Care Home: Ilsham Valley Nursing Home

Similar services:

• The Vicarage
• 7 Hyde Road
• 5 Seafield Road
• Trevaylor Manor
• 12 Orchard Mews
• Stallcombe House
• Stepping Stones
• Cornerstones

What the care home does well Ilsham Valley nursing home provides a good level of nursing and personal care for people who live there. The staff team are dedicated, supportive and wellqualified. The manager and new owners are committed to providing training. There was a real commitment to ensuring staff had the skills they needed to provide good care. More than 50% of the care staff employed have achieved a National Vocational Qualification (NVQ) level 2 or above in care. In addition to the care staff the health and personal care of people living at Ilsham Valley was overseen by a registered nurses day and night. People spoken with during the inspection were happy living at Ilsham Valley and felt they were well cared for. People said they are consulted about what was important to them. Activities were being arranged for people that staff had established they enjoyed. People spoken with during the inspection commented how much they enjoyed the meals. One commenting there was always a choice and plenty of food. What has improved since the last inspection? This was the first inspection following re-registration for change of ownership in December 2008. The new owners have been able to demonstrate clear improvement both to the way care was managed and the environment people live in. Medication storage and audit of medication practices have improved. Many areas in the home people have access to have been refreshed. The reception area of the home has been redecorated and new furniture has been provided. Information about the staff team, which included their photographs and staff members` role in the home, was clearly displayed. The new Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 statement of purpose and homes new brochure shows clearly how the service can meet the needs of the people they care for. What the care home could do better: Any improvements made will build on already good practice in the home. Key inspection report CARE HOMES FOR OLDER PEOPLE Ilsham Valley Nursing Home Ilsham Close Torquay Devon TQ1 2JA Lead Inspector Rachel Proctor Key Unannounced Inspection 3rd June 2009 09:00 DS0000072929.V375819.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ilsham Valley Nursing Home Address Ilsham Close Torquay Devon TQ1 2JA 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) 01803 292075 01803 292075 matron@ilshamnursing.com www.ilshamnursing.com Greenhill Care Homes Limited Miss Jane Elizabeth Billingham Care Home 23 Category(ies) of Physical disability over 65 years of age (23) registration, with number of places Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home with Nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Physical Disability aged 65 years of age or over on admission (Code PD(E)) The maximum number of service users who can be accommodated is 23 New Registration change of ownership 2. Date of last inspection Brief Description of the Service: The Home is part of Greenhill Care Homes Ltd and adopts the Greenhill ‘Charter for Care’ philosophy. This is displayed in the Lobby of the Home and also in the Service User’s Guide. All staff were presented with this Charter upon change of ownership. Ilsham Valley nursing home has 23 beds. It is situated 1 1/2 miles from Torquay town centre and only yards from Kents caverns, a local attraction. It has 21 single rooms (6 with en suite) and one double room with en suite. These are laid out between two floors. The home has a nurse call system installed in every room that the people living there use, such as bedrooms, bathrooms and toilets. There is a five-person shaft lift provided between the two floors as well as a staircase in the centre of the home. The home provides nursing care; thus a registered nurse is on duty at all times. People with disabilities are able to enjoy using specialist baths. Hoists are used at the home which means people can be moved in a safe way. Handrails are provided where they are needed. There is adequate parking to the side of the home close to the front entrance. People can sit out during the warmer weather either at the front of the home, on the veranda or at the rear, where there is a paved garden area. The homes statement of purpose and, the inspection report can be found in the reception area of the home. The information regarding fee levels was provided on 03/06/09, fees are from £465 -£600; actual fee is calculated according to the dependency and care needs of the individual people. Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. This was a key unannounced inspection which took place on the 3rd June 2009. During the visit a tour of the home completed. Two people had their care followed as part of this inspection. This involved reviewing the persons care plan and visiting the room they occupied in the home. And where possible speaking to them and or their representatives. People living at the home, staff and visitors were spoken with during the inspection. Information received from the home since the new owners registered with the Commission was also reviewed. A sample of the home records and documents relating to the care management of people and the management of the home were viewed. Some of the comments made during the inspection have been incorporated into the report. What the service does well: Ilsham Valley nursing home provides a good level of nursing and personal care for people who live there. The staff team are dedicated, supportive and wellqualified. The manager and new owners are committed to providing training. There was a real commitment to ensuring staff had the skills they needed to provide good care. More than 50 of the care staff employed have achieved a National Vocational Qualification (NVQ) level 2 or above in care. In addition to the care staff the health and personal care of people living at Ilsham Valley was overseen by a registered nurses day and night. People spoken with during the inspection were happy living at Ilsham Valley and felt they were well cared for. People said they are consulted about what was important to them. Activities were being arranged for people that staff had established they enjoyed. People spoken with during the inspection commented how much they enjoyed the meals. One commenting there was always a choice and plenty of food. What has improved since the last inspection? This was the first inspection following re-registration for change of ownership in December 2008. The new owners have been able to demonstrate clear improvement both to the way care was managed and the environment people live in. Medication storage and audit of medication practices have improved. Many areas in the home people have access to have been refreshed. The reception area of the home has been redecorated and new furniture has been provided. Information about the staff team, which included their photographs and staff members’ role in the home, was clearly displayed. The new Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 6 statement of purpose and homes new brochure shows clearly how the service can meet the needs of the people they care for. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6, People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given sufficient information about Ilsham Valley to make an informed choice about whether the home can meet their needs The home manager has a comprehensive assessment process in place, which was reviewed regularly; this should enable people’s needs to be met. The home does not provide intermediate care. However the home does offer respite short stay for crisis intervention placements when beds are available. EVIDENCE: Ilsham Valley has information provided about the home and its services in the reception area of the home. This includes photographs with the names of the staff employed and their position in the home. Since registration Ilsham Valley Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 9 has introduced a web address www.ilshamnursing.com where people are able to see the home’s statement of purpose and other information about the services offered. At the time of this inspection seventeen people were living at Ilsham Valley. As part of this inspection two people had their care followed. These people’s plans of care included risk assessments, which covered manual handling, nutrition, pressure sore risk, risk of falls and individual risk assessments for the persons chosen activity. Personal preferences and choices for people had been recorded about the care they received and how they like to be addressed were also included. Personal profiles are completed as part of the assessment process. This enables people to let staff know what interests them and who and what was important to them. Both people whose care was followed had an initial assessment of their care needs completed on admission. Information from health professionals and a copy of the care manager’s assessment and care plan were also provided for those who had been admitted to the home through the care management process. One person whose care was followed said they had chosen to come to Ilsham Valley and had been helped by family to choose the home that suited their needs. The said staff had spoken with them about their care needs and what was important to them. Their relative confirmed that staff spoke with them about the persons care before and after their admission to the home. The home Annual Quality Assurance Assessment stated. “The Home actively encourages prospective residents and their families to visit the Home. This enables the nurse ‘in-charge’ at the time to answer any questions and concerns that they may have and also to assess whether the Home is capable of meeting the Service User’s needs.” This was found to be the case during the inspection Ilsham Valley does not provide intermediate care. However the home does offer respite short stay for placements when beds are available. They also facilitate crisis admissions for Torbay Care Trust for people who are able return home following a short stay at the home. Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The person centred care planning approach adopted by the manager means that people have the care provided in a way they would do themselves if they were able. People receive the health and personal care they need from a staff team who understand them. Medication practices are safe. People living at Ilsham Valley are treated with respect and dignity. Staff are friendly caring and supportive and people can have confidence that staff will listen to them and act on what they say. People can have confidence that their wishes for end of life care will be met by the staff at Ilsham Valley. Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 11 EVIDENCE: The home provides nursing care for up to twenty three older people. People’s health care is monitored and assessed by a team of registered nurses over twenty four hours seven days a week. At the time of this inspection seventeen people were living at Ilsham Valley. The care planning system has changed since the change of ownership. Individual care plan were easy to follow and identified the persons health, personal and social care needs. Part of the care planning documentation included the persons life story, people that were important to them the things they enjoyed and what was important to them now. This painted a picture of the person, which enables staff who care for them to understand them better. Two people living at Ilsham Valley had their care followed as part of this inspection. Each person had a daily care plan checklist to ensure that their personal care was maintained and where possible to ensure that their capacity for self-care was promoted. People’s weight, fluid intake and bowel movements are also monitored as part of its care plans. The manager confirmed that these are completed for all the people living at Ilsham Valley. Care plans clearly recorded the person’s health, personal and emotional care needs. Where people were able to sign their plans of care this had been done. Four people living at the home were able to confirm that staff had spoken to them about their care and what was important to them. One person whose care was followed had been admitted to the home recently. They were able to say they had sufficient information about the home to help them decide that they wanted to move in. They said the home had been recommended to them by a friend and they were very happy with the care provided and liked the room they had in the home. They had chosen to stay in their own room. Their interests and hobbies had been recorded. Risk assessments were an integral part of the care plan. These included falls risk, pressure sore risk, nutritional risk assessment and manual handling. Where risk had been identified a plan of care had been put in place to guide staff how the risk for the person could be reduced. The person was being cared for in a hospital style profiling bed, which had an airflow pressure relief mattress. The pressure sore risk assessment had identified they were at risk of developing pressure sore, the air flow pressure relief mattress should reduce this risk for the person. Bed guards had been fitted to the bed. Risk assessments and consent for the use of the bed guards had been recorded. The registered nurses take responsibility for reviewing and up dating the plan of care and risk assessments for people. The people whose care was followed had reviews of their care plans recorded at least monthly and when care needs Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 12 had changed. This should ensure staff always have up to date information to refer to when providing care for people. The other person whose care was followed had been at the home for over twelve months. The improvement in their ability to move independently from their bed to their wheel chair had been clearly demonstrated. The person said they were pleased that they were able to do more for themselves and also said staff encouraged them to do this. Their care plan clearly recorded what they were able to do for them selves and what they needed help with. They said staff are always polite and kind to them. A staff member brought a drink for the person, they were polite and asked the person if they needed anything else and where they would like them to put the drink. The staff member was using the persons preferred name, which had been recorded in the care plan. The Annual Quality Assurance Assessment returned to the Commission stated. “Every resident has a comprehensive assessment of their health, social and personal needs and desires on admission and a comprehensive care plan is formulated for each individual resident. The plan includes a personal profile including social needs. Where residents are able to care for them selves in any way, this is assessed and they are encouraged to use this independence as far as possible.” This was found to be the case during the inspection. The evidence and records seen during the inspection shows people have access to health professionals including their GP, Opticians, Chiropodists and therapists form different areas of health care. People were able to see them in the privacy of their own rooms. A separate record was being kept for individuals for health and social care professionals who visited. These included the persons GP, physiotherapists, speech therapist and social workers. The deputy manager advised that when an entry sheet for the person had been completed it was filed with the person’s care planning records. The home has lockable medicine storage cupboards and a lockable trolley to store medication for people. Since the new owners took over a second medication trolley had been purchased, although this had still to be set up at the time of the inspection. The manager advised that it was intended that one medication trolley should be provided on each floor. The medication trolley in use had good stock control. The medication records for the two people whose care was followed were viewed and a sample of the medication being stored was seen for each. Records had been completed and signed by the registered nurses administering the medication. The record of a controlled drug for one person was checked against the record and stock for that person as correct. Policies and procedure are provided for staff use in the office. Reference material and books were also provided for medication. The medication disposal system ensures that medication disposed of was recorded and signed by a registered nurse. A medication audit had been completed recently and some practices had changed to ensure medication Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 13 practice followed best practice guidelines. The Annual Quality Assurance Assessment returned to the Commission also stated. “New medicine policies and the purchase of a specialist pharmacy fridge demonstrate the Home’s commitment to maintaining only the highest possible standards of medicine management and care. Combined with the two Pharmacy audits the Home has made excellent progress in this area.” Medication standards were found to be high during the inspection. The Annual Quality Assurance Assessment returned to the Commission also stated. “When residents arrive at their time of death every effort is made to ensure a peaceful and dignified death in accordance with resident’s wishes. The Home encourages personalization of resident’s bedrooms upon admission to the Home to ensure that they are surrounded by familiar items at the time of their death.” One person was receiving end of life care at the time of this inspection. The registered nurses had implemented the Liverpool care pathway, which is a care planning system that ensures people receive the care they need in the way they want it for end of life care. The involvement of the person their family and the multi-disciplinary team had been clearly recorded in the person’s plan of care. Family members were being offered the opportunity to stay with the person as long as they wished. The manager advised that they are able to accommodate relatives in the home when bed spaces allow enabling them to remain with their relative at the time of their death. Staff training included care of the dying and staff appeared to be knowledgeable about the needs of a dying person. The deputy manager advised that she and some of the staff were in the process of completing a palliative care distance learning course Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Ilsham Valley nursing home can have confidence that their personal preferences will be taken into account and where possible their personal life style choices facilitated. Meal times are a pleasant experience for people living at Ilsham Valley, food given is nutritionally balanced and attractively presented. EVIDENCE: Staff were spending time talking to people about things in the news or helping them look at their news papers. One person liked playing dominos. A key worker system was in use. The deputy manager advised that this enabled people to have some one who could do the little things that were important to them. Like making sure they had the toiletries they liked or helping them take part in things they enjoyed. One person who was seen in their own room said staff had manicured their nails and applied nail polish for them. The deputy Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 15 manager advised that staff provided one to one support for people where possible and help them with what ever the person’s interested in. A monthly activities list was provided for people, which showed the planned in house activities each week on Wednesdays, Fridays and Sundays. These included chair exercises, arts and crafts and skittles. The manager advised that they had started encouraging people to do some gardening using pots that could be easily transported into the home’s lounge or person’s room. The names of people who were taking part in this were on the pots of herbs they had planted. During the afternoon of the inspection those people who wanted to took part in chair exercises with the staff in the lounge. The Annual Quality Assurance Assessment indicated that there were plans to provide a decking area outside, which would increase the amount of outside space for people to use and hopefully encourage them to spend time out side weather permitting. The manager advised that people are given the opportunity to go out to local attractions or sea front with a staff member. One person had continued to use a wheelchair accessible taxi service to enable them to meet up with friends outside the home. Visitor were coming and going freely through out the inspection visit. Two relative spoken with said the staff are always helpful and their relative had settled in the home. One commenting that they could not fault the care their relative was receiving. Peoples individual rooms had been personalized with items of their choice such as photographs, pictures and ornaments. People were being given the opportunity to stay in their own rooms if they wished to do so. People had a choice of main meal and dessert at lunchtime during the inspection. The food was attractively presented and nutritionally balanced. Very little wastage was seen at the lunchtime meal. People were eating their meals in the lounge or their own rooms. Four people spoken with commented how much they liked the food. The cook advised that all the food is prepared fresh each day using fresh produce where possible. The Annual Quality Assurance Assessment stated; “Our experienced chefs cook all the meals fresh where possible. Little or no processed foods are used. Dietary needs, taste and presentation are all to a high standard and choice and quality exceeding the guidelines is provided every day.” Food was being prepared and presented to a high standard during the inspection and people who were asked said the food is always good and plenty of it. Cakes were being prepared for the tea time meal. The deputy manager said that meal times are important for people and it has been Ilsham Valleys aim to make this an enjoyable experience for people living there. The staff assisting people to eat their food were doing so in a discreet and sensitive way. Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People continue to be cared for by a friendly caring staff team who listen to them and endeavor to address any concerns they raise in a way that values their individuality. EVIDENCE: The revised complaints policy was easily available for people who live at the home and their relatives. The revised statement of purpose, which reflected the changes made since the change of ownership was being kept in the reception area of the home. This contains the homes complaints policy, which tells people how to raise concerns. Letters and comments received from relatives are also kept here. The Commission has not received any complaints about Ilsham Valley since the change of ownership in December 2008. The (AQAA)) Annual Quality Assurance Assessment returned to the Commission stated that: - “The home has a comprehensive yet simple to understand complaints policy which complies with the Minimum Standards. These complaints procedures are also part of the Service User’s Guide, and they are also displayed in the entrance lobby to the Home.” This was found to be the case at the time of the Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 17 inspection. The manager advised that Issues are dealt with as they occur and action taken if necessary. People spoken with during the inspection were aware who they need to speak to if they have any concerns. The homes policies and procedures included guidance for staff for the protection of the vulnerable adults. The policies included guidance on whistle blowing. The manager advised that protection from and correct attitudes to any potential abuse were also included as a key part of staff training and are a core value in the home. She also confirmed that all staff are vetted thoroughly prior to their employment including references and police checks. The staff records seen during the inspection support the home has safe recruitment practices. And staff receive training for the protection of vulnerable adults. The home has a policy and procedure folder, which was available for staff in the office. This includes guidance for staff for the protection of vulnerable adults. The manager advised that policies have been kept under review and some policies have been revised since the change of ownership. The (AQAA)) Annual Quality Assurance Assessment returned to the Commission stated that: - “We have made our complaints procedures more widely available by posting them on our website.” The web page was viewed during the inspection. This provided a different source for information for people regarding the services provided at Ilsham Valley. Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 18 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Ilsham Valley have a homely environment, which has been adapted to meet their needs. The home continues to be kept clean, fresh and pleasantly decorated for people. Improvements made since the change of ownership and changes planned to further improve the environment will continue to enhance the living accommodation for the people living at Ilsham Valley. EVIDENCE: A tour of the home was completed as part of this inspection. Some individual peoples rooms were entered. Two of these had been redecorated and new carpet fitted since the change of ownership in December 2008. This revealed that the decoration and refreshing of individual peoples rooms has continued. The home was odor free, fresh and cleans in all the areas visited during the Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 19 inspection. The house keeper was working in the home during the morning of the inspection. People living in the home who were asked said their rooms are always kept fresh and clean. The reception area of the home and ground floor corridor had been redecorated and refreshed. In addition to this some individual bedrooms had been re-carpeted and decorated. The manager advised that further improvements are planed. These included re-carpeting the lounge and providing new lounge furniture as well as continuing to up grade individual rooms as occupancy levels allow. Samples of the carpets being considered were in the home. The manager advised that people who were able had been asked about their preferences as well as the staff team. A small garden area for the people who live at Ilsham Valley to use was available. The majority of the garden was arranged with steps on a steep bank. The patio area in the garden was not easily accessible for people with restricted mobility. However there was a small balcony off the lounge that people could sit in if they chose. The manager advised that plans to provide a larger patio area outside for people were being considered. The manager and new owners provided information for the Annual Quality Assurance Assessment, which detailed the improvements made since the change of ownership. These included improving security of the home and maintenance, redecoration and refurbishment of the home. The one double and six of the single bedrooms have en-suite facilities. All bedrooms have washbasins. There are assisted bathing facilities and adequate lavatories on both floors. A tour of the home revealed that some vanity units and washbasins in individual rooms had been replaced. The home has two hoists and a dedicated stand aid to help mobilize people to their maximum potential. All floors are level or ramped. Individual peoples rooms entered during the inspection had been personalized with items of their choice. This included pictures, ornaments and family photographs. Two people spoken with in their own rooms said they liked the rooms they were in and they had all the things they needed around them. The laundry area is sited away from people’s accommodation. The laundry floor had a painted surface which was worn and not easily cleanable. The manager and maintenance man advised that the floor was repainted regularly and was due to be redone soon. The home has sluices on each floor for staff use. Staff observed during the inspection were using gloves and aprons when providing personal care for people. Gloves and aprons were readily available for the staff to use. Staff training included infection control. The Annual Quality Assurance Assessment (AQAA) indicated that 22 staff had completed infection control training. The AQAA also indicated that staff lockers with Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 20 antibacterial coating had been provided since the new owners took over the home. This should further reduce the risk of cross infection for people living at Ilsham Valley. Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 21 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 consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Ilsham Valley nursing home continue to be cared for a by a caring staff team who have their best interests at heart. Recruitment practices are safe and should protect people from unsuitable staff. The manager and owner have ensured that the staff receive training relevant to the care they provided for individuals living at Ilsham Valley. This ensures that the staff team working at Ilsham Valley are competent, knowledgeable and have clear understanding of the health and personal care problems for the people they care for. EVIDENCE: A duty rota, which showed which staff were on duty and in what capacity they were employed was seen. This shows that more staff are on duty at peak times. The manager advised that staffing levels continue to be planned around the needs of the people living at Ilsham Valley. Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 22 There are registered nurses on duty to cover a 24-hour period seven days a week. The registered nurses direct and monitor the health care of the people living at Ilsham Valley. A team of health care assistants supports them. The manager advised that they had a stable work team who knew the people they were caring for well. The manager commented that this had enabled all shifts to be covered in house with out the need to rely on agency cover. The key worker system continues, each carer being responsible for a set number of people living at Ilsham Valley. The key worker ensures that the person has the things they need and is responsible for completing the daily record check list for the people they provide care for during their shift. As well as the care staff there are two chefs, a domestic and a maintenance person. The owner (registered person) takes an active interest in the home and visits regularly. The chef, housekeeper and maintenance man were working in the home at the time of the inspection. The Annual Quality Assurance Assessment (AQAA) indicates that more than 50 of the staff team have achieved an NVQ level 2 or above in care. The four staff spoken to during the inspection said they had good access to training and there was always new information about courses in the office. Two staff files were viewed during the inspection. The information needed for staff files to support safe recruitment practice had been followed was available. This included an application form, references, proof of identity and evidence of a police check being completed. Registered nurses had had their Nursing And Midwifery Council (NMC) registration checked against the NMC register. And the manager had a system for ensuring information about current registration was kept up to date in the registered nurses staff file. The deputy manager was also taking responsibility for coordinating the training and development of the staff team. They advised that training and development needs for staff are discussed and recorded as part of the supervision process. Two staff records of supervision showed this to be the case. Staff induction records were available in their staff files. This showed that their induction had been completed with in the first six months of their appointment. The manager advised that the registered nurses are given the opportunity to access courses to improve and up date their skills. The deputy manager was in the process of completing a distance learning palliative care course. The Annual Quality Assurance Assessment (AQAA) information indicated that the registered nurses are enabled to keep up to date with their prep training requirements for registration. Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 23 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 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The knowledgeable manager ensures staff have access to information about people’s conditions and illnesses. She was approachable and ensures staff have clear lines of accountability with in the home. The manager tries to ensure the homes run in the best interests of the people living there. People are asked about the service they receive through regular quality audit questionnaires, this means people are able to influence the way the homes run. Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 24 EVIDENCE: The manager has a first level nurse qualification and is registered with the Nursing and Midwifery Council (NMC), she has several years experience. She is supported by a deputy manager also a first level nurse with several years experience. The systems and practices in the home ensure that all staff are kept up to date with current best practice through training or available reference material in the home. The Annual Quality Assurance Assessment provided the following information. “She (the matron) is approachable and has an “open door” policy at all times. There are clear lines of accountability in the home, from the domestic staff to matron and on to the Responsible Individual (the owner), who takes a keen and personal interest in the Home in his capacity as Director of Greenhill Care Homes Ltd. The Responsible Individual regularly visits the Home and has also, in February 09, held an ‘all staff meeting’, another is planned for the end of July. The Technical director of Greenhill Care Homes Ltd also visits the home. Information and practices observed during the inspection found there to be clear lines of accountability with in the home and the matron and her deputy open and approachable for staff, people living in the home and visitors. The manager advised that policies and procedures had been up dated and new information added since the change of ownership. The mental capacity act and depravation of liberty act were discussed. Information was provided for staff regarding the Torbay care Trust’s policy for managing people who lacked capacity to make informed choice. This shows that the manager has followed best practice guidelines. The Annual Quality Assurance Assessment also stated. “We have also introduced the ‘Ilsham Gold Care Award’. This award scheme is designed to encourage all staff members to participate in improving the service levels that Ilsham Valley Nursing Home is able to offer its residents. This can take many forms and is not limited in scope. All suggestions will be looked at on their merits and no suggestions will be deemed to be insignificant. Not all suggestions would merit an award but they may nevertheless be implemented by the management of the Home.” This show staff opinions about improvements for the service are taken seriously. This should ensure improving the service for the people who live there receives a high priority. The Home also awarded a lifetime achievement award to one of their RGN’s in recognition of 57 years service to Nursing and elderly care on the 15 April 2009. The event was attended by people living at Ilsham Valley and staff and also the Torbay Mayor. The event was featured in the local newspaper. Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 25 The deputy manager confirmed that secure facilities continue to be provided for the safe keeping of money and valuables on behalf of people living at the home. These were checked for one person whose care was followed. Clear records of money held were being kept and copies of receipts were available for expenditure. The Annual Quality Assurance Assessment also stated. “The home does not take responsibility for the main financial affairs of any resident. If residents are capable, they are encouraged to manage their own affairs”. Supervision records were available for the care staff who work at the home. These showed that they received regular supervision from a senior member of staff that was relevant to the work they did. Staff spoken with said they felt supported to do their work and felt able to discuss work freely with the manager and her deputy. However records of supervision for the registered nurses were not currently being kept. The manager advised that the registered nurses support each other and informal supervision does takes place. The matron and deputy also used the manager/matron forums set up by Torbay Care Trust for support. The security of Ilsham Valley has been improved by the addition of external door alarms and CCTV cameras on all four corners of the building. Records of safety checks and service were up to date. This included equipment servicing, portable electrical equipment checks and Legionella checks. The Environmental health inspection report was provided for inspection. The manager confirmed that all the recommendations made in the report had been met. Examples of the changes made were seen during the inspection, for instance a new food hygiene policy is in place. This shows that the manager has acted promptly to make the improvements recommended. Records of accidents and incidents were being kept and completed appropriately. The manager or the senior person in charge has kept the Commission informed of any untoward incidents that adversely affects people living at the home. People who live at Ilsham Valley and the staff who work there have their health and safety protected by the systems and practices in the home. Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 26 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 3 X 4 Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Refer to Standard OP19 OP36 Good Practice Recommendations The Laundry floor should be easily cleanable to reduce the risk of cross infection. The registered nurses who work at Ilsham Valley should have a recorded system of supervision to support the informal supervision that currently takes place. Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 28 Care Quality Commission South West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Ilsham Valley Nursing Home DS0000072929.V375819.R01.S.doc Version 5.2 Page 29 - 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!