Care Home: The Valleys Care Home

Similar services:

• Abbey The
• Snydale Care Home
• Whiteley House
• Larchfield Manor
• Hawkhills
• Beeches The - North Yorkshire County Council
• Carentan House

What the care home does well The atmosphere at the home is warm and friendly and visitors are made to feel welcome. The staff show respect to people living at the home and were observed being kind and courteous throughout the day. The manager or deputy manager visit people before they arrive at the home to see if their needs could be met and then a detailed care plan is developed so the staff know what care the person needed. People have the opportunity to read and discuss their care plan and had signed to evidence this. People are very satisfied with the standards of care provided. One relative wrote in a survey " Reception is excellent and informative, the manager and deputy are friendly and accessible, the care staff kind and watchful". People who live in the home said that they had choices about how they lived their lives in the home, when they got up, went to bed, activities and meals. People enjoyed the meals they were provided with and they liked the staff who cared for them. The home provides a very good standard of accommodation and facilities; it is well decorated and furnished throughout. People said they were happy with their bedrooms and could bring in their own possessions, making it feel more like home. The manager had made sure that people living in the home would be safe with the staff employed in the home by obtaining criminal record checks and references before staff started work. Staff feel they are well supported, they can access regular meetings and one to one sessions with their manager to discuss how well they are doing, or if they need any more training or support with their work. This better ensures that they can provide a good standard of care for the people who use the service. What has improved since the last inspection? This was the home`s first inspection visit. What the care home could do better: They must look at care plans more consistently to check that the care plan is still relevant and up date care plans where required, this will ensure that peoples care needs are identified and planned for. Staff must access training in food hygiene so they can safely provide support at mealtimes.Staff must look more closely at incidents of challenging behaviour in the home to see if they managed the situation well or if people need other support. CARE HOMES FOR OLDER PEOPLE The Valleys Care Home Lakeside Parkway Scunthorpe DN16 3UA Lead Inspector Mrs Jane Lyons Key Unannounced Inspection 19th May 2008 09:00 X10015.doc Version 1.40 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 The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Valleys Care Home Address Lakeside Parkway Scunthorpe DN16 3UA 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) 01724854863 trish@unitedhealth.co.uk www.unitedhealth.co.uk United Health Limited Mrs Patricia Blenkinsopp Care Home 84 Category(ies) of Dementia (84), Mental disorder, excluding registration, with number learning disability or dementia (84), Old age, of places not falling within any other category (84) The Valleys Care Home DS0000071196.V364664.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 the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, Dementia - Code DE, Mental Disorder, excluding learning disability or dementia - Code MD, Physical disability - Code PD. The maximum number of service users who can be accommodated is: 84 2. Date of last inspection Brief Description of the Service: The Valleys is owned and managed by United Health Ltd. The Valleys is a large, detached, purpose built care home providing accommodation over two floors with lift access to the first floor. The home is registered for eighty-four people under the categories of: nursing, old age, dementia, mental disorder and physical disability. All rooms are single and en-suite. There are a good variety of lounge and dining rooms. Assisted bath and shower facilities are provided on each floor. Garden and patio areas are located at the rear of the building and there is parking within the grounds. The whole feel of the home is one of comfort with pleasant, clean and homely surroundings. The home is situated approximately a mile from Scunthorpe town centre and is well served by the local bus service. There are a number of shops and amenities close by. There is a lot of housing development currently taking place around the home and a new road has improved vehicular access. Weekly fees are: £338.47- £500. The home operates a system whereby the fees include a third party contribution. Additional charges are made for the following: toiletries, newspapers/magazines, hairdressing, chiropody, transport to appointments and escort fees. Information on the service is made available to prospective and current service users via the statement of purpose, service user guide and inspection report. Documents are made available prior to and following admission, copies are always held in the reception area. The Valleys Care Home DS0000071196.V364664.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 2 star. This means the people who use this service experience good quality outcomes. This inspection included an unannounced site visit carried out by Mrs Jane Lyons on the 19th May 2008. During the visit we spoke with some of the people who live at the home, a number of relatives, nursing staff, care staff, the cook, a visiting care manager from the local authority and the manager. We looked round the home to see if it was kept clean and tidy. Some of the records kept in the home were checked. This was to see how the people who live in the home were being cared for, that staff were safe to work in the home and that they had been trained to their job safely. We also checked records to make sure that the home and the things used in it were safe and were checked regularly. The manager at the home also completed an annual quality assurance assessment that was requested by CSCI (Commission for Social Care Inspection), which includes information about people who live at the home, the staff that work there, the service provided and any incidents or accidents that have occurred. Prior to this visit, surveys were sent out to obtain the views of people who live at the home, staff and some health and social care professionals. Five surveys were returned from people who live at the home and five from the staff. Comments from surveys have been included in the main body of this report. The home opened in December 2007 and this was the first inspection visit following registration therefore all the standards were looked at. An experienced manager has been appointed who has to date recruited a very positive staff team. Occupancy at the home has steadily increased over the last five months. The home provides a very friendly atmosphere and people who live in the home and visitors said they were very happy with the care provided. We would like to take this opportunity to thank everyone who participated in the inspection process. The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: They must look at care plans more consistently to check that the care plan is still relevant and up date care plans where required, this will ensure that peoples care needs are identified and planned for. Staff must access training in food hygiene so they can safely provide support at mealtimes. The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 7 Staff must look more closely at incidents of challenging behaviour in the home to see if they managed the situation well or if people need other support. 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. The summary of this inspection report can be made available in other formats on request. The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 8 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 The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 and 6. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides detailed information to enable people to make an informed choice about the services they provide. People are properly assessed prior to moving into the home to ensure that their needs can be met. EVIDENCE: Information about the service is provided in a statement of purpose, service users guide, brochure and a contract/statement of terms and conditions. These are made available in the home or could be sent to prospective persons. The statement of purpose should include information to support emergency admissions to the home. All documents were written in plain English and could be made available in large print on request. The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 10 In the reception area there are photographs of all the staff and information regarding planned activities and how to make a complaint. Leaflets about local advocacy services and other information was available. Information provided by the manager prior to this visit taking place indicates that people are able to visit the home without the need for an appointment prior to them or their relative moving in. Pre-admission assessments are carried out either by the manager or deputy manager who visit the person at their own home or in hospital which ever is applicable at the time. One relative spoken to during the visit said how impressed he had been by the deputy manager at the pre assessment visit; she had developed a very good rapport with his wife which gave the family confidence that the home would manage her care needs well. Community Care Assessments are obtained from the funding authority, these outline the person’s current health and personal care needs. The information collated from visiting people and that supplied by the funding authority is taken into consideration when making a decision as to whether the home is able to meet the person’s needs. The home writes to individuals following the assessment visit however the letter focus’s on the contractual arrangements and should include a statement relating to the home’s ability to meet the persons needs. There was evidence in three peoples’ care records to confirm that their needs were properly and thoroughly assessed prior to being offered a place at the home. People who completed the CSCI’s surveys confirmed that they received enough information about the home before they moved in. One relative described how she had visited with her husband for the day which enabled her to see how he settled with the staff and other people living there and how useful it had been. People are unable to make a choice of staff gender when deciding whom they would like to deliver their care, as the home currently employs only female care and nursing staff; the manager is hoping that male staff will join the home as the recruitment programme continues. The home does not currently provide intermediate care dedicated to accommodate individuals with intensive rehabilitation needs, so standard six is not applicable. The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There were detailed care programmes in place to support the care that was given in the home although some inconsistencies with recording meant that care plans were not always updated as needs changed. Medication systems are generally well managed. People’s rights to privacy and dignity are supported by caring staff. EVIDENCE: Three people’s care plans were looked at in order to obtain a picture of what their needs are and how staff support them. The care plans were detailed and focused on the individual’s abilities as well as areas in which they required assistance. There was evidence in the plans that individual risk assessment was undertaken and regularly reviewed; risk assessments for moving/ handling, tissue viability, falls, nutrition, bed rails and general issues were in place. Daily diary records were well maintained and detailed as were records to support communications with relatives and health care professionals. The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 12 There was good evidence in peoples’ care records to indicate that they are able access health care services, such as the dentist, chiropody, opticians and everyone living at the home is registered with a doctor. There was evidence that people’s health was monitored and professional advice sought for pressure area care, challenging behaviour and dietary needs. There was evidence that care plans had been discussed with people and their relatives and the majority had signed to agree them. One relative said that she had assisted staff with the assessment information which had helped them to write plans which reflected her husbands choices and preferences. Relatives are asked to help complete the life history section of the care plan and this information is beneficial in terms of getting an insight into the kind of hobbies, leisure past times and significant events that make up this person’s life. Having this information helps staff to see the person as an individual in their own right and to engage people in things they are interested in such as a past hobby or a particular talking point. Although the care plans were evaluated regularly and included detail about the persons health and wellbeing over the previous week/month; when changes in need had occurred the care plans had not always been updated or when new areas of need had been identified a care plan had not always been put in place. These inconsistencies in recording were found in a number of plans on both units. Some of the people who use the service display behaviours which can be challenging at times; there was good evidence that the staff had consulted with relevant professionals to support the care provision with very positive results. One relative said how much her loved one’s behaviours had settled with regular medication reviews and the kind, consistent staff approach. Records are maintained of challenging behaviours and action the staff have taken in respect of this, it is important though that staff formally review incidents of challenging behaviour with a view to informing best practice in such circumstances. Information obtained must be used to inform and support individual risk assessments and behaviour management plans. There was good evidence in the records that people who use the service had accessed formal review meetings. We spoke to a care manager during the inspection who was carrying out an assessment; she said that the individual’s relatives lived some distance away and had been very satisfied with the care support at the home and the communication with the staff had been very positive. All people spoken to and surveys returned indicated that everyone was very satisfied with the standards of care in the home. One survey detailed “I have seen other residents come into the nursing section from either home, hospital The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 13 or other care homes. Without exception they have been looked after and welcomed by the staff and all have shown an improvement in their demeanour and seem happy/ relaxed in their environment.” Records of the receipt, administration and disposal of medication, including controlled drugs, were clearly maintained. The temperature of medication storage areas was monitored, although records showed that the ground floor storage area was regularly exceeding the recommended maximum temperature as identified by the drug manufacturers. The staff member assisting the inspector had completed the safe handling of medication course and demonstrated good knowledge of the homes procedures and medications in general, the other senior care assistant on day duty needs to complete this course; medications are administered at night on the unit by the nursing staff. The home had not obtained written confirmation of the dose required where warfarin was prescribed, this is recommended. People are supported to administer their own medications where possible and risk assessments are completed; one person spoken to said that she was pleased she had been able to continue to manage her own tablets during her short stay at the home. Evidence from observation of practise, discussion with people and staff indicated that people’s privacy and dignity were well respected. Staff were observed to be kind, use people’s preferred term of address and knock on bedroom doors before entering. We spent a lot of time during the visit observing the staff interact with people living at the home and at all times this was very positive. A relative wrote in a survey “One of the staff commented the other day that it is not just a care home, it’s “their” home.” There are systems in place to support end of life care at the home, the home would utilise specific documentation “The Liverpool Pathway of Care” in line with the community health care team to support palliative care needs. The manager is currently sourcing some courses for staff to access to support this area of practice such as bereavement and pain control. The Valleys Care Home DS0000071196.V364664.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are able to make their own choices about how they spend their time and are offered activities. They maintain contact with their families as they wish and formal communication systems between the home and relatives are good. People receive a good quality, varied and nutritious diet. EVIDENCE: Observation and discussions during the visit indicates the home routines are based around the individual needs and preferences of the people living in home. The atmosphere was friendly and relaxed; staff were often observed sitting quietly with individuals. One relative said when he arrived each day he often found one of the staff sitting with his wife holding her hand. The home has an ‘activities plan’ displayed in the reception area so visitors can see the type of activities available to people on a daily basis. Typical activities that take place range from crafts, painting, dominoes, skittles, watching DVDs, reminiscence, quizzes, and playing ball games. The manager said she had The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 15 experienced difficulties in recruiting a full time activities co-ordinator, which is ongoing, however in recent weeks one of the care staff has taken on this role on a part time basis with very positive results. The activities co-ordinator has visited all people who use the service and consulted with their relatives where possible to develop more individualised social care plans; these plans focus more on what the individual currently enjoys doing and how they are able to participate. During the visit people were enjoying some craft work, making bird boxes and birthday cards. The co-ordinator also explained some of the one- to one support she provides for people with more dependent needs; from sitting and chatting to playing music, reading, helping to write letters, looking at photos and doing manicures and hand massages. The home has a new minibus and people have enjoyed trips out to the garden centre and for an ice cream. Two large storage rooms on the first floor are currently being adapted for use as an activities room and the other as a quiet sensory room, which will provide people with more variety in where they can spend their time. Lots of photographs of people participating in various activities were displayed around the home, one relative wrote in a survey “ Hasn’t been there long, but they asked permission to take him out and I agreed- photos show the result! Very good” In discussion staff displayed a good knowledge of people’s needs, likes/ dislikes, family support and records contained information about people’s religious observances. A local minister visits the home regularly. Relative surveys indicated that they were able to visit their relative at any time and there is no restriction on visiting. Those relatives and friends visiting during the inspection confirmed that they were made to feel very welcome, always offered refreshments and are able to have a meal with their loved ones if they choose to. The meals observed were good quality and offered a choice. There were cooked options available at all meal times; most of the comments about the meals were very positive however two people commented that the menu choices for the evening meal were not as good. Comments in the surveys include: “Tea times seem to be a bit hit and miss with the menu choice. Lunch meals are excellent and plentiful. Residents are able to have breakfast at their own pace after getting up in the morning. Visitors are welcome at meal times and the atmosphere is very relaxed” and “Since his move to the home, Dad has proper man sized portions and accepts seconds! I do believe he is beginning to put on a little weight.” Staff encourage independence and aids are provided, staff were seen to offer assistance to people in a sensitive and discreet manner. The kitchen was The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 16 generally clean and tidy and all associated records for the safe handling of food were maintained. Discussions with the cook identified that he is informed by staff of people’s individual nutritional needs although there were no formal records held in the kitchen, this may be a satisfactory arrangement whilst occupancy is relatively low in the home however as numbers increase more formal records should be held to ensure people’s specialist diet provision and preferences are maintained. The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has systems in place to protect people from abuse. People can be confident that their complaints will be listened to and acted upon. EVIDENCE: People who completed surveys responded ‘yes’ when asked if they knew how to make a complaint. Those people spoken with during the day also confirmed they knew who to go to if they were unhappy about something. The complaints procedure is displayed in the front entrance of the home. It is also available in the home’s statement of purpose. No complaints have been received by the home or the commission since the home opened; the manager has systems in place to support the investigation and management of complaints. Information about advocacy services is displayed in the reception area. The administrator completes the registration documentation enabling people who live in the home to vote. There are policies and procedures in place to reduce the risk of abuse. All staff commencing employment have a CRB (Criminal Records Bureau) and a POVA (Protection of Vulnerable Adults) check before starting work in the home. All The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 18 staff have received safeguarding (adult protection) training which provides information on how to protect people from abuse. The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 ,20, 21, 22, 23, 24, 25 and 26. People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The standard of the environment in this home is high, providing people with a very safe, comfortable and attractive place to live. EVIDENCE: The Valleys is a purpose built home which opened in December 2007, it has two floors that are accessed via stairs or passenger lift. The home is divided into four units, two on each floor; doors to each unit have key code access for security purposes. The décor and furnishings throughout the building are of good quality providing very comfortable and pleasant accommodation. All areas of the home are well lit the lighting is domestic in style. All bedrooms are for single occupancy offering ensuite facilities. Those people who spoke with the inspector were happy with their rooms; they explained The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 20 how they had been able to bring in some of their own possessions making their room feel more homely and personalised. A number of the room doors had name plaques which some people had made themselves at craft sessions, staff said that these helped some people to recognise their room. There are a variety of bathrooms and shower facilities on each floor, the baths have hoist facilities, the rooms are spacious and well ventilated. Each unit has a dining area with servery attached. There are a range of lounge areas on each floor where people can choose to sit and spend their time, the provision of an activities room and quiet sensory room on the first floor will also allow people greater choice in where to spend their time. Each communal lounge has a large digital plasma television making easy viewing for those people who may have sight problems. The home feels spacious; corridors and doorways are wide to accommodate wheelchair users. Grab rails have been provided in corridors, bathrooms and toilets; these have also been provided in people’s individual accommodation where required. Staff said that the provision of equipment in the home was good; there are a variety of portable hoists and the majority of beds are the “profile” style which are electric and better enable staff to adjust the height and position to suit the individual’s needs. Laundry facilities are sited on the ground floor. Policies and procedures are in place for control of infection; this is covered in the induction-training programme for new staff and staff confirmed that they had good supplies of protective clothing. All areas of the home were seen to be exceptionally clean and tidy; there were no odour problems. There is a good-sized garden and patio area to the rear of the home which is accessed through the ground floor lounge. The garden areas are enclosed and are currently being developed, a variety of seating and shade is in place with plans for raised beds and a water feature this summer. The Valleys Care Home DS0000071196.V364664.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s needs are met by trained staff who have undergone a thorough recruitment process before they are allowed to work in the home. EVIDENCE: The manager began recruiting staff for the home in November to support the admission of people when the home opened in December 2007. At the time of the visit twenty-four people were residing in the home and the recruitment programme continues to support the further admissions the home expects. The care and nursing staff work a variety of shifts including 12 hour ones which they said worked well. Currently two units in the home are open, staff rotas and discussions with people indicated that there were enough staff to meet individual needs. Observation during the day also confirmed this with people receiving support in a calm, paced manner and staff having time to spend with people. All people spoken to during the day and comments on surveys were extremely complimentary about the staff at the home. The staff themselves recognise what a positive team there is and spoke about the respect they have for each other and the support provided by the management team. Some of the comments from relatives include “ Nothing is too much trouble for any of The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 22 them”, “Its about trust, I have no concerns when I leave the home as I know that the staff will take wonderful care of my husband” and “All the staff are kind and caring”. Many of the nursing and care staff have a wide range of experience in looking after older people, the deputy manager is a qualified Registered Mental Nurse and has provided staff with in house training on caring for people with dementia. The home also employs a range of support staff including an administrator, domestics, cooks, kitchen assistants, laundry staff and a maintenance man. The manager’s hours and a proportion of the deputy manager’s hours are supernumerary. The home is committed to the provision of NVQ training. Information received prior to the visit showed that of the 18 care staff employed 5 of them had gained level 2 or above (28 ) however a further 8 staff had recently enrolled on the level 2 course and on completion of the course the percentage of qualified care staff will increase to 78 . This said the recruitment programme is ongoing to increase and develop the staff base and a proportion of new staff are likely to have already gained NVQ qualification and those staff without qualification will also be encouraged to enrol on the course. The recruitment files of four members of staff were audited in detail and found to contain the required information and recruitment checks. These checks are necessary to help protect people from potentially unsuitable staff. The manager explained that all new staff receive induction and mandatory training in accordance with Skills for Care, the National Training Organisation for care staff. All new staff work alongside more experienced staff as part of their induction. There was evidence from staff records and discussions with staff that there was an active training programme in place. The majority of staff had completed training in mandatory areas since November 2007. Food hygiene training is needed and the manager is currently arranging these courses for staff. The majority of staff have also accessed training in dementia care and the manager is currently sourcing some challenging behaviour training for staff. Although staff have received “accredited” medication training from the home’s pharmacy provider it is advised that all care staff responsible for administration of medications complete a more comprehensive course such as “Safe handling of medicines” which provides more information about aspects of medication systems and has a competency assessment attached. The manager uses a variety of formats to present training including staff meetings, videos, and in house and external courses. The manager maintains a The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 23 training overview plan on the computer and course certificates are held in the individual staff members files. Staff spoken to were very positive about the training they had received at the home, comments on surveys included “Some of the training we have had has been led by the management team which has enabled us to relate the theory to practice in the home. This has been balanced with some of the training sessions led by outside agencies which has given me ideas to bring back to the workplace. I feel that all the training has been relevant and well organised.” The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 and 38. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well managed and the health, safety and welfare of people living at the home and staff is promoted and protected. EVIDENCE: Mrs Patricia Blenkinsopp is the registered manager at The Valleys. She is a qualified nurse, has completed her Registered Managers Award, has many years experience in providing care for the elderly and demonstrates sound management practices. The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 25 Mrs Blenkinsopp is keen to promote and provide good quality care to vulnerable people. She has a good rapport with people living at the home, who spoke very highly of her. People said that she is very approachable, kind and caring. Ms Blenkinsopp shows a clear sense of direction in terms of how she wants the home to progress, she has experience of managing large care settings. She operates an ‘open door’ policy where she welcomes ideas from staff and values the opinions from people living at the home and their relatives on how the home can improve. An experienced administrator has been appointed. Staff reported that moral in the home was very good. Evidence from interviews with and surveys from care staff indicate that they consider the manager and nursing staff to be very professional; that they encourage a team approach with a strong focus on person centred care. A system of monitoring the quality of the care provided has been implemented. The manager completes regular audits of key areas such as the facilities, care records, medication system and accidents. There was evidence of involvement in the process from people who live in the home in surveys and the first “residents and relatives” meeting had been arranged for the following month. The home has received a number of ‘thank you’ cards and letters from relatives of people who once lived at the home who were thanking the staff for their care and kindness during their loved ones stay at the home. The majority of comments from the surveys were very positive with a few concerns raised about the level of activity support which the manager has started to address and made some significant improvements. Action plans should be developed to support any areas of deficiency and results of surveys and action plans need to be displayed. The manager explained that she would be completing the annual development plan, which supports the quality programme, later in the year given the recent opening of the home. The homes business and financial plan and insurance arrangements were in place and submitted to support the home’s registration. The manager confirmed that a company representative carries out monthly visits to the home in line with Regulation 26 and staff confirmed at interview that they have the opportunity to speak to the area manager. There were no reports generated from these visits currently held at the home. Some people have small amounts of personal money that is held safely at the home by staff. Records are available to show when money is deposited on behalf of people. The records show the individual cash balance for each person and how their money is used on their behalf, including receipts for goods and items purchased. Three peoples’ finances were checked during the visit and were found to be correct. The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 26 There were policies and procedures in place for all areas of practise. A formal staff supervision programme was in place and records showed that staff had received regular sessions with the manager. One staff member commented on a survey “ At the end of my probationary period the manager had an in depth one- to -one with me and it was clear that she had observed me and discussed my progress with both my “senior” and the deputy.” The home had systems in place to manage health and safety in the home and appropriate records were maintained. Risk assessments were in place and regularly reviewed. All the systems and equipment in the home is new, contracts have been arranged for the maintenance and servicing of equipment as necessary. The home carries out weekly fire safety checks and these are recorded and staff are involved in fire drills periodically to ensure they know what to do in the event of a fire; advice was given to document an appraisal of the staff’s response during the fire drill to support any further training they may need. Accident reports are completed and audited on a monthly basis by the manager identifying any trends that may be apparent and taking the necessary action. The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 27 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 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 3 18 3 4 4 3 3 4 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 3 3 2 3 The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? N/A 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 OP7 Regulation 15 Requirement Timescale for action 15/07/08 2. OP7 OP18 12(1) and 13(6) 3. OP30 18 (1)c The registered person must make sure that where monthly evaluations identify changes in peoples needs and that where changes have occurred the care plans are up dated so they reflect all peoples care needs. This is so that people’s needs continue to be met. 15/07/08 The registered person must implement a system in the home whereby incidents of challenging behaviour are reviewed with a view to informing best practice in such circumstances. Information obtained must then be used to inform and support individual risk assessments and behaviour management plans to protect the rights of people and to ensure their welfare and safety. The registered person must 20/08/08 provide evidence to the commission that all staff have received training in food hygiene, this will better protect people who use the service. The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 29 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 OP1 OP9 Good Practice Recommendations The registered person should ensure that the statement of purpose includes information on emergency admissions to the home. The registered person should take action to reduce the temperature in the medication storage areas if the temperature continues to exceed the recommended temperature guidance from the medication manufacturers. The registered person should obtain written confirmation from the GP of the warfarin levels to be administered to reduce the risk of errors. The registered person should ensure that all care staff who have responsibility for administering medication access an appropriate accredited medication course. The registered person should review the tea- time menu in line with comments received from relatives. The registered person should ensure the cook receives copies of nutritional risk assessments and other information relating to individual’s meal preferences and specialist dietary requirements. The registered person should ensure that 50 of the care staff have gained NVQ level 2. The registered person should ensure that action plans are developed to support any deficiencies identified through the quality surveys and that the findings of the surveys are displayed. The registered person should ensure that reports to support visits to the home to comply with Regulation 26 are held in the home. 3. 4. 5. 6. OP9 OP9 OP15 OP15 7. 8. OP28 OP33 9. OP37 The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 The Valleys Care Home DS0000071196.V364664.R01.S.doc Version 5.2 Page 31 - 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!