Inspection on 31/08/05 for Valley View Residential Nursing Home

This inspection was carried out on 31st 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Valley View Residential Nursing... 02/03/09

Valley View Residential Nursing... 09/11/07

Valley View Residential Nursing... 10/07/06

Valley View Residential Nursing... 01/02/06

Valley View Residential Nursing... 22/03/05

Valley View Residential Nursing... 15/02/05

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Valley View Residential Nursing Home Maidstone Road Rochester Kent ME1 3LT Lead Inspector Sally Hall Unannounced 31 August 2005 10:00 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 Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Valley View Residential Care Home Address Maidstone Road Rochester Kent ME1 3LT 01634 409797 nil nil Dr. P.P. Jana 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) Mrs. H. Beattie-Burrows Care Home 33 Category(ies) of 33 - Old Age registration, with number of places Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: nil Date of last inspection 22 March 2005 Brief Description of the Service: The home is purpose built. Service user accommodation is located on the ground and the first floor. There are 27 single bedrooms and three double rooms and all have en suite toilet facilities. The communal lounge and dining area is on the ground floor and there is also a pleasant conservatory. On the first floor there is a small lounge and on the lower ground floor there is a visitors’ room. There is a passenger lift. The home is accessible for wheelchairs and there are aids and adaptations to support those with mobility problems. The accommodation is built in a square around an enclosed courtyard garden. There are further gardens around the property at the front and rear and ample parking space is provided. The home is managed by a registered nurse and employs a further 5 trained nurses. In addition the home employs care, domestic, catering, maintenance staff and an activity organiser. Valley View is privately owned and the registered providers have two other homes in the area.The home is located in a residential area of Rochester close to local amenities and a bus route. Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Inspection at Valley View Nursing home took place on 30th August 2005 at 9:55am. The Inspectors agreed and explained the inspection process with the Registered Manager. Documentation and records were read, including care plans. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. A tour of premises was also undertaken. The focus of the inspection was to assess Valley View Nursing Home in accordance to the National Minimum Standards for Older People. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. What the service does well: What has improved since the last inspection? What they could do better: The home should be involving the residents and /or their families in the formation of the care plan on at least a six monthly basis. This is when a re assessment needs to be made and new care plan should be written. The home needs to ensure that all documentation, including and policies and procedures are kept up to date. A revision of the homes routine and staffing levels has been recommended to ensure staff can meet all the needs of the service users. Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 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 View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 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) 1,3,4 The service users do not have the benefit of having access to a Statement of Purpose or Service Users Guide which contain up-to-date information. Service users can be confident that the home is able to meet their assessed needs at the time of admission. EVIDENCE: The Statement of Purpose and Service Users Guide were seen. They had not been reviewed and the information contained in them was not up to date. The documents also contained two different complaint procedures; one in the Service Users Guide did not have time scales. The name of the regulatory inspection unit has changed this has not been reflected in either document. Prior to admission the home undertakes an assessment of need which is followed up by an admission assessment. In the files sampled it was evident that the needs are fully assessed at this stage, and includes tissue viability, manual handling and cognitive assessment where necessary. Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 9 On admission the initial assessments were used as the basis for the initial care plans. These detailed the care required upon admission. The staff training records showed that staffs were receiving the training they required to meet the needs of the service users. Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 10 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) 7,8,9, The service users do not have the benefit of being fully involved in their care planning to ensure that all their care needs are being fully addressed. Service users cannot be confident that the home is promoting or maintaining their health needs. Service users are put at risk by the home’s inadequate medication procedures and practice. EVIDENCE: The sampled files indicated that the care plans are still based on the original assessments done at admission. It was explained to the owner that these in some cases were several years out of date. The assessment should be renewed each six months and a new care plan written. No evidence was seen of the service users and/or representative involvement in the formation of any plans. In some cases care plans have been reviewed monthly but with others it was found that care plans did not truly reflect the service user’s current situation. For example in one care plan the service users actual mobility needs did not reflect what was stated in the care plan. Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 11 The daily record did not show the time of the care given and events that had happened during the day to service users. They also lacked detail of how the staff are promoting independence. Often the daily records did not cross reference to the care plans and some events were not recorded. The health care needs are not being fully identified because the needs assessments are so out of date. The plans of care did not always show the require intervention to protect the service users from pressure sores or promote tissue viability. They also did not always show the treatment required when a break down of the skin was recorded. The interventions for preventing falls were found in some cases to be out of date. The risk assessments were also found not to have been reviewed as required in all cases. Some risk assessments seen had not be reviewed since written in 2001 –4. Some service users needed nutritional screening again records were not all found to be up to date. Although the medication administration, storage, and recording were not fully evidenced at this inspection, it was noted that the trolley was left out of sight of the nurse in the corridor for some time. It was also noted that a service user who had been given medication some time earlier still had all the tablets in her mouth and seemed unable to drink enough water to enable her to swallow them. Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 12 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, 13, 15 Service users benefit from a selection of activities which vary in choice and skill level so as to meet the diverse needs of all service users. Whilst service users benefit from the provision of home cooked meals using fresh ingredients they do not benefit from the timing of meals being so close together. EVIDENCE: The home has an experienced Activities Co-ordinator, who works between two homes. There are a variety of activities in place for service users including games of varying skill levels, arts and crafts, group and individual sessions, games and activities which include using different senses and areas of skill. She aims wherever possible to ensure that the many activities can be used to prompt reminiscence and promote well-being with the individual. Other activities also include s knitting, sewing, jigsaws and monthly film shows etc. The Activities Co-ordinator accesses specialist organisations that cater for special recreational activities. An entertainer or singer also visits the home, and the service users also go out on trips to the seaside. It was evidenced that outings occur on a regular basis during this inspection. The home keeps good records that show all service users are being motivated on a regular Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 13 basis. This standard has been exceeded due to the family tree and life story work done by the activity co-ordinator. The home actively promotes ‘open’ visiting hours and encourages family and friends to participate wherever possible. A selection of menus were viewed that showed a choice of meals were available, service users spoken to all exclaimed that the meals at the home are excellent. The times of the meals were discussed as they are close together and leave a long gap over night. The owner said that this would be addressed. Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 14 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 Service users know that their concerns and complaints are taken seriously. Service users are protected from the risks of abuse, however the procedure needs to reflect recent changes to the local authority’s protocol. EVIDENCE: The inspector viewed a copy of the Home’s complaints procedures. The procedure included details of how to complain, timescales for response and information for referring a complaint to the NCSC this needs to be changed to Commission for Social Care Inspection. A copy of the complaints procedure has been provided in the Service Users Guide and shows no time scales and differs from the one in the Statement of Purpose. The inspector viewed and discussed copies of the Home’s Policy for the Protection of Service Users and staff “Whistle blowing” procedure. These include procedures for the reporting of suspicion or evidence of abuse with a format for the recording of any allegations and action to be taken. These procedures do need to be reviewed. In light of the new protocols being supplied by the local authority, changes are required. The owner provides training in adult protection during induction. More courses are planned to ensure all staff receive the training required to protect service users from abuse. Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 15 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) 19,20,21,26 Service users do not benefit from living in a safe and clean environment. EVIDENCE: The communal spaces provided throughout the home are sufficient to meet the needs of the service users and for its stated purpose. These included a lounge and dining area on the ground floor to which there was an adjacent conservatory. On the first floor there was a small lounge. Some seating had also been provided in a corner adjacent to windows on the first floor. On the lower ground floor there was a room, which could be used for larger gatherings. All were attractively furnished. In addition there was an enclosed courtyard where there were plant boxes and seating in summer months. The grounds are kept tidy, safe and accessible to service users. The home has four bathrooms and a walk in shower room. The coving in the lower bathroom is coming away from the ceiling and the floor was found to be dirty. The toilet seat was broken on the first floor and a number of hoists were parked in the corridors a potential; trip hazard. All bedrooms had en suite toilets. Staff advised that in the main these were accessible for those in wheelchairs and who required staff assistance. Other toilets were provided Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 16 close to communal areas. The home had sluice facilities on each floor and these were separate from the toilets and bathrooms. The home was free from offensive odours, however the rooms surfaces were dusty and floors were messy, and surfaces in the corridors were sticky. This gave the appearance that the home is dirty. The domestics were going about the cleaning while the inspector did a tour of the building but it was apparent that some of what was seen had built up over days of non attendance. The home was actively adhering to infection control procedures. Staff were observed following these and to wear protective clothing when it was necessary and appropriate. Laundry facilities met the requirements of this standard, there were two dryers and two washing machines that had a sluice facility. The laundry assistant had a systematic approach to her work and ensured that clothing was well maintained. During the tour of the building it was noted that a bed rail was seen propped up against the wall in the up stairs lounge and a mattress was seen similarly against a wall on the first floor, both of these with the hoist and other items blocking the corridors presented a risk to service users and staff. The risk assessment for the home was last done in 1998. The health and safety policy seen had not been reviewed. Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 17 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) 27,28,29 The service users are protected by the home’s good staff recruitment and induction procedures. However, the care of service users is compromised because of the home’s low staffing levels. EVIDENCE: It was evident form speaking to service users, family and staff plus direct observation that the staffing levels in the home need are too low. These now need to be reviewed in light of the increasing dependant service users they now care for. The service users at the home commented that staff are always busy and not able to attend to the needs straight away. Some service users said that they had to wait a long time to be taken to the toilet for example. The call system was in use continually during the inspection. Staff explained that due to the number of service users that need a hoist to be transferred it was not always possible to attend other service users for some time. It was noted that some service users would not be able to even summon staff as the call bell was out of reach, as were drinks. Staff said they often feel rushed and are not able to provide the care that they would like too because of the time pressures. The owner has been asked to review both the routine of the day and the staffing levels verses the dependency level of the service users in the home. The home is to be congratulated on the 90 of care staff having gained the NVQ level 2 in care. All new staff are registered on the induction and foundation courses that meets the TOPPS requirements. Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 18 The staff files were excellent and contained all the required information. Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 19 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) these standards were not inspected due to the manager being on leave. EVIDENCE: Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 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 2 x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 3 x x x x 2 STAFFING Standard No Score 27 2 28 3 29 4 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x x x x x x x Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 21 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 OP1 Regulation 4,5, schedule 1 Requirement The registered person produces and makes available to service users an up to date statement of purpose setting out the aims, objectives, philosophy of care, services and facilities and terms and conditions of the home; and provides a service users’ guide to the home for current and prospective residents. The statement of purpose clearly sets out the physical environmental standards met by a home in relation to standards 20.1, 20.4, 21.3, 21.4, 22.2, 22.5, 23.3 and 23.10: a summary of this information appears in the homes service users guide. A service user plan of care generated from a comprehensive assessment(see Standard 3) is drawn up with each service user and provides the basis for the care to be delivered. The registered person shall ensure that the care home is conducted so as— (a) to promote and make proper provision for the health and welfare of service users; Timescale for action 31st October 05 2. OP7 13,15 31st October 05 3. OP8 12, 13, 30th September 05 Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 22 (b) to make proper provision for the care and, where appropriate, treatment, education and supervision of service users. The registered person shall make arrangements for service users— (a) to be registered with a general practitioner of their choice; and (b) to receive where necessary treatment, advice and other services from any health care professional. 4. OP9 13(2) The registered person shall makearrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home.Regulation The registered person ensures that there is a simple, clear and accessible complaints procedure which includes the stages and timescales for the process, and that complaints are dealt with promptly and effectively. 22.—(1) The registered person shall establish a procedure (“the complaints procedure”) for considering complaints made to the registered person by a service user or person acting on the service user’s behalf. (2) The complaints procedure shall be appropriate to the needs of service users. The registered person ensures that service users are safeguarded from physical, financial material, psychological or sexual 30th September 05 5. OP16 22(1)(2) 31st October 05 6. OP18 12, 13 31st October 05 Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 23 7. OP19 13(4) 8. OP26 13,16,23 9. OP27 18 abuse, neglect, discriminatory abuse or self-harm, inhuman or degrading treatment, through deliberate intent, negligence or ignorance,… 13.—(4) The registered person shall ensure that— (a) all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety; (c) unnecessary risks to the health or safety of service users are identified and so far as possible eliminated, The premises are kept clean, hygienic and free from offensive odours throughout and systems are in place to control the spread of infection, in accordance with relevant legislation and published professional guidance. The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users— (a) ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users; 30th September 05 30th September 05 30th September 05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 24 No. 1. Refer to Standard Good Practice Recommendations Valley View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent, ME16 9NT 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 View Residential Nursing Home H56-H06 S26211 Valley View V246862 310805 Stage 4.doc Version 1.40 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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