Archived: The Vale Care Home

Updated 23 January 2020

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

One inspector, an inspection manager 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.

Service and service type

The Vale 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 service had a manager registered with the Care Quality Commission. 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

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We sought feedback from the local authority and professionals who work with the service. We also reviewed data we had received about the service. We used all of this information to plan our inspection.

During the inspection-

During the inspection we spoke with six people and three relatives to ask about their experience of the care provided. Some people were unable to tell us their experience of their life in the home, so we observed how the staff interacted with people in communal areas.

We spoke with five staff members, a member of the domestic team, the cook, three care staff, a senior, a training nurse and agency nurse. We also spoke with the registered manager and the area manager who was present for the feedback.

We reviewed a range of records. This included five people's care and medicine records. We also reviewed the process used for staff recruitment, various records relating to the management of the home and other procedures developed and implemented by the provider.

After the inspection –

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 23 January 2020

About the service

The Vale care home is a care home providing personal and nursing care to 35 people aged 65 and over at the time of the inspection. The service can support up to 40 people. The home is set over two floors with communal spaces on each level. There were also bathing and bedrooms on each floor. There was an accessible garden.

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

People and staff felt there was not an open culture at the service. All the staff reflected on the registered manager not being a visual part of the home. Staff did not always feel supported and had not received supervision. Audits had been completed, however these had not always reflected in actions being taken to address errors or drive improvements.

There was not always enough staff to support people’s needs. We found some errors in the recording of medicines which raised concerns to the administration being done correctly. People’s dignity was not always respected, and this had an impact on their needs and well-being. For some people this also impacted on their independence.

Staff understood the importance of safeguarding people from harm and had investigated any which were raised. However, the staff had not raised concerns in relation to verbal or physical aggression which had occurred, so they could be investigated. Some lessons had been learnt, however other lessons in relation to people’s behaviour had not always been addressed.

The meal experience was chaotic and did not always encourage independence. Staff had received mandatory training, however there was no training for people’s specific conditions, which could impact on the care they required. There was limited signage around the home to support people who may have a cognitive impairment and require support to orientate themselves.

Care plans had been completed and included people’s preferences and needs. However, for some people these wishes had not been provided due to lack of equipment or changes in people’s needs. Activities or stimulation had been restricted by the staff member in this role being diverted to support care needs. Information was not always provided in formats to support peoples understanding and verbal concerns had not always been recorded to show how they had been addressed.

The provider had completed risk assessments for people and there was detailed guidance available for staff which we saw was followed. Staff maintained good standards in hygiene to reduce the risk of infection. Staff had been recruited safely.

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.

People had received support with their health care needs and staff had raised referrals when people’s needs required additional support or guidance. Family and friends were made welcome to the home.

People and relatives told us the staff were friendly and caring. We saw how relationships had been developed and these made a real difference to the support people received.

The provider worked in partnership with health and social care professionals. We saw the home had displayed their rating on site and on their website. Overall, we had received notifications to events at the home, however we reminded the registered manager to ensure all areas were reported.

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 Good (27 April 2017)

At this inspection we found improvements were required and the rating had deteriorated to Requires Improvement with four regulation breaches. You can see the action we have asked the provider to take at the end of the report.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.