- Care home
The Vale Residential Care Home
All Inspections
11 January 2018
During a routine inspection
The Vale Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The Vale Residential Care Home provides care and accommodation to a maximum of 28 people. There were 24 people living at the service at the time of our inspection, some of which were living with dementia.
At the last inspection, the service was rated Good. At this inspection, we found the service remained Good.
Why the service is rated Good.
At the time of our inspection there was a manager at the service who had applied to become registered with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
There continued to be arrangements in place to keep people safe and to help safeguard people from the risk of abuse. Staff understood their responsibilities for safeguarding people from harm and followed the provider’s policy and procedure. Potential risks associated with people, the environment and equipment had been identified and managed.
People continued to receive their medicines safely. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed regularly. People were protected by the prevention and control of infection where possible. Accidents and incidents were monitored and recorded.
People’s needs and choices continued to be assessed when they started using the service. People received care that was personalised to their needs. People were supported to take part in meaningful activities which they enjoyed. People were encouraged to raise concerns or complaints and were asked for feedback about the service they received.
People continued to have access to food that they enjoyed and were able to access drinks and snacks throughout the day. People’s nutrition and hydration needs had been assessed and recorded. Staff and the kitchen team met people’s specific dietary needs and support. Staff ensured people remained as healthy as possible with support from health care professionals, if required.
Staff were seen to be kind and caring towards people. People and their relatives were involved with making decisions about care and support. People were treated with privacy and dignity.
There continued to be enough staff on duty with the right skills to meet people’s needs. Staff received the training and support that they needed to carry out their responsibilities in delivering care and support that was effective and responsive. Recruitment practices were safe and checks were carried out to make sure staff were suitable to work with people who needed care and support.
People and others were encouraged to express their views and had completed surveys. Systems were in place to monitor the quality of the service being provided to people. They were a range of checks and audits carried out to ensure the safety and quality of the service that was provided to people.
Further information is in the detailed findings below
12 November 2015.
During a routine inspection
The inspection was carried out on 12 November 2015 and was unannounced.
The home provided residential accommodation and personal care for older people living with dementia. The accommodation was provided over three floors. A lift and stair lift was provided for people to move between floors. There were 26 people living in the home when we inspected.
There was a registered manager employed at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the home is run.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Restrictions imposed on people were only considered after their ability to make individual decisions had been assessed as required under the Mental Capacity Act (2005) Code of Practice. The registered manager understood when an application should be made. Decisions people made about their care or medical treatment were dealt with lawfully and fully recorded.
Prior to this inspection we received information of concern about the management of medicines and the management of training. These concerns could not be corroborated at this inspection.
There were policies and a procedure in place for the safe administration of medicines. Staff followed these policies and had been trained to administer medicines safely.
New staff received an induction and training was on going and planned in advance. Supervisions and appraisals for staff were taking place in line with the providers policy.
We observed people who looked relaxed and safe. Relatives told us that their loved ones were well cared for and safe in the home. Staff had received training about protecting people from abuse. Staff understood their responsibilities to protect people from harm. The management team had access to and understood the safeguarding policies of the local authority and followed the safeguarding processes.
Recruitment policies were in place. Safe recruitment practices had been followed before staff started working in the home. The registered manager ensured that they employed enough staff to meet people’s assessed needs. Staffing levels were kept under constant review as people’s needs changed.
People had access to GPs and their health and wellbeing was supported by prompt referrals and access to medical care if they became unwell and additional care from community nursing teams.
The registered manager and care staff used their experience and knowledge of people’s needs to assess how they planned people’s care to maintain their safety, health and wellbeing. Risks were assessed and management plans implemented by staff to protect people from harm.
Incidents and accidents were recorded and checked by the registered manager to see what steps could be taken to prevent these happening again. The risk in the home was assessed and the steps to be taken to minimise them were understood by staff.
Managers ensured that they had planned for foreseeable emergencies, so that should they happen people’s care needs would continue to be met. The premises and equipment were maintained to keep people safe.
People and their relatives described a home that was welcoming and friendly. Staff were upbeat and happily provided friendly compassionate care and support. People were encouraged to get involved in how their care was planned and delivered. The care planning systems in the home took account of people’s independence and rights to make choices.
The registered manager involved people and relatives where appropriate in planning their care by assessing their needs and asking them about their lives and histories. This helped staff deliver care to people as individuals. After people moved into the home they were asked on a regular basis about their experiences of the care they received. Each person had a key worker and we observed that staff knew people well.
Supported by the registered manager and staff, people benefited from a highly motivated and creative activities lead who promoted individualised and group activities we observed people enjoying.
The registered manager and staff understood the challenges people faced from their dementia. They demonstrated a commitment to work with other health and social care professionals and do all they could to work through some of the issues people faced. Staff encouraged and supported people to maintain their health by ensuring people had enough to eat and drink.
If people complained they were listened to and the registered manager made changes or suggested solutions that people were happy with. The actions taken were fed back to people.
The home was well led by an experienced registered manager. The registered manager had a wider management support network so that they could keep up to date with best practice in social care. Staff and relatives told us that managers were approachable and listened to their views. The registered manager and other senior managers provided good leadership.
5 February 2014
During an inspection looking at part of the service
We found that people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were being maintained.
15 August and 12 September 2013
During a routine inspection
A pharmacist inspector visited the service and looked at how medication was managed throughout the home. There were appropriate arrangements in place to manage medicines within the home.
We looked around the home and the environment. The service had appropriately risk assessed building work that was taking place in order to protect people's safety.
We looked at how the service monitored the quality of care that it provided. We saw that audits were in place and action was taken to make improvements. We found that people and their relatives were able to contribute their ideas as to how the service was run.
We looked at care records and management records held by the service. We found that care records were not always up to date to reflect people's current needs.
7 March 2013
During a routine inspection
Staff we spoke with knew about different types of abuse and how to contact other agencies if they needed to.
Relatives of people we spoke with told us that they were pleased with the care that their relatives received. One person told us 'It is absolutely wonderful here'.
We looked at how medications were stored, dispensed and recorded. We saw that the processes in place were not appropriate for ensuring that medication was administered safely and medication was not always recorded accurately.
We saw that there was a complaints procedure available in a communal area of the home. Relatives of people we spoke with told us they were aware of the procedure but had never had a reason to make a complaint.
We looked at care records for people. We saw that some care records were not accurate and did not reflect all of people's needs.