Background to this inspection
Updated
28 August 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was completed by an inspector from the Care Quality Commission (CQC).
Service and service type:
Lady of the Vale 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.
At the time of this inspection, the service had a manager registered with the CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
The inspection was unannounced which meant the service did not know we were coming.
What we did before inspection:
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. No serious concerns were shared with us.
During the inspection:
We spoke with five people who lived at the home and two visiting relatives, to understand their experience of the care provided. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We spoke with seven members of staff including the deputy manager, regional manager, the clinical lead nurse, a nurse, and care assistants.
We reviewed a range of records. This included five care plans and associated documentation. We looked at three staff files in relation to recruitment and five to review staff supervision records. Multiple records relating to the management of the service and a variety of policies and procedures were reviewed during the inspection.
After the inspection:
We asked the regional manager to provide supplementary evidence for governance and quality assurance. This was reviewed as part of the inspection.
Updated
28 August 2019
About the service:
Order of The Sisters of St Joseph of The Apparition, known as and referred to in this report as 'Lady of the Vale' is a nursing home registered to accommodate up to 39 older people. At the time of this inspection, 36 people lived at the home. Accommodation is over two floors accessible by two passenger lifts, one of which is suitable for wheelchairs.
People’s experience of using this service and what we found:
People living at Lady of the Vale, and their visiting relatives, told us they considered the home be a safe and welcoming place to live.
People were positive about the way in which staff supported them and they told us staff were kind and caring.
Since our last inspection, a rarely used lounge on the ground floor had been converted into an additional dining room. The conversion had been completed to a high standard and was well presented.
There was signage around the building to help people with dementia and memory loss find their way around. People had personalised 'memory boxes' on the wall outside their own bedrooms. This helped to remind people where their bedroom was located.
The home benefited from large well-maintained gardens that were accessible for wheelchair users and people with limited mobility.
People were supported to maintain a balanced and varied diet that met their nutritional requirements. The mealtime experience was unhurried, relaxed and people received the right amount of support in a timely way. Food was home cooked and people were offered a variety of choices.
Systems for the safe management of medicines were operated effectively. This included protocols for the receipt, storage, administration and disposal of medicines.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The home had a regular programme of resident and relatives’ meetings that were held throughout the year. Minutes of meetings demonstrated people were encouraged and supported to attend and participate.
We looked at how staff recognised and responded to the needs of people from different backgrounds. We found improvements were needed to ensure a consistent approach to equality and diversity. We have made a recommendation about this in the 'caring' section of the full report.
The home had a varied programme of weekly activities and various events were held throughout the year. However, feedback from people indicated there was distinct lack of activities taking place out in the wider community. We have made a recommendation about this in the 'responsive' section of the full report.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection:
The last rating for this service was requires improvement (published 20 June 2018) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up:
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.