Background to this inspection
Updated
3 April 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 carried out by three inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. They specialised in dementia care.
Service and service type: This service 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 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.
What we did: Before the inspection we checked information, we held about the service. This included notifications the provider had sent us about events or incidents that occurred and which affected their service or the people who used it. We contacted the local authority’s adult safeguarding, commissioning and quality monitoring team as well as Healthwatch England, the national consumer champion for health and social care, to ask if they had any information to share. We used this information to help plan our inspection.
Some people who used the service were unable to tell us about their experiences. 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. During the inspection, we spoke with 15 people who used the service and 10 relatives to ask about their experience of the care provided. We also spoke with the registered manager, the deputy manager, a registered manager from another of the provider’s services, a nurse, a nursing assistant, two senior and two care workers, the cook, activity person, housekeeping staff and two visiting professionals.
We looked at a range of documentation such as care files and medication records for 20 people. We looked at other records for the management of the service such as recruitment, staff training, surveys and systems for monitoring quality.
Following the inspection, we received confirmation from the provider's representative they had created and implemented a record for staff to document communications with the dispensing pharmacy in relation to out of stock medicines.
Updated
3 April 2019
About the service: The Valleys Care Home is registered to provide nursing and personal care to 84 older people, including people living with dementia. The service was supporting 63 people at the time of our inspection.
People’s experience of using this service: People did not always receive a service that provided them with safe care. The management of some people’s medicine was not safe. Staff did not consistently follow good infection prevention and control practices to maintain adequate standards of hygiene.
The provider used a range of audits to check quality and safety. There had not been consistent oversight to ensure all improvements were identified and made to the quality of the service people received. We recommend the provider implement a reliable and effective quality monitoring system.
Staff were safely recruited and enough staff were deployed to meet people’s needs. Staff had been trained to respond to safeguarding concerns. The registered manager was proactive investigating and responding to concerns to keep people safe. The service had taken action to address recommendations made.
A new electronic recording system for accidents and incidents had been put in place which showed action was taken to reduce risk when issues occurred. The management team were analysing the information to look for trends and patterns and there had been a reduction in the number of falls in recent months.
Care was planned around people’s choices and preferred routines. People and their relatives were supported to receive information in an accessible way to enable them to be involved in their care and support.
Staff were trained and their skills and knowledge checked through competency assessments. Staff worked closely with healthcare professionals and sought their advice, guidance and support on how to best meet people’s needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People told us they felt safe and well cared for and staff afforded them respect and dignity. People were supported to maintain their independence and they accessed local facilities and activities.
Recent changes to the management of the home had been positive and resulted in better and consistent care being provided. Staff told us the registered manager was supportive and approachable. People knew the registered manager and told us they trusted them.
People and relatives had the opportunity to provide feedback about the service and there was a system to respond to any complaints.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection: At the last inspection the service was rated Good (report published 8 February 2017).
Why we inspected: This inspection was brought forward in response to incidents that had occurred in the service and concerns that had been raised about the safety and management of the service. At the time of the inspection we were aware of incidents being investigated by another agency.
We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 around safe care and treatment. Details of action we have asked the provider to take can be found at the end of this report.
Follow up: We will continue to monitor this service and inspect in line with our re-inspection schedule or sooner if we receive information of concern.