Inspection on 26/05/05 for Valley View Residential Home

This inspection was carried out on 26th May 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.

Other inspections for this house

Valley View Residential Home 25/07/07

Valley View Residential Home 11/07/06

Valley View Residential Home 07/10/05

Valley View Residential Home 28/09/04

Valley View Residential Home 20/05/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Valley View (Winlaton) Burn Road Winlaton Blaydon NE21 6DY Lead Inspector Sharon McDowell Unannounced Thursday, 26 May 2005 : 10:00 th 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 View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Valley View Address Burn Road, Winlaton, Blaydon 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) 0191 414 0752 Valley View Residential Homes PC Care home only 44 Category(ies) of 44x OP; 12 x DE(E); 4 x PD(E); 2 x SI registration, with number of places Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 28th September 2004 Brief Description of the Service: Valley View provides personal care for up to forty-four older persons, with care staff available at all times over the twenty-four hour period. Nursing care is not provided at the home.The building is a two-storey, the first floor being accessed by stairs and a passenger lift. Car parking is available to the front of the home. A large grassed area is available to the rear of the building, which is not yet fully landscaped.Valley view is situated in a semi-rural area on the outskirts of Winlaton Village, close to the shops, bus route and local amenities. However access to the Home from Blaydon is at the top of a steep bank. Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over 7.5 hours by two inspectors, Mrs S McDowell and Ms N Shaw. The inspectors met with twelve residents and four visitors to discuss their views about care provided at the Home. Five staff were spoken with, a range of documents including care plans, drug administration records, accident records, staff training files, fire safety and training records, menus and complaints register were reviewed and a tour of the building conducted. What the service does well: What has improved since the last inspection? What they could do better: Care plans should clearly reflect the needs of the residents through assessment and documenting care needs and how they will be met. This will ensure the resident’s needs are identified and give instruction to staff as to how they are to meet their needs. The acting manager agreed with this and was receptive to suggestions. Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 Page 6 Some management areas, such as documenting complaints, organisation of staff training, supervision and the recruitment process need to be developed to ensure the residents are protected and supported by well-trained staff. 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 View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 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 View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 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) 3 & 4 Care needs assessments are not completed in sufficient detail to ensure the needs of the residents will be met at the Home. EVIDENCE: Care plan documents do not all contain a detailed care needs assessment prior to admission. The Home has a comprehensive pre-admission document for completion however where a care manager assessment has not been made available not all sections of the assessment are completed in sufficient detail to enable staff to plan for the care needed by the resident. Residents were able to speak about some of their care needs, which were not documented in the care plan. Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 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 & 9 Care plan documentation does not provide sufficient detail of residents care needs therefore the Home cannot demonstrate that the health, personal and social care needs of the residents are being met. The Home has improved practices in the administration and storage of medication therefore residents are assisted to take their medication safely. EVIDENCE: Care plan documentation is not always completed in enough detail to enable the resident’s needs to be identified or for care staff to meet the needs. Several entries are vague, for example, one care plan stated the goal of care was to make the resident feel safe and the plan was to let the resident know she was safe but did not identify what was making the resident feel unsafe and what actual measures were being implemented to help her feel safe. One resident had no care plans at all, with daily notes made, ‘good day’, ‘no bother’, ‘slept well’. Some entries were made about changes in physical health but no entry to inform the reader of the intervention or outcome to the identified problem, for example, an entry in the daily notes stated, ‘feet swollen and shiny and the resident states they are sore to touch, another Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 Page 10 identifies ‘ a big break on bottom’. There were no nutritional, pressure area, falls or moving and handling risk assessments in the care plans seen. Staff spoken to were knowledgeable of the residents individual needs and observations made on the day of the inspection confirmed that the staff addressed the residents daily care needs adequately. Observations made confirmed that equipment such as specialist mattresses have been provided for those residents identified as being at risk of developing pressure areas. Care staff are currently completing a ‘safe handling of medicines’ course. The fridge temperature was recorded as 5-9 degrees however it actually measured 12 degrees. There is no tablet counter tray available, which is needed to enable staff to count medication without touching with their hands. A controlled drug (CD) for return to the pharmacy was found stored in the CD cupboard, which was not recorded in the CD register. This medication had been received in to the Home on the discharge of a resident from hospital. There is no up to date drug reference book for staff to look up information about medication. The medication is supplied in blister pack and had been delivered the previous day. Medication had been administered correctly as seen by the records signed by staff against medication given to residents, which means the health needs of residents is promoted through correct administration of medicine. Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 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) 12 & 15 The employment of an activity person has improved the social and recreational opportunities for the residents. The dietary needs of the residents are well catered for with a balanced selection of meals that meets the resident’s needs. EVIDENCE: The Home now employs an activity person who organises social and recreational events in the Home and outings to local areas, for example, trips out to the Customs House in South Shields, local pubs and local beaches. Some residents said they liked to get out of the Home and some made comments, such as ‘can’t be bothered’, ‘I like to stay in my room’. The cook on duty has worked at the Home for five months and was enthusiastic in her approach to her work. She confirmed she had good support from the Registered Provider and was able to provide a good range of meals and that kitchen equipment was speedily repaired or replaced when needed. Most food is home baked, which the cook said she enjoyed doing. On the day of inspection there was steak pie, coconut tart and custard or rice pudding. Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 Page 12 Care staff confirm with residents what they would like to eat at the meal time. The food is served from a hot trolley in the dining room by the cook and taken to the residents by the care staff. During mealtime a couple of residents had their relatives to dine with them. One relative stated the food was very good, it was hot, in sufficient quantity and tasty. Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 Page 13 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 & 18 Little improvement has been made in the documentation of complaints therefore it is not clear if complaints are managed effectively and to the satisfaction of the complainant. Not all staff have attended training in Protection of Vulnerable Adults therefore residents might not be fully protected from harm or abuse. EVIDENCE: The complaints register is maintained however it is not well set out making it difficult to assess the detail and outcome of the compliant investigation and does not always specify if the complainant is satisfied with the results of the investigation. There have been five complaints since the previous inspection. Seven care staff have attended training in Protection of Vulnerable Adults. The manager stated there is difficulty in accessing a training provider at present therefore some staff are not able to attend training therefore have limited knowledge as to how to recognise abuse and what to do if they need to report concerns. Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 Page 14 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 The environment is generally well maintained however ongoing work to other parts of the Home might be distracting the Registered Provider from the maintenance of the existing facilities. EVIDENCE: These outcomes were not the focus of this inspection but will be reviewed at the next inspection However some areas were noted during the inspection. The carpet in the first floor lounge (dementia care unit) is badly stained and still patched at the TV point despite the Registered Provider stating this would be rectified when the unit was registered. The garden to the rear of the building has a large grassed area but has not been landscaped or developed with plants or garden seating. The majority of bedrooms are well personalised, comfortable, clean and light. Some bedrooms on the first floor of the original building have window coverings that let in a lot of light. Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 Page 15 Refurbishment to the original part of the Home is progressing well with larger bedrooms being created and a new medication storage area. Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 Page 16 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 Staffing levels are insufficient staff to meet the current needs of the residents living in the home. A generally competant staff team meets residents care needs. Staff recruitment procedures are not robust therefore do not safeguard residents from potential abuse. EVIDENCE: Minimum staffing levels have not been maintained for the number of residents living in the home. At the time of the inspection there were 32 people in the home, with 4 staff on duty, which means staff have little time to spend time with the residents. This issue was discussed during the last inspection and immediate requirement notice issued to increase staffing levels. A positive development since the last inspection has been the recruitment of an activities co-ordinator to implement a social and recreational programme of events. Seven of the nineteen care staff have achieved the NVQ level 2 qualification in care, five staff are currently completing this, whilst a further three staff are completing the NVQ level 3 qualification therefore providing a trained staff group who should be more aware of the needs of the people they are caring for. Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 Page 17 The majority of staff have not received in-depth training in relation to the needs of people with dementia. However, The acting manager has recognised this and is in the process of arranging for 10 staff to complete a 12-week training course in this area. There is no deputy manager employed therefore the manager has little support for the management tasks required in the Home and there is no management representative when the manager is off duty or on holiday. Many staff files did not contain training certificates to confirm some statutory training, such as, moving and handling, fire safety therefore providing little evidence that staff are up to date with health and safety matter for the protection of staff and residents. Seven staff have been recruited since the last inspection. Of the sample of staff files examined a number of records were not available, for example, in one staff file, only one reference was available from a “friend” of the employee. In another two staff files the job application form had not been fully completed and there was no record of the person’s past employment history. An Enhanced CRB check was available in one person’s file; however, this check had been carried out with the person’s previous employer, not with Valley View. The acting manager was advised that since the establishment of the Protection of Vulnerable Adults list Criminal Record Bureau clearance is no longer portable. Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 Page 18 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 & 38 The acting manager is making good efforts to ensure the Home is well run however she has some limitations and needs support to ensure the needs of the residents are met and safeguarded. The training programme does not fully ensure that staff are well trained to meet the needs of the residents. EVIDENCE: The home has an acting manager at present who was the deputy manager and has worked at the Home for nine years. She has NVQ Level 2 in care and is currently working towards the NVQ Level 4. Staff confirmed they do not currently have supervision. Some staff have attended statutory training in fire safety, infection control, moving and handling and food hygiene. Staff stated they have sufficient disposable Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 Page 19 equipment to carry out their work, for example, aprons and gloves. They are currently waiting for some small slings for the hoist. Accident reports are recorded however Regulation 37 notifications, required b y the Commission for Social Care Inspection have only recently been submitted. Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 Page 20 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 x 2 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 2 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 2 x x x x x x 2 Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 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. 3. 4. 5. 6. 7. Standard 3 7 7 9 16 18 19 Regulation 14 15 15 13(2) 22 13(6) 16 & 23 Requirement The needs of the residents must be fully assessed prior to and regularly following admission. Care plans must reflect the current needs of the resident snad how they are to be met. Riak assessments must be implemented in residents care plans. Issues identified in the body of this report regarding medication must be addressed. The investigation and outcome of complaints must be fully documented. All staff must attend Protection of Vulnerable Adult training. The lounge carpet in the dementia care unit must be adequately cleaned or replaced and the patched area made good. Staffing levels must be maintained to meet the needs of the residents at all times. The recruitment process must ensure the well being of the residents as specified in the National Minimum Standards. All staff working in the dementia care unit must attend training in Timescale for action 31/7/05 30/9/05 31/8/05 31/7/05 31/7/05 30/9/05 30/9/05 8. 9. 27 29 18(1) 18 26/5/05 26/5/05 10. 30 18 30/11/05 Page 22 Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 this subject. 11. 12. 31 33 8 24 The Registered Provider must make arrangments for a manager to be appointed. A quality assurance system must be implemented. 30/9/05 30/9/05 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. 3. Refer to Standard 19 32 36 Good Practice Recommendations The garden area should be developed to enable residents to have a pleasant area to sit and look on to. The Registered Provider should stringly consider the appointment of a Deputy Manager to support the manager. All staff should receive supervison a minimum of six times a year. Valley View (Winlaton) B52 B02 S7382 Valley View (Blaydon) V219743 26 May 05 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Baltic House Port of Tyne South Shields NE34 9PT 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. 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