Inspection on 09/12/05 for Valley Road Care Home

This inspection was carried out on 9th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Valley Road Care Home 02/03/09

Valley Road Care Home 29/11/06

Valley Road Care Home 10/08/05

Valley Road Care Home 13/12/04

Valley Road Care Home 19/07/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Valley Road Care Home 1 - 7 Valley Road Gedling Nottinghamshire NG5 1HS Lead Inspector Meryl Bailey Unannounced Inspection 9th December 2005 02:30 Valley Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 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 Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 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 Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Valley Road Care Home Address 1 - 7 Valley Road Gedling Nottinghamshire NG5 1HS 0115 9562309 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) www.mencap.org.uk Royal Mencap Society Lisa Rooks Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Valley Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th August 2005 Brief Description of the Service: Valley Road care home is a comprised of two separate buildings, which accommodate a total of 11 adults with a learning disability. These houses are situated adjacent to one another and set within their own grounds, with a shared garden to the rear with seating and shaded areas. There is also parking for vehicles at the rear. Service users have single rooms on ground and first floors. The ground floor has level access, but there is no lift to the first floor. The home is sited within the local community in a residential area close to a leisure centre. Service users are supported and encouraged to use all local amenities and public transport. Valley Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and conducted by one inspector during one afternoon. Most service users were seen and some were able to contribute their views. Comments and views of some staff have also been incorporated into this report. Some information has been gained from records. The communal areas of the home, including kitchens were seen, but just one bedroom was viewed on this occasion. What the service does well: What has improved since the last inspection? Individual support plans have been improved and well maintained since the last inspection. Attention has been given to the labelling of stored food in the refrigerators. Staff have been pursuing appropriate training. Valley Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 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 Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 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 Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 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): These standards were not assessed at this inspection. EVIDENCE: Valley Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 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 and 7 Support is well planned and service users are encouraged to make their own decisions. EVIDENCE: The files of three service users were inspected and very clear and comprehensive individual support plans were found. All areas of need were addressed and linked to risk assessments. There was clear evidence of regular updating as needs had changed. Service users themselves had been involved in drawing up the plans and Positive Futures had assisted to support those that required advocacy. The plans and other signed documents on files demonstrated that rights were respected and individual choices were encouraged. Valley Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 Page 10 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): 15, 16 and 17 Support and encouragement is given in maintaining relationships and rights and responsibilities are generally respected. However, a healthy diet is not being offered to all service users. EVIDENCE: There was a family and friends relationship plan for each service user and this included a list of birthdays. Some service users spoke of contact with family. There was a finance file for each service user and responsibilities for cash and bank accounts were well managed. They each had a key to their own rooms. Both kitchens were seen and found clean. Food in the fridge was appropriately labelled and temperatures were monitored. Meals eaten were recorded, but menus were not prepared in advance. On the day of inspection, in one house staff took service users to the freezer to choose a frozen meal to prepare. In the other house staff had prepared chicken casserole for staff and three service users. One course only was provided. The other two service users prepared their own. Valley Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 Page 11 However, records showed that meals chosen were not balanced, as they consisted of frozen and canned foods such as potato waffles, hot dogs and ravioli on one day and chips and cheese on another. No vegetables were used. Staff said that there had been some encouragement given for one service user to be involved in a healthy eating programme, but this was not accepted. Sunday lunch was always a balanced meal and provided for all service users at home on that day. Further attention needs to be given to menu planning in advance and all service users should be involved in this. The manager must ensure a more balanced diet is offered for all service users and the recommendation made at the last inspection should receive further consideration. Valley Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 Page 12 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 Health needs are clearly identified and action is taken to meet them. Medication is well organised, but records are not complete, which could put service users at risk of not receiving prescribed medication. EVIDENCE: In addition to health needs being specified in the individual support plans there were health records on personal files and all contacts with health professionals were recorded together with advice to be followed. Details of what to do if someone had a seizure were clear on one individual plan. Nutritional needs need attention as already stated under standard 17. The need for additional 1:1 support was identified for one service user due to a deteriorating condition and, although provision was made for this, there were comments in daily notes indicating that there were insufficient staff to fully meet this need. See comments under Standard 33. The service user was taken from one of the houses to the other to sit with other service users whilst the staff member was involved in providing personal care to another service user. Medication was delivered from the pharmacy during this inspection and was checked by a member of the support staff. The pharmacist dispensed all tablets into doset boxes and these were held securely within the home. Valley Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 Page 13 One service user held their own medication and since the last inspection this has been held securely in the person’s own room. Consents to medication were on service users’ files and risk assessments and plans described how selfmedication was monitored. Records of medication administered during the current week were maintained, but previous ones found on service users’ personal files showed no confirmation of prescribed medication being given in the afternoon and evening of 04/12/05. All staff must be reminded of the importance of maintaining these records. Valley Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 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): 22 and 23 Service users complaints are taken seriously and protection is assured by adherence to local procedures. EVIDENCE: The complaints procedure was available to service users. A recent complaint had been received relating to protection and both Social Services Department and Mencap had investigated this. Appropriate action was being taken to protect service users and staff. The manager was fully aware of the Nottinghamshire Committee for the Protection of Vulnerable Adults policy and procedure and all staff had received some training relating to protecting service users from abuse. No other complaints had bee received and recorded. Valley Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 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 The premises are generally comfortable, but attention needs to be given to heating. EVIDENCE: The premises are comprised of two separate houses that have side entrances facing one another. The communal areas of both were viewed and found clean. In the rear lounge of house 5 – 7, one radiator was found very hot and another was cold. None of the radiators were covered and the risks associated with the radiators must be assessed and recorded, with action taken to reduce risks. Service users were cold on their return from day services and the manager must ensure heat is adjusted for their comfort. Sitting areas appeared well maintained and had a choice of seating available. Valley Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 Page 16 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, 33, 34 and 35 Staff are supported to gain national qualifications and other training is given to help them meet specific needs. There is a well-established recruitment policy in place. There are not always sufficient staff to meet the need for individual support and this can be distressing for service users. EVIDENCE: Rotas showed that there was always one support worker in each of the two houses. The manager’s hours and domestic hours were in addition. At night, one support worker was sleeping in and night time needs were kept under review. As stated under Standard 19, there were comments in daily notes indicating that there were insufficient staff to fully meet the need for additional 1:1 support for one service user. This was not the case every evening and during this inspection 1:1 support was observed. However, it was recorded that the service user was taken from one of the houses to the other to sit with other service users whilst the staff member was involved in providing personal care to another service user. This had caused some distress to the service user concerned and to others. Valley Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 Page 17 Rotas showed that timings of the 1:1 support changed dependent on staff availability rather than the need identified. There must be consistency in this provision. Of the nine current staff, three had already gained the National Vocational Qualification in care at level 2 and two of these were working towards level 3. Two others had commenced level 2. Staff files were made available and those checked at random gave evidence of checks having been made with the Criminal Records Bureau. References were held separately and were not viewed. There were records of various training in moving and handling, Health and safety, personal safety, risk management, challenging behaviour and adult protection. In addition staff had undertaken basic Foundation Training provided by Mencap and the national Learning Disability Framework accredits this training. Valley Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 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): 37, 39 AND 42 The home is generally well run and views of service users are sought in making improvements. Health and safety are promoted, but risk assessment must be extended to risks posed by uncovered radiators. EVIDENCE: The home is run by Mencap with a registered manager present on most week days. Mencap policies and procedures were well established in the home. The manager had started the Registered Managers’ Award and National Vocational Qualification level 4 in Care. She holds National Vocational Qualification assessor awards, so that she can assess other staff in their training. There were copies of questionnaires completed by service users on their individual files. These had been used every 12 months. Mencap management also regularly reviewed the service. Generally, health and safety is promoted in the environment with clear risk assessments having been carried out in respect of individual service users and staff. However, radiators need some attention as required under standard 24. Valley Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 Page 19 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 X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 2 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Valley Road Care Home Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 2 X DS0000008781.V271704.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13(2) Requirement Ensure staff always follow medication procedures and initial the record to confirm medication has been taken. Risks associated with the radiators must be assessed and recorded, with action taken to reduce risks. Provide staff consistently to meet the need for 1:1 support Timescale for action 07/12/05 2. YA24YA42 13(4) 31/01/06 3. YA33 18(1)(a) 31/01/06 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 YA17 Good Practice Recommendations Assess nutritional needs and review risks associated with low weight, obesity or any eating disorders and provide a nutritious balanced diet to meet needs. Valley Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Road Care Home DS0000008781.V271704.R01.S.doc Version 5.0 Page 22 - 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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