CARE HOME ADULTS 18-65
Valmark House 90 Mill Road Colchester Essex CO4 5LJ Lead Inspector
Pauline Dean Unannounced Inspection 12th January 2006 13:15 Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 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 Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 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. Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Valmark House Address 90 Mill Road Colchester Essex CO4 5LJ 01206 853539 01206 843367 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) Broad Horizons Limited Mrs Jean Brown Fleming Revelle Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 5th October 2005 Brief Description of the Service: Valmark House is an established small care home, for three young adults with learning disabilities, first registered in November 1998. The registered provider is Broad Horizons Ltd. The responsible person is Mrs Jean Revelle. Mrs Revelle is also the registered manager of Valmark House. Valmark House is one of three small care homes located in Mill Road, Colchester and there is close cooperation between all three. Valmark House is found in a residential area of Colchester, located close to Colchester General Hospital. There are local shops and facilities nearby, with the main town centre offering shopping and leisure facilities a short bus ride away. Accommodation for the three service users is on the ground and first floors, each service user having a single room with a wash hand basin. There is a bathroom and toilet on the first floor. An office/staff bedroom is also found on the first floor. On the ground floor there is a lounge/dining room and kitchen. The property is semi-detached and has gardens to the front and rear. There is some off-road parking. The rear garden is enclosed with a patio area, flowerbeds and lawns. Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over one day in January 2006. This was the second inspection of the inspection year 2005 to 2006. Throughout the day there was discussion with the registered manager, Mrs Jean Revelle. All three service users were spoken with during this inspection. No visitors or relatives were present at this inspection. A tour of the premises was conducted at this inspection and some care and staff records were sampled. In addition some of the policies and procedures were sampled and inspected. Fifteen of the forty-three standards were inspected at this inspection; of these twelve were met, with three standards nearly met. All of the twenty-two key standards were inspected over the two inspections of the year. As at the last inspection there is an improvement in meeting the requirements. The shortfalls found were as at the last inspection namely the development of a Service Users’ Guide in a format that would be readily understood by individual service users; staff supervision and the quality assurance and quality monitoring processes. What the service does well:
Broad Horizons Ltd. offers their service users a homely environment. Ongoing maintenance and decoration ensure that the premises are light and bright and in good order. Bedroom accommodation is personalised and individual with service users involved in arranging their room and belongings. Mrs Revelle said that the need for training is highlighted and staff are offered training opportunities as highlighted. She spoke of the ways in which staff training, skills and experience is brought into the home to enhance the care of service users. Within the home there was a relaxed atmosphere with service users accessing communal areas as they wished and coming and going to and from their rooms. They were seen to have friendships within the home and within the other two homes of Broad Horizons Limited. Service users spoke positively of their friendships and the interaction between service users and service users was friendly. Furthermore the relationship between staff and service users was relaxed and friendly with examples of support and guidance observed during the inspection. Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 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 Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 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): 1. Clear detailed information, by the way of the Statement of Purpose and the Service Users’ Guide, is provided to placing authorities, prospective service users and their families to enable them to make a choice of whether they wish to be admitted to the home. EVIDENCE: As detailed at the last inspection the home’s Statement of Purpose and Service Users’ Guide have been reviewed and revised and they meet requirements. There is, however, still a need for Broad Horizons Limited to further develop the Service Users’ Guide into a briefer and more accessible format for each individual service user within the home. Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 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): None of these standards were inspected in full at this inspection. EVIDENCE: All of the above key standards were inspected at the last inspection. None of these standards were inspected in full at this inspection. There was however some discussion with one of the service users who spoke of their ability to make decisions about their lives. They spoke of their college courses - Job Club, Media & Computer Club and a Multi-Skills Workshop. They obviously enjoyed these courses and had gained knowledge and friends through their college attendance. In addition they spoke of their friendships within Broad Horizons and continuing family links, which are actively encouraged by the care home. Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 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. Service users are supported and enabled to have appropriate personal, family and sexual relationships. EVIDENCE: From discussion with a service user and Mrs Revelle, it was evident that service users are supported and enabled to have appropriate personal, family and sexual relationships. Links through telephone calls, visits and outings are encouraged and enabled by the care home and the service user related visits and outings over the Christmas/New Year period. Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 Page 11 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): None of these standards were inspected in full at this inspection. EVIDENCE: All of the above key standards were inspected at the last inspection. None of these standards were inspected in full at this inspection. There was however some discussion with Mrs Revelle, which confirmed that service users access healthcare professionals as needed. Records held in care planning files confirmed this. Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 Page 12 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 & 23. Appropriate practices were in place to help ensure that service users’ views are listened to and acted upon and their protection is promoted. Staff training, the awareness of management and staff, policies and procedures and staff recruitment practices help to safeguard this. EVIDENCE: From sampling policies and procedures, both the complaints procedure and the adult protection procedure were seen to be in place and they met requirements. Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 Page 13 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): 25, 26, 27 & 28. Valmark House provides a safe, homely and pleasant environment, which was clean and comfortable. EVIDENCE: Valmark House continues to offer a bright, clean and a homely environment. The premises are of a domestic type and are in keeping with the local community in a residential area. Decoration and maintenance is ongoing. Bedroom accommodation remains as at previous inspections with planned decoration and maintenance ongoing. Each bedroom was personalised by the individual service user. Photographs, soft toys, CDs, DVDs, games and videos were seen in their rooms. Within the home there is a bathroom comprising of a bath with an overhead shower, a toilet and wash hand basin. All of the current service user group are able to use these facilities without the use of any specialist equipment or environmental adaptations. Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 Page 14 The communal areas of the home are the lounge/dining room and the kitchen. Furnishings and furniture are of good quality appropriate to the needs of the three service users. Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 Page 15 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 & 36. Staffing levels and skills are appropriate to the needs of service users. There is a need to introduce regular recorded supervision sessions for care staff to ensure that service users are supported and protected. EVIDENCE: As stated at the last inspection, Broad Horizons Limited has introduced Learning and Disabilities Framework (LADF) Training for all care staff. Staff have completed courses entitled the Safe Practitioner, Communication and Abuse Awareness training. National Vocational Qualifications (NVQ) training is also encouraged and progressed. Over 50 of care staff at Valmark House have obtained a NVQ level 2 qualification in care. Whilst staffing rotas were not inspected at this inspection, staffing levels were found to be met on the day of the inspection. Mrs Revelle spoke of flexibility within the staffing levels to ensure that service users needs are met as they access college courses, activities and appointments in the community. Consideration is given to the Department of Health Residential Forum Guidance. From discussion with Mrs Revelle it was evident that there is still a need to review and plan regular supervision sessions within the home. As in other Broad Horizon homes a new supervision record sheet is being introduced. Consideration and thought is to be given as to how this should be used. The
Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 Page 16 home is reminded of the need to ensure that topics as listed within the National Minimum Standards – Standard 36.4 are fully considered in supervision sessions. Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 Page 17 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): 38, 39, 40 & 43. Staff and service users are well supported by the home’s manager, who is hands-on and part of the care team in the home. They benefit from competent and accountable management of the home. An effective quality assurance and quality monitoring system is still required. The home has reviewed and revised their policies and procedures to help safeguard service users’ rights and best interests. EVIDENCE: From discussion with Mrs Revelle the management approach in the home was seen to be open and positive. Record keeping and management planning evidenced this. Whilst a quality assurance surveys have been used in the past, a new stakeholder survey is to be sent out to service users’ families and their social workers in the next two weeks. Following this, there would be a need to analyse the responses and implement an annual development plan for the home. It is hoped that the analysis will be completed in three months. Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 Page 18 As in the other Broad Horizons Limited homes, the company has adopted policies and procedures produced by Mulberry House, a consultancy. Of those policies and procedures sampled, they were found to meet requirements. The care home however, is reminded of the need to ensure that in adopting these policies and procedures there is a need to guarantee that they are appropriate and applicable to the individual care home. The business and financial plan for the home were not inspected at this inspection. Insurance certification for Employers Liability was seen to be current, appropriate and on display. Insurance cover was said to be in place to cover any loss or damage to the assets of the business. Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 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 Standard No Score 1 2 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 X 25 3 26 3 27 3 28 3 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 X 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X 3 2 3 X X 3 Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 Page 20 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 YA36 Regulation 12 (5), 18 (2) Requirement Timescale for action 05/03/06 2. YA39 The registered person must ensure that staff receive support and supervision to carry out the job as detailed in the National Minimum Standards for Care Homes for Adults (18 - 65). 24(1)(a)(b), The registered person must (2) (3) ensure that there is an annual development plan for the home, based on a systematic cycle of planning-action-review, reflecting aims and outcomes for service users. (This a repeat requirement. Previous timescales of 31/07/05 and 25/11/05 were not met.) 05/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 Page 21 1. YA1 The Service Users’ Guide should be summarised in a clear and accessible format and addressed directly to service users in terms, which can be easily understood by them. Valmark House DS0000017990.V277390.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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