Vale Court Care Home

About the service

Vale Court is a residential care home providing nursing care to up to 59 people. The service provides support to older people and those living with dementia in one purpose-built building. At the time of our inspection there were 58 people using the service.

People’s experience of using this service and what we found.

The governance of the service was not always effective. For example, people at risk of dehydration did not have their intake of fluids recorded accurately despite new recording systems being introduced a few months prior to our visit. This meant the service could not always evidence effective oversight to ensure people were not at risk.

Auditing systems had not identified safeguarding events and as a result been reported to other agencies for investigation. The provider responded by introducing new systems and safeguards to ensure this did not re-occur and had sent notifications to CQC retrospectively.

Daily records were not always specific for those living with dementia. Records made reference to “distraction techniques” in order to reduce distress in individuals yet there was no indication as to what these involved. Records also made reference to people being “non-compliant” in their support which did not take their dementia experience into account. Staff outlined recent dementia training had been received which the registered manager considered had been beneficial to better understand people.

People appeared to be safe and relaxed with the staff team. Nursing and senior care staff were clear about the processes they need to follow to escalate any safeguarding events to the registered manager.

Medication systems were safe with people receiving their medications in a timely manner. Recruitment processes were robust and staff were available to attend to the needs of people.

The building was well maintained, clean and hygienic throughout. 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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 27 July 2018).

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding incidents. A decision was made for us to inspect and examine those risks.

You can see what action we have asked the provider to take at the end of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence the provider needs to make improvements. Please see the safe and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Vale Court on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to governance systems at this inspection. We have made recommendations in relation to the provider sustaining new systems put into place for ensuring people are protected from abuse, monitoring where there are many conditions placed onto deprivation of liberty orders and in building staff knowledge in the needs of those living with dementia.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We found the following examples of good practice.

Systems were in place to screen visitors for symptoms of Covid-19. Relatives confirmed they were required to wear facemasks when visiting their loved ones. When face to face visits couldn’t be supported, people kept in touch with friends and family using video and phone calls.

People were supported to self isolate upon admission to Vale Court. Staff described how they provided additional support during this time to ensure people’s emotional and nutritional needs were met. One person told us they had chosen to shield within the home and confirmed they felt well cared for and had access to everything they needed.

Staff wore appropriate personal protective equipment (PPE) and confirmed they had access to adequate supplies. Staff were also able to describe what PPE had to be worn and under what circumstance. People receiving care and relatives also confirmed staff wore PPE.

People living at the service and staff members had access to regular Covid-19 testing.

The registered manager had ensured staff were deployed to work in designated parts of the home. This helped to protect people from the risk of infection.

Vale Court had appointed infection control leads. Their role was to undertake daily health checks on staff and to share any changes in local or national guidance with their colleagues.

Further information is in the detailed findings below.

Vale Court is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and we reviewed both areas during this inspection.

This is the first time this service has been inspected under the new registered provider.

Vale Court is a modern purpose-built two storey home situated in the Whitby area of Ellesmere Port close to the town centre. The home provides care for older and for younger adults with a physical disability over two floors and is registered to take up to 57 people. People living on the ground floor are living with dementia whilst people living on the first floor require support with nursing needs. At the time of our inspection there were 56 people living in the home.

The service has had a registered manager in post since 2012. 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.

Individual risks to people living in the home were accurately assessed and reviewed regularly with measures in place to manage the risks identified and keep people safe from harm.

Staff were aware of different types of abuse and how to report safeguarding incidents. Those that were reported had been done so appropriately. Staff had received appropriate training in safeguarding and were able to explain how to keep people safe from abuse - Staff were also aware of the whistleblowing policy.

Staff had received training in areas such as infection control, health and safety and manual handling. Appropriate infection control measures were in place and the safety of the environment was checked on a regular basis.

Accidents and incidents were reported and recorded appropriately. They showed evidence of analysis, review and action taken where needed.

Medicines were managed and stored safely and staff had received appropriate training in order to safely administered medication. Those responsible for administering medication had their competency levels assessed regularly.

Sufficient staff were deployed to meet the needs of the people living in Vale Court.

Consent for care was obtained in accordance with the Mental Capacity Act 2005; staff showed a good awareness of the need to obtain consent when providing care and support.

Staff had received training appropriate to their roles and were supported through regular supervision.

People’s nutritional needs were assessed and met to ensure they maintained a health balanced diet; care plans clearly identified people with specific dietary requirements and provided guidance for staff to manage this.

People were supported with access to other health and social care professionals such as GP, podiatrist, opticians and wound specialists.

People receive care and support specific to their needs; care plans were person centred and provided detailed information for staff to know the people they were supporting.

Whilst people were provided with a range of activities, the registered provider told us they had plans to improve on the quality of activities offered to people in the home.

The quality and safety of the service was regularly monitored with the use of effective audits and checks completed by the registered manager.

The registered manager notified CQC of important incidents and events that occurred within the home.