Care Home: Valley Lodge Nursing Home

Similar services:

• Byars Care Home
• St Marys Nursing Home
• Bramble Lodge
• Parkmanor Residential Home
• Thornham Grove
• Hunter`s Lodge
• London Road Neurological and Specialist Care Unit
• Carlton Care Home

What the care home does well People live in a safe, clean and comfortable and well-maintained environment, which suits their needs.They are well informed about the service, which assists them in choosing to live there and overall their needs, including their health care needs, are well accounted for. One person said, `staff know how to help me and my needs are always met.` People are treated with respect and their rights to privacy and dignity upheld by staff that recognise these aspects as central to people`s care delivery. One person told us, `I am treated as an individual, not as a group and cared for on a needs basis.` People`s lifestyles experienced in the home, usually matches with their expectations and preferences and meals provided suit their tastes and assessed needs. Two people told us, `The meals are very good and varied,` and `The food we have is excellent.` People may be confident that the home takes its responsibilities seriously in respect of dealing with complaints and protecting people from abuse and that they strive to act in people`s best interest in respect of these. People benefit from care and support from staff that is usually effectively recruited, inducted, trained and deployed. One person told us, `All the staff are welcoming, kind and smile as well as being capable and efficient.` `They are always very attentive.` Overall, the home is well managed and run and in people`s best interests with their health, safety and welfare reasonably well promoted and protected. What has improved since the last inspection? All four requirements made at our last key inspection are complied with four of the seven quality recommendations achieved, including attention to specified areas of environmental health and safety and quality. Also people`s documented risk assessments have regularly recorded reviews. What the care home could do better: Specify the actual range of fees charged for people so as to best inform them. Ensure that reports are provided of the monthly visits from the registered provider (or suitable representative), and which include for direct consultation with service users, their representatives and persons working at the care home to enable them to inform opinion as to the standard of care provided in the home.Better account for people`s capacities and rights to make informed choices and decisions about their lives and facilities within their individual needs assessment and care planning records in accordance with the Mental Capacity Act 2005. Continue to develop its quality monitoring systems in respect of record keeping. So as to best demonstrate the efficient and effective running of the home and accountability for practise there. CARE HOMES FOR OLDER PEOPLE Valley Lodge Nursing Home Bakewell Road Darley Dale Derbyshire DE4 3BN Lead Inspector Susan Richards Unannounced Inspection 18th June 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 Valley Lodge Nursing Home DS0000002094.V367589.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. Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Valley Lodge Nursing Home Address Bakewell Road Darley Dale Derbyshire DE4 3BN 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) 01629 583447 www.ashmere.co.uk Ashmere Care Group Mr Gerald Poxton, Mrs Sandra R Poxton, Mrs Ann Theresa Poxton, Dr Michael G Poxton, Mr David A Poxton Manager post vacant Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd May 2007 Brief Description of the Service: Valley Lodge Nursing Home is registered to provide accommodation, nursing and personal care and support for up to thirty-three older people. The home is located in Darley Dale, on the A6 (main bus route) and approximately half a mile to north west of the market town of Matlock. Accommodation is provided over two floors with a large lounge, communal dining room and a smaller quieter lounge to the ground floor. There is a range of environmental aids and adaptations to assist those who may have mobility problems, including corridor hand rails, grab rails in toilets, hoists and moving and handling equipment and a shaft lift and emergency call system throughout. Many rooms have en suite facilities provided and people are encouraged to bring in their own personal possessions and to personalise their own rooms. Access to the rear garden is currently off limits due to due to major buildings extension works in progress. There are raised flowerbeds and car parking spaces to the front of the home. Hotel services are centralised and the acting manager is supported from a team of care and hotel services staff and also external management arrangements. The range of fees charged per week is: £375.00 - £621.00. There are no additional charges. Fees charged are determined in accordance with individual’s assessed needs and room type. They include contributions from the local authority (personal care and accommodation) and/or local primary care trust, (for any nursing care contribution), as determined by those authorities for those who may be eligible. A copy of the most recent inspection report in displayed in the main reception area of the home, along with the home’s key service information, including its service guide. Valley Lodge Nursing Home DS0000002094.V367589.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. For the purposes of this inspection we have taken account of the information we hold about this service. This includes our previous key inspection report of 02 May 2007 and our annual quality assurance assessment questionnaire (AQAA), which we asked the home to complete in order to provide us with key information about the service. At this inspection there were twenty-four people accommodated, including sixteen people who receive nursing care and eight who are provided with personal care and support only. We used case tracking as part of our methodology, where we looked more closely at the care and services that three of those people receive. We did this by talking with those people, direct observation of staff interactions with them, looking at their written care plans and associated health and personal care records and we also looked at their private and communal accommodation. We received survey returns from three residents, six relatives/representatives and eight staff before our visit to the home. We spoke with staff about the arrangements for their recruitment, induction, training, deployment and supervision and we examined related records. In the absence of the acting manager, who was not on duty on the day of our visit, we spoke with the area manager present about the arrangements for the management and administration of the home and we examined associated records. All of the above was undertaken with consideration to any diversity in need for people who live at the home. At the time of our visit all people accommodated are of British white backgrounds and of Christian based religion (either practising or non-practising). What the service does well: People live in a safe, clean and comfortable and well-maintained environment, which suits their needs. Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 6 They are well informed about the service, which assists them in choosing to live there and overall their needs, including their health care needs, are well accounted for. One person said, ‘staff know how to help me and my needs are always met.’ People are treated with respect and their rights to privacy and dignity upheld by staff that recognise these aspects as central to people’s care delivery. One person told us, ‘I am treated as an individual, not as a group and cared for on a needs basis.’ People’s lifestyles experienced in the home, usually matches with their expectations and preferences and meals provided suit their tastes and assessed needs. Two people told us, ‘The meals are very good and varied,’ and ‘The food we have is excellent.’ People may be confident that the home takes its responsibilities seriously in respect of dealing with complaints and protecting people from abuse and that they strive to act in people’s best interest in respect of these. People benefit from care and support from staff that is usually effectively recruited, inducted, trained and deployed. One person told us, ‘All the staff are welcoming, kind and smile as well as being capable and efficient.’ ‘They are always very attentive.’ Overall, the home is well managed and run and in people’s best interests with their health, safety and welfare reasonably well promoted and protected. What has improved since the last inspection? What they could do better: Specify the actual range of fees charged for people so as to best inform them. Ensure that reports are provided of the monthly visits from the registered provider (or suitable representative), and which include for direct consultation with service users, their representatives and persons working at the care home to enable them to inform opinion as to the standard of care provided in the home. Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 7 Better account for people’s capacities and rights to make informed choices and decisions about their lives and facilities within their individual needs assessment and care planning records in accordance with the Mental Capacity Act 2005. Continue to develop its quality monitoring systems in respect of record keeping. So as to best demonstrate the efficient and effective running of the home and accountability for practise there. 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. Valley Lodge Nursing Home DS0000002094.V367589.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 Valley Lodge Nursing Home DS0000002094.V367589.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 & 3. (NMS 6 is not applicable to this service). Quality in this outcome area is good. This judgement has been made using evidence available, including a site visit to the service. Overall, people are well informed about the service to assist them in choosing to live there and their needs are well accounted for. EVIDENCE: At our last key inspection we judged that peoples’ needs were being fully assessed before admission so that care was provided in a way that meets individual needs and expectations. In our annual quality assurance questionnaire completed by the home, they say that they provide people with key service information and that their needs are fully assessed before their admission to the home to ensure that the home can meet these. Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 10 They say they have improved their processes in respect of the above over the last twelve months and also now routinely encourage potential residents the opportunity to visit the home before their admission. They feel they could improve further in terms of their communication with outside professionals concerned with people’s admission and also by ensuring that individual’s needs assessment information is in accordance with the Mental Capacity Act guidance and implications for care homes. They intend to focus on the development of these over the coming twelve months. At this inspection people told us that they are provided with the service information they need. One person said ‘Joanne is very informative and makes sure I get the information I need about home. Others told us that they are provided with a welcome pack/brochure in their own rooms and that staff had also talked with them about the information there. A copy of the home’s guide/brochure is also displayed in the reception area along with a variety of other literature, including activities information, easy read summary on the Mental Capacity Act, leaflets and information about funding and finance, access to advocacy service, complaints information, a visitors pack, results of quality audits about the service, including people’s views of the home and letters of appreciate and plaudits. A lot of key information is also provided in large print and some in picture format. The service guide/brochure does not state the actual range of fees, although it does give some information about how these may be determined. People also told us that their needs are always met. Comments made include: ‘The level of care provided is excellent.’ ‘The home is reliable, everything is up to scratch and the staff are caring and helpful.’ ‘Staff know how to help me and my needs are always met.’ Recorded needs assessment information we looked for those people case tracked were fairly comprehensive and documented in accordance with a recognised nursing assessment tool. They included initial pre-admission assessment information and also full needs assessments. Copies of the single assessment and care plan were also provided by way of local authority arrangements for placement. Individuals’ actual involvement and their capacities with regards to any key decision-making were not always best recorded. Examples of this, in accordance with their needs assessment information, includes provision of locks to bedroom doors, lockable storage, access to care plans, flu vaccination, some decisions made about their personal care and support, including as to their choice and capacity to manage their own financial affairs. Valley Lodge Nursing Home DS0000002094.V367589.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): NMS 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. For the most part, people’s health care needs are well accounted For, and their rights to privacy and to be treated with dignity and respect are upheld. EVIDENCE: At our last key inspection we judged that peoples’’ health, personal and social care needs were being well set out in individual plans of care although these were not always regularly reviewed. We recommended that regular reviews of people’s care plans and risk assessments are always recorded and that quality auditing of care plans is periodically undertaken. Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 12 In our annual quality assurance questionnaire completed by the home, the say that each resident has detailed written care plans, which are individualised. They say that they have improved by ensuring that care plans are regularly reviewed and in promoting people’s involvement in those. They also tell us that they could improve further by continuing to develop their care planning systems so as to accurately reflect the care being provided to people. At this inspection people told us that they always or usually receive the care and support they need, including medical care and that staff listen and act on what they say and treat them with dignity and respect. Comments received included: ‘I have been her for two years and my sister and myself is well looked after.’ ‘My mothers nursing and personal care needs are very well met.’ ‘I am treated as an individual, not as a group and cared for on a needs basis.’ ‘Staff is very attentive.’ The written care plans that we looked at for people case tracked were formulated in accordance with people’s risk assessed needs, for the most part had regularly recorded reviews. Overall they were reflective of recognised care practise concerned with older persons, although for one person their care plan relating to their assessed risk of falls did not best account for the care interventions they may require to prevent these. That person had three falls recorded in accordance with the home’s accident and incident reporting and recording procedures. However, staff spoken with was conversant with their needs and the care they required in respect of their identified falls risk. People’s actual involvement in their care plans, including reviews and key areas of decision-making in accordance with their individual capacities are not best accounted for within their care planning documentation. However, people told us that staff is usually sensitive to their individual needs and choices People case tracked was provided with the aids and equipment they needed. The arrangements for the management and administration of people’s medicines were also satisfactory and in accordance with the home’s comprehensive policy and procedural guidance for staff. Although, three individual creams prescribed for a service user who no longer lived at the home, were stored in a cupboard in one bathroom. The manager removed these and arranged for their disposal. For one person, that we case tracked, their eye drops did not have the date of their opening recorded, which is necessary as they have a limited shelf life. However, other people’s eye drops that we looked all had the date of opening recorded. Also, a cream prescribed for that person, records did not clearly Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 13 reflect its administration, as staff were using different codes on the medicines administration record sheet, for which there was no clear explanation provided. Valley Lodge Nursing Home DS0000002094.V367589.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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s lifestyles experienced in the home, usually matches with their expectations and preferences and meals provided suit their tastes and assessed needs. EVIDENCE: At our last key inspection of this service we judged that people were provided with a range of satisfying activities and were able to maintain contact with relatives and the local community. We also judged that people are provided with an appealing and well balanced diet. In our annual quality assurance questionnaire completed by the home, they say that they ensure activities are regularly available that people can engage in, accounting for their personal choices and with records kept of people’s daily living activities and social engagement. Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 15 They say that over the last twelve months they have made improvements in meeting people’s personal wishes and choices in respect of the food they receive and in ensuring that menus are followed as planned. They also feel that they provide more substantial entertainment and social activities for people to engage in, including religious practise and they intend to continue to develop the arrangements for activities and also food provided in consultation with people. At this inspection people told us that there are always or usually activities they can join in, although one said there sometimes are, however that person told us that they like their own company and like to read in their own room. People also told us that they enjoy the food provided and that they are always asked what they would like if they do not want anything from the menu. Comments received include: ‘The meals are very good and varied.’ ‘The food we have is excellent.’ People also told us that staff will support them well and know their preferred daily routines and that they can receive visitors when they wish. They also say that they were able to bring their own personal possessions into the home with them into their own rooms. One person brought their cat to live with them in the home. A range of leaflets and advisory information are also displayed in the main reception area, these include information about citizen’s rights, access to advocacy, information about independent assistance with finances and funding information. A weekly programme of activities is also organised and information about this is posted in the main reception area of the home. Activities include video afternoons, movement to music, crafts, hand massage, reminiscence, board games and music amongst a range. A planned diary of event is posted on a monthly basis, which for June included a visiting piano player, trips out, father day tea (with relatives invited), a Spanish theme night. A choice of daily newspapers is also provided for people in the reception area. A regular newsletter is produced for people, which also includes activities and events information, together with information about fund raising for the residents fund and volunteering opportunities. We observed lunches being served. Tables were attractively set and meals were well presented and served in a calm and unhurried manner, with sensitive assistance provided for individuals as necessary. People said there Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 16 are times when the food served does not match the menu, however, they say they are always consulted about this. Valley Lodge Nursing Home DS0000002094.V367589.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): NMS 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People may be confident that the home takes its responsibilities seriously in respect of dealing with complaints and protecting people from abuse and that they strive to act in people’s best interests in respect of these. EVIDENCE: At our last key inspection of this service we judged that people were confident that any complaints they had would be listened to and that they were suitably protected from abuse. In our annual quality assurance questionnaire completed by the home, they say they always ensure that all complaints are taken seriously. They say they have improved over the last twelve months by ensuring that all staff is provided with safeguarding training, that staff is conversant with the home’s whistle-blowing policy and that are currently providing training for all staff in the Mental Capacity Act. Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 18 They feel they can always improve by ensuring that staff are continuously kept up to date with relevant policy and procedural guidance in the home by way of training and instruction and intend to continue with this process Information they gave us in the dataset part of the questionnaire tells us that they have received three complaints, since our last key inspection, including one allegation of neglect investigated via joint agency safeguarding adults’ procedures. Records we looked at for this inspection told us that complaint alleged a poor standard of food provided, although there was no outcome recorded in the complaints record in respect of this complaint. Another complaint was made in respect of one individual requiring a new wheelchair and the new furnishings in their bedroom blocking access to their en suite. This was upheld, and action taken is recorded and as to the satisfaction of the complainant. The third complaint/allegation investigated via joint agency safeguarding adult’s procedures is not substantiated. However, as a result of those investigations, a number of recommendations were made in relation to a specific area of the home’s care practises. These have resulted in changes being implemented to specific recording methodology used and also via staff training and instruction. This complaint is fully recorded in the home’s complaints file. People told us that they know who to speak to if they are unhappy and that they know how to make a complaint. However, some clarified this by saying that they did not need to complain, as any issues or matters they raise are dealt with and acted on by the home, usually to their satisfaction. Up to date information about how to complain is displayed in large print in the reception area of the home, although the information in the home’s welcome pack/brochure was out of date in terms of recent changes to the contact details of the Commission. Management advised that the recently revised version was also being introduced into these. Staff spoken with were conversant with their roles and responsibilities concerned with dealing with complaints and in protecting people from abuse, including responding to any allegation or witnessing of the abuse of any person living at the home. They also demonstrate an understanding around restraint issues and the use of bed rails, which is determined via a recognised risk assessment process. Valley Lodge Nursing Home DS0000002094.V367589.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): NMS 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a safe, clean, comfortable and well-maintained environment, which suits their needs. EVIDENCE: At our last key inspection of this service we judged that people were provided with a homely and generally well-maintained environment, with personalised bedrooms. But, improvements were needed in terms of identified health and safety aspects within the environment. Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 20 We made three requirements, to comply with the recommendations of the Fire Officer following their recent visit there, to review arrangements for the storage of equipment in the home to prevent this being left in bathrooms, which was restricting safe access there, and to replace double glazed window units, which are obscured by condensation. We also made two recommendations – to routinely provide locks to bedroom doors and also lockable storage facilities in those rooms so as to provide people with the choice as to whether to use them or not. In our annual quality assurance questionnaire completed by the home, they say that always ensure the environment is safe, clean and with suitably facilities. They say they have improved by ensuring that cleaning rotas are always adhered to and by areas of redecoration and refurbishment, including replacement bedroom furniture for twenty bedrooms, including providing lockable storage facilities. They also say that self-closing devices are now fitted to all fire doors and smoke seals have been replaced where necessary. They feel they could improve further by ensuring that all environmental risk assessments are regularly reviewed and they also intend to continue to ensure cleanliness in the home, and to review facilities in accordance with their building extension planned. At this inspection people told us that the home is always fresh and clean and that they are satisfied with their environment and its facilities, although one person said that their laundry sometimes gets mixed up, despite being labelled. With that persons permission we discussed this with management who agreed to look at this further with that person. Works are well underway in respect of a large buildings extension, which we are informed of the provider’s intention to submit a registration application on its completion in respect of an increase to the existing number of beds and an additional care category. Given the works underway the former extensive and very attractive rear gardens no longer exist for people to access. However, people told us that they have been fully consulted and informed about this development and have been informed that a large courtyard type garden is to be provided. Some planned upgrading and renewal of the existing home is also tied into this development plan, including replacement of double glazed windows, some of which are now complete. All parts of the home, which we inspected were fresh and clean and well furnished, decorated and suitably equipped. There had been a review of Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 21 storage arrangements since our last key inspection and bathrooms were clutter free and safe for people to access. It was also confirmed at this visit that all matters raised by the Fire Officer were complied with. Locks to bedroom doors are not routinely provided and risk assessments recorded in respect of their possible provision in the individual files of those people we case tracked did not give account of their wishes, nor their involvement in that decision making process. No person case tracked had an external door-lock fitted to their bedroom. The laundry room is small, however facilities (which include two industrial washers and two dryers) are reasonably well organised and suitably located and staff is provided with suitable hand washing facilities and hand disinfectant gel, suitably located around the home. Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 22 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): NMS 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are usually well met from staff that is effectively recruited, inducted, trained and deployed. EVIDENCE: At our last key inspection of this service we judged that people’s needs are met, from satisfactory levels of staffing and a generally well-qualified staff group. We also judged that people were fully protected by staff recruitment procedures and that staff was trained and provided with the skills they needed to do their jobs. In our annual quality assurance questionnaire completed by the home, they say that they ensure that staff are effectively recruited, inducted, trained and deployed. They say that they have made improvements over the last twelve months by ensuring that all staff have fully completed their training plan for the year and by maintaining staffing levels commensurate with people’s needs and they aim to continue with the above. Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 23 In the data set information they provided this tells us that eight out of thirteen care staff have achieved at least NVQ level 2 or above and that a further five are currently working towards NVQ level 2. At this inspection people told us that they are always or usually well supported. That they receive the care they need from staff that they feel have the right skills. People also told us that staff do always listen and act on what they say and are usually available when they need them. In terms of the latter, one person, said they sometimes are, however this person gave no additional/supporting information on their survey and said they did not wish to speak with an inspector. Staff told us about satisfactory and suitable arrangements for their recruitment, induction, training and deployment and related records that we examined were reflective of this. Comments receive from people included: ‘All the staff are welcoming, kind and always smiley faced as well as being capable and efficient.’ ‘I have no fault to find, my father is always well cared for and is always in the best of hands. During our visit we observed staff to be patient and courteous with people and to be sensitive in their approaches and interactions with them. Valley Lodge Nursing Home DS0000002094.V367589.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): NMS 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall, the home is well managed and run and in people’s best interests, with their health, safety and welfare is promoted and protected. Although gaps in record keeping potentially undermine its accountability for practise. EVIDENCE: At our last key inspection of this service we judged that people benefit from a good management approach and that the home was being run in the their best interests and their health and safety well promoted. Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 25 We made one requirement, for the acting manager to submit an application to the Commission for their registration under the Care Standards Act 2000. This has been achieved and approval for their registration was granted. However, that person has recently resigned from that position at the home and interim suitable acting management arrangements have been effected. In our annual quality assurance questionnaire completed by the home, they say that they always aim to ensure that the home functions to its full potential. That continuous quality monitoring procedures are in place and that people are consulted with about the home and the services it aims to provide. They say they have improved over the last twelve months by taking action arising from their quality monitoring and auditing systems, including ensuring that people’s needs assessment documentation is accurately maintained and by review of the systems and arrangements for the management and handling of people’s own monies. They also gave us satisfactory information in the dataset section regarding arrangements for the maintenance and servicing of equipment at the home. They aim to continue with the above and to engage in regular meetings with people who use the service and with people who have an interest in it or who work there. At this inspection the acting manager was not on duty, however, the area manager was present and assisted us with our inspection. People expressed confidence in the service, and with regard to the competence of the newly appointed acting manager. Staff told us that they are usually well supported in their role, although one person surveyed felt that communication between staff could be improved. However, they did not indicate as to how and did not wish to speak with an inspector. We sampled the home’s records in respect of their quality assurance and monitoring systems. These include full service audits, which are conducted on a monthly basis. Satisfaction surveys are sent out every other month to different people, either that use the service or who have an interest in it, including outside health and social care professionals. The most recent one had been sent out to professionals (May) with returns awaited. Residents meetings are held every 2-3 months and minutes of these are displayed in the reception area in a ‘quality file.’ We looked at the minutes of the last meeting held in April which included reference and discussions with people about the building extension works currently underway, meals and Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 26 social activities. People’s views and suggestions were recorded there along with any action agreed. We discussed the remit of monthly visits to be undertaken by the registered provider or their representative with the area manager, as there were no separate focused reports of those visits in place, including direct consultation with people accommodated, their relatives and staff who work there. We looked at various records throughout this inspection process, including individual care records for those people we case tracked, including care plans, medicines records and complaints records. Although overall these are well maintained and individual’s records are safely and securely stored, although there were occasional gaps in recording in those areas. We have referred to these specifically under the Healthcare and Complaints section of this report as well as above in respect of monthly provider reports. The provider, or any person working at the home does not act as appointee or directly manage individual’s monies on behalf of any person accommodated at the home. However, they do safe keep small amount of personal monies on people’s behalf. These were sampled and were safely stored and properly accounted for. Comments made under the Choice of Home section is this report with regard to people’s choices and capacities to manage their own financial affairs are not best accounted for within individual’s needs assessment records. At our visit staff described satisfactory arrangements to ensure safe working practises, including core health and safety training, provision of equipment and their role and responsibilities with regard to the reporting and recording of accidents and untoward incidents in the home. There are suitable arrangements in place in respect of staff training relating to the above and records kept reflect this. Equipment provision is satisfactory, although staff felt that some hoisting equipment, whilst adequate would benefit from upgrading. The environment was generally free from hazards and details of satisfactory hot and cold water system maintenance were also provided. Although, in one bathroom a confirmed disinfectant type cleaning solution was left out, which was decanted into an unlabelled container. The area manager removed this and requested staff responsible to ensure that it be correctly labelled and stored. Valley Lodge Nursing Home DS0000002094.V367589.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 2 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 2 X 2 3 Valley Lodge Nursing Home DS0000002094.V367589.R01.S.doc Version 5.2 Page 28 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. 1. 2. Standard OP1 OP9 Regulation 5A 13(2) Requirement The service guide must specify the actual range of fees charged. Safe medicines practises must be ensured: Creams and lotions must be safely stored in accordance with recognised guidance to ensure they are used only for the people for whom they are prescribed (and are stored at the correct temperature). Staff responsible must ensure that where a medicine is not administered for any reason that they record the correct code to indicate the reason for its nonadministration. Eye drops must have the date of opening recorded to ensure their safe administration to people. Reports of monthly visits from the registered provider, or their representative must be produced in accordance with that stated under this regulation. This shall include for direct consultation DS0000002094.V367589.R01.S.doc Timescale for action 31/08/08 16/08/08 3. OP33 26(2)-(5) 18/08/08 Valley Lodge Nursing Home Version 5.2 Page 29 4. OP37 17(3) with service users, their representatives and persons working at the care home in order to form an opinion as to the standard of care provided in the home. Records relating to any service 31/08/08 user must always be kept up to date and properly maintained, in order to ensure accountability for practise. In this instance, medicines administration records sheets and care plans. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP3 Good Practice Recommendations (NMS OP 7 & 24 also applies here). People’s capacities and rights to make informed choices and decisions about their lives and facilities, should be accounted for within the their individual needs assessment and care planning records in accordance with the Mental Capacity Act 2005. People’s care plans should be monitored by way of regular quality checks to ensure that they always detail the action, which needs to be taken by care staff to ensure their needs are met and in accordance with relevant clinical and professional guidelines concerned with the care of older people. (In this instance, with particular attention to the prevention of falls). The outcome of the complaint made about food as recorded in the home’s complaints file in March 2008 should be detailed there. The home should continue to develop its quality monitoring systems in respect of record keeping. So as to always best demonstrate the effective and efficient running of the home and accountability for practise there. (Reference here is made to care plans, medicines records, complaints records and regulation 26 reports). DS0000002094.V367589.R01.S.doc Version 5.2 Page 30 2. OP7 3. 4. OP16 OP37 Valley Lodge Nursing Home Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Valley Lodge Nursing Home DS0000002094.V367589.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!