18 December 2019
During a routine inspection
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.