Inspection on 05/10/05 for Valmark House

This inspection was carried out on 5th October 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Valmark House 18/12/06

Valmark House 12/01/06

Valmark House 15/03/05

Valmark House 01/12/04

Valmark House 24/02/04

Valmark House 15/12/03

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

CARE HOME ADULTS 18-65 Valmark House 90 Mill Road Colchester Essex CO4 5LJ Lead Inspector Pauline Dean Final Announced Inspection 09:30 5 - 6th October th Valmark House DS0000017990.V255927.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 Valmark House DS0000017990.V255927.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. Valmark House DS0000017990.V255927.R01.S.doc Version 5.0 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.V255927.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th March 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.V255927.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place over two days in October 2005. This was the first inspection of the inspection year 2005 to 2006. Throughout the two day inspection there was discussion with the responsible individual/registered manager, Mrs Jean Revelle. The three small care homes of Broad Horizons Limited were inspected over the two day period of the 5th & 6th October 2005, with the inspector moving from one home to the other during the inspection. A total of 15½ hours was spent on the inspection in the three care homes. Three members of the care staff were interviewed and all service users were met and spoken with during this inspection. No visitors or relatives were interviewed during this inspection. A tours of the premises was conducted during the inspection and both care and staff records were sampled. In addition, some of the policies and procedures were sampled and inspected. Twenty-four of the forty-three standards were inspected; of these twenty-one were met, with three standards nearly met. There is a marked improvement since the last inspection. The shortfalls noted related to the production of a Service Users’ Guide in a format that would be readily understood by Service Users; quality assurance and quality monitoring processes; and the need to review and revise policies and procedures. What the service does well: When asked what the service does well, Mrs Revelle said that she felt Broad Horizons Limited, in their three care homes, were able to offer a homely environment. The one service user able to communicate verbally confirmed that they were happy living at Valmark House, highlighting the activities and college courses that they enjoy attending. Service users were said to be actively involved in the running of the home, no domestic staff are employed. Service users were seen to be involved in the domestic duties around the home, such as laying the table, offering refreshments and cleaning and tidying their rooms. This was evidenced on the day of inspection. Within the service Broad Horizons Limited has a small, established staff group. Relationships between service users and care staff were seen to be sensitive and caring and established friendships have developed within the service user group. Valmark House DS0000017990.V255927.R01.S.doc Version 5.0 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.V255927.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 Valmark House DS0000017990.V255927.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): 1 & 2. 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. Prospective service users’ individual needs and aspirations are assessed prior to admission to ensure that the home is able to meet their needs. EVIDENCE: The home’s Statement of Purpose and Service Users’ Guide have been reviewed and revised, in terms of content, to 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 the current service user group. Valmark House DS0000017990.V255927.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, 7 & 9. Service Users’ assessed and changing needs and personal goals are detailed in their individual care plans to help ensure that their personal needs are met. Care planning records detail service users’ rights to make decisions about what they wish to do. Overall, staff enable service users to take responsible risks with both risk assessments and risk management strategies in place. EVIDENCE: Individual plans of care are in place for all service users. All aspects of health, personal and social care needs are identified and planned for within nine aims and a personal needs section. Within this documentation there was evidence of service user involvement in the management of their care needs. Records detailed choices made and acted upon. Risk assessments and risk management strategies have been developed and are detailed within the care planning documentation. During the inspection the inspector observed ongoing discussion and training on the management of personal safety. One service user was clearly able to detail management strategies they should take to ensure their own safety. Valmark House DS0000017990.V255927.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): 12, 13, 16 & 17. Service users are supported and enabled to have opportunities for personal development through the provision and promotion of appropriate leisure and training activities in the community. Family contact and visiting arrangements are open and relaxed, with family links promoted and encouraged. The home offered a healthy, varied, planned menu, with consideration given to preferences and dietary requirements. EVIDENCE: Service users are enabled and supported to participate in meaningful activities within the home and in the community. Records detailed evidence of service users accessing local community facilities such as leisure centres, for the spa pool and swimming, and drives into the surrounding countryside. All of the current service user group are unable to engage in employment as their skills are limited and outside this attainment. One service user is able to access a local college and they spoke positively of their experiences at the training courses at the college. They were able to give examples of course work and leisure activities that they enjoyed. Shopping trips for clothes into Colchester were seen recorded in the record keeping. Valmark House DS0000017990.V255927.R01.S.doc Version 5.0 Page 11 All three service users take holidays. Each individual funds these as all three were resident at Valmark House before the introduction of the National Minimum Standards. The home has the use of a holiday caravan at St Oysth and during the summer service users have had day trips and overnight stays at the caravan. One service user said that they enjoyed these trips, particularly enjoying the evening entertainment and the karaoke. Links with families and friends are supported and encouraged. All of the service users at Valmark House have links with relatives and one service user detailed visits and trips out with their relatives. During this inspection, they went out with a relative and on their return related the events of the afternoon. Records were seen to support service users’ rights and responsibilities. This was with regard to the provision of a bedroom key and a front door key. Of the three service users only one service user was able to hold their keys. Care planning records detailed risk assessments that had been completed. During the inspection service users were seen to choose and select their teatime menu. Detailed records are kept of how this selection is made. Service users are encouraged in assisting with the preparation of food and drinks, as they are able, and service users were seen to lay the table for a meal. Meals were seen to be relaxed and unrushed, fitting in with service users’ activities and schedules. Valmark House DS0000017990.V255927.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): 18, 19 & 20. Service users’ personal and healthcare needs are met within the home and records evidenced that service users are supported to access healthcare professionals as needed. The administration of medication for service users was found to be detailed and recorded to help ensure that service users’ health needs are met. EVIDENCE: From speaking with care staff and the registered manager, the inspector understands that service users receive personal support in the way they prefer and require. One service user was able to confirm that they are able to choose what time they get up and what time they go to bed. Care planning documentation further evidenced this. All three service users use the service of a local GP surgery located across the road. Service users are escorted to GP visits and are supported in decisions made about healthcare/medical treatment. Other healthcare services are used as required. Records on care planning files evidenced this. Medication storage, administration and medicines entering and leaving the home were sampled and inspected for all three service users. The records were found to be in good order, with adequate secure storage. Valmark House DS0000017990.V255927.R01.S.doc Version 5.0 Page 13 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: The home’s complaints procedure was seen to be in place and is to be found with the Service Users’ Guide and in care planning documentation. A simple pictorial complaints procedure has been drafted for service users. Two members of care staff interviewed were aware of this procedure and said that should they have any concerns they would take them to the registered manager. Equally they had a good understanding of the Adult Protection Procedure and again they would raise any concerns with the registered manager. Recent Adult Abuse Awareness training under LDAF training had further enforced this procedure. One service user spoken with said that if they had any concerns they would raise them with ‘Jean’. Valmark House DS0000017990.V255927.R01.S.doc Version 5.0 Page 14 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 & 30. Valmark House provides a safe, homely and pleasant environment, which was clean and comfortable. EVIDENCE: Valmark House offers accommodation in a domestic type dwelling. It was light, bright and airy and is in keeping with the local community in a residential area. Decoration and maintenance is ongoing, with decoration ongoing in the first floor office/staff room accommodation. One of the service users is assisting with this decoration. All three bedrooms and the lounge/dining room have been decorated to the liking of the service user group and new work surfaces, cupboards, kickboards and a sink unit are planned for the kitchen. Mrs Revelle said that these changes are to be completed by Christmas 2005. Some landscaping and changes to the rear garden are planned for Spring 2006. Garden statues chosen by service users have been introduced into the front garden of the home. The inspector was informed that the service users had assisted in these renovations. Valmark House DS0000017990.V255927.R01.S.doc Version 5.0 Page 15 A domestic washing machine is located in the kitchen, with a dryer fitted in the garden shed. They were found to meet requirements. Valmark House DS0000017990.V255927.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 & 25. Staffing levels and skills are appropriate to the needs of service users. There are appropriate recruitment procedures in place. An induction and basic staff training programme helps to ensure that training and skills requirements are identified and met. EVIDENCE: Broad Horizons Limited has introduced Learning and Disabilities Framework (LADF) Training for all care staff. A total of nine staff members have completed three courses - Safe Practitioner, Communication and Abuse Awareness training. In addition, National Vocational Qualification (NVQ) training is encouraged. Two senior care staff members at Valmark House have completed NVQ level 2 in care and are awaiting final assessment of their final module for NVQ level 3 in care. The majority of care staff at Broad Horizons have completed or are completing NVQ level 2 in care. Mrs Revelle said that she hopes to meet the requirement of having 50 of care staff in each home achieving a care NVQ level 2 by the end of 2005. Within the staff group of Broad Horizons Limited there is a worker who is aged under 18. They are on a BTEC Business Management course and they undertake domestic duties only. Mrs Revelle said that this worker works under the direct supervision of qualified staff and does not undertake personal care tasks. Valmark House DS0000017990.V255927.R01.S.doc Version 5.0 Page 17 At this inspection clarification and confirmation of staffing levels, having been determined with consideration given to the Department of Health Residential Forum Guidance, was requested. An immediate requirement was left with the registered manager and subsequently calculations and staffing levels have been sent to the Commission. Current staffing care hours at Valmark House are calculated to be 153.48 hours, with the provision of 168 hours detailed in an action plan. The need to regularly review staffing levels with regard to service users’ changing needs is highlighted. The files of two care staff members were sampled and inspected. These contained evidence that all the required checks, including references, Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks, had been satisfactory carried out and copies of relevant identification documents had been obtained e.g. birth certificate, passport and photograph. Copies of Terms and Conditions were seen. The General Social Care Council (GSCC) code of conduct and practice were not considered at this inspection. Valmark House DS0000017990.V255927.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): 27, 39, 40 & 42. 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. An effective quality assurance and quality monitoring system is still required. The home needs to monitor, review and revise their policies and procedures to safeguard service users’ rights and best interests. The health, safety and welfare of service users is promoted and protected by the registered manager helping to ensure safe working practices through the implementation of safety certifications, basic training opportunities and knowledge of relevant legislation. EVIDENCE: Mrs Revelle, the registered manager has completed the National Vocational Qualification Assessor’s course and is looking to working with her staff on their NVQ training courses. Mrs Revelle said that she is currently working on her NVQ level 4 in care and management. Three senior care staff members working at Valmark House over the inspection period said that they found the manager to be readily available and supportive. Valmark House DS0000017990.V255927.R01.S.doc Version 5.0 Page 19 Whilst a quality assurance survey had been completed in the past, Mrs Revelle acknowledged that there is a need to consider undertaking a new survey and to develop an annual development plan. Policies and procedures were sampled and reviewed. In addition to policies and procedures already referred to in this report, both the Whistle Blowing and a policy on Bullying were reviewed and were found to meet requirements. Other policies inspected were the Recruitment policy and the Police Check policy. These were dated February 2005 and had no reference to the requirement to complete Criminal Record Bureau (CRB) checks for all staff. It became clear from viewing policies and procedures in each of the three homes that senior care staff were unclear as to the current and old policies and procedures on file. Mrs Revelle was made aware of this and copies of policies and procedures are to be reviewed, revised, amended and dated. NICEIC Electrical Installation certification was seen and dated 28th July 2005. This had a five-year lifespan. Portable Appliance Testing (PAT) is arranged for December 2005. Broad Horizons Limited has employed a business consultant to complete an internal audit of the care homes. Some recommendations were made and these were found to be completed. Basic training courses, videos and workbooks help ensure safe working practices. Examples of these courses and training are detailed earlier in this report. Valmark House DS0000017990.V255927.R01.S.doc Version 5.0 Page 20 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 2 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Valmark House Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 2 2 X 3 X DS0000017990.V255927.R01.S.doc Version 5.0 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 Standard YA39 Regulation 24(1) Requirement The registered person must 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 timescale of 31/07/05 not met.) The registered person must ensure that all policies and procedures are signed by the registered manager and are dated, monitored, reviewed and amended. Timescale for action 25/11/05 2 YA40 12,13, 16-19, 23,24 25/11/05 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 Refer to Standard YA1 Good Practice Recommendations 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.V255927.R01.S.doc Version 5.0 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 © 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 Valmark House DS0000017990.V255927.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!