefore been met. Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: These standards were not assessed on this occasion. All of these standards were assessed and met at the last inspection of the service. Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The complaints procedure assists in residents being able to voice their concerns and to be assured that they will be responded to. EVIDENCE: Discussions with two residents indicated that they were aware of the complaints procedure and would speak to a member of staff if they were not happy about any aspects of their care. A complaints procedure was in place and two complaints had been recorded as being received by the home since the last inspection. One of these had been resolved and one of these had been referred to the head office of the company. No complaints have been received by the CSCI. Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 24, 25 and 26 The home was generally clean, comfortable and well maintained, however a planned programme of redecoration and refurbishment is required to maintain a good standard of accommodation. EVIDENCE: A tour of the building indicated that the home was generally comfortable and residents considered that the environment was comfortable and homely and that the home was generally well maintained. There was no planned programme of redecoration and renewal of the premises although the acting manager had completed an audit of the accommodation in preparation of plans to implement a programme. Some of the bedroom carpets were worn or marked and were in need of replacement and a number of the bedrooms were in need of redecoration. A range of communal space was provided including one large lounge on the ground floor, a smaller quieter lounge and a communal dining area. A Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 14 programme of providing locks on bedroom doors and suitable lockable storage had not progressed since the last inspection. The home was generally clean and hygienic and free from offensive odours with the exception of the entrance hall. The acting manager advised that a programme of shampooing carpets had been implemented and a deodoriser had been purchased. Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 The general care needs of residents appeared to be met although minimum staffing levels in respect of RGN cover was not being maintained. A training plan needs to be put in place to ensure that all staff receive appropriate training for the work they carry out. EVIDENCE: There were 27 residents accommodated on this visit. 24 residents were assessed as having nursing needs and 3 residents as personal care only. 14 residents were assessed as having high dependency needs and 13 residents with medium dependency needs. Staffing rotas were provided that indicated that one RGN was on duty for the 24 nursing residents. This was not in accordance with Department of Health guidelines and was reported as being a contributory factor in the care plans not having been consistently reviewed, updated and completed. (See standards 3, 7 and 8). The acting manager had begun to progress the training and development plan and a food hygiene training course was in progress for staff during this inspection. A requirement has been carried forward from the last inspection report. Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 36, 37 The appointment of a registered manager will support the running of the home and assist in meeting its’ stated purpose, aims and objectives. EVIDENCE: The Registered Manager resigned earlier this year and an acting manager has been appointed in the last three weeks. A formal application for the registered manager has not been made to the CSCI. Staff reported that the staff meetings had taken place and that they felt the management was open and positive with some improvements being made in areas of training and development. There was an established system of quality assurance and Provider visits under Regulation 26 had regularly taken place with records being kept for inspection. A system for the formal supervision of staff was in place, however it was not clear that systems were in place for clinical leadership within the home. Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 17 Records were kept securely and completed in accordance with known guidelines. However, those records identified in the main body of the report specifically assessments and care plans had not been fully completed. Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 2 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 2 3 x x x 2 3 3 STAFFING Standard No Score 27 2 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x 3 x x 2 2 x Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 19 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. Standard OP2 Regulation 5 (a) (b) Requirement Where a nursing contribution is paid in respect of nursing provided at the care home to the resident, the registered person must provide a statement specifying the date of payment and the amount of the nursing contribution to the resident. The registered person must ensure that the assessment tool is fully completed for new residents admitted to the home. From inspection report 21.03.05 Timescale for action 01.02.06 2. OP3 14 3. OP7 14 4. OP7 15 5. OP7 15 Previous timescale 01.08.05. New timescale 01.01.06 Documented risk assessments Previous for service users must be timescale reviewed monthly. From 30.06.04. inspection report 08.03.04. New timescale 01.01.06 Care plans must be kept up to Previous date, be reflective of each timescale service users health, personal 30.06.04. and social care needs and be New reviewed at least at monthly timescale intervals. From inspection report 01.01.06 08.03.04. The risk assessment introduced 01.01.06 for the prevention of falls must be used in accordance with residents needs. C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 20 Valley Lodge Nursing Home 6. OP8 15 (b) 7. OP19 23 (1) (a) 8. OP24 16 9. OP27 18 (1) (a) 10. OP30 18 11. OP31 8 12. 13. OP36 OP37 18 8, 17 Schedule 3 The registered person must ensure that a record is maintained of nutrition including weight gain or loss and appropriate action taken. A planned programme of redecoration and refurbishment must be developed including timescales for completion. Service users must be provided with suitable lockable storage space in their own rooms. Together with suitable locks to their bedroom doors, which they may actively choose to use and in consultation with them and in accordance with risk assessed needs. From inspection report 08.09.03. The registered person must ensure that Department of Health guidelines are followed in respect of RGN cover. The registered person must ensure that the training and development plan is completed and individual staff straining and development profiles are completed. From inspection report 21.03.05. The registered person must appoint a manager to the care home and submit a formal application to the CSCI. A system must be put in place for clinical leadership within the home. The registered person must ensure that care records are kept in accordance with Schedule 3 of the National Minimum Standards. From inspection report 08.03.04 01.01.06 01.02.06 Previous timescale 01.08.04. New timescale 01.03.06 31.12.05 Previous timescale 01.08.05. New timescale 01.01.06 01.02.06 01.02.06 Previous timescale 30.06.04. New timescale 01.01.06 Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Valley Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection South Point, Cardinal Square Nottingham Road Derby DE1 3QT 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 Lodge Nursing Home C52-C02 S2094 Valley Lodge V245435 220805 Stage 4.doc Version 1.40 Page 23 - 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!