Archived: Sutton Valence Care Home

Sutton Valence Care Home is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Sutton Valence Care Home is registered to provide accommodation and personal care for up to 67 people. There were 67 people living there on the day of the inspection.

Many people living at the service had complex nursing care needs and required help with all aspects of their care. Others who needed nursing care on a daily basis were encouraged to lead as independent a life as possible within the service and around the local community.

The service was arranged into three units; each unit being led by a registered nurse with a team of care staff to support the needs of people. The team was further supported by a domestic worker every day to make sure the unit was kept clean.

At our last inspection we rated the service as Good. At this inspection, we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

People told us they felt safe living at Sutton Valence Care Home. Registered nurses assessed people’s needs and identified risks, putting measures in place to manage these safely. We spoke to staff who told us how they kept people safe. They understood their responsibilities in ensuring people were safe from abuse and their role in reporting any concerns they had.

Accidents and incidents, including safeguarding matters were recorded, investigated and reported in a timely manner to the local authority or CQC as necessary.

There were enough staff employed to be able to provide the nursing and personal care people had been assessed as needing. Staff were recruited safely and recruitment processes were robust. Staff training was up to date, and the team had a mix of skills, knowledge and experience. Staff had opportunities to enhance their skills and knowledge and all were qualified in health and social care.

The management team supported staff through supervision and appraisals which were held regularly and recorded. Competency checks were carried out to ensure staff remained competent in their role.

People’s medicines were administered safely and when they needed them. Policies and procedures were in place so that people took their medicines when needed. People were supported to remain as healthy as possible and they had been given access to specialist healthcare professionals who could support them.

People had access to the food and drink that they enjoyed. People were supported to choose what they wanted to eat. Peoples nutrition and hydration needs had been assessed and recorded.

People and their relatives said the staff had a caring approach and looked after them well. There was a calm and relaxed ambience and the staff were friendly and happy to chat. People appeared comfortable and were not calling out for assistance, everyone looked well cared for. There were good examples of people being treated with dignity and respect.

People were central to the support they received. Care and support was planned with people and their relatives and reviewed to make sure people continued to have the support that they needed. People were encouraged to be as independent as possible.

People took part in activities of their choice within the service and in the local community. People could choose what they wanted to do each day. There were enough staff to support people to participate in the activities they chose.

Processes were in place to monitor the quality and they regularly asked people for feedback about the service.

Complaints were investigated and responded to well as were accidents and incidents. The registered manager and the provider took the opportunity to learn from complaints received and incidents that had happened to be able to improve the service provided.

People, their relatives and the staff thought the service was well run and the management team were approachable and supportive. Many people said the registered manager had an ‘open door’ policy, inviting people to speak to her at any time. Positive feedback was also received about the registered nurses and the leadership of their teams, making sure people got good proactive care.

Further information is in the detailed findings below.

Sutton Valence Care Home is registered to provide nursing and personal care services for up to 67 people. There were 63 people living at the home on the day of our inspection.

Many people living at the home had complex nursing care needs and required help with all aspects of their care. Others who needed nursing care on a daily basis were encouraged to lead as independent a life as possible within the home and around the local community.

The home was arranged into three units, each unit being led by a registered nurse with a team of care staff to support the needs of people. The team was further supported by a domestic worker every day to make sure the unit was kept clean.

There was a registered manager employed. 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. A deputy manager was also employed to support the registered manager in their role.

The home had a pleasant atmosphere with good facilities. A number of seating areas and lounges of varying sizes meant people had a choice of where to sit. A large conservatory overlooking the village cricket ground was a bright and airy room and had the benefit of having had new air conditioning installed, making it pleasant at any time of the year. A family room with kitchen and sleeping facilities provided was available for loved ones to stay if people were ill.

People and their relatives told us they felt safe living at the home. They knew who they would speak to if they were worried about anything and were confident they would be listened to. Registered nurses assessed people’s needs and identified risks, putting measures in place to manage these safely. We spoke to staff who were able to tell us how they kept people safe. They understood their responsibilities in ensuring people were safe from abuse and their role in reporting any concerns they had.

There were suitable numbers of staff to be able to provide the nursing and personal care people had been assessed as needing. Registered nurses were employed to provide the professional expertise required to respond to people’s often complex care needs. Care staff were not expected to undertake cleaning or cooking duties as experienced chefs and domestic staff were employed. This meant care staff could concentrate on providing the care people required. Safe recruitment methods had been used when employing new staff to make sure only suitable staff were employed to work with people.

A training plan was in place and all staff received the training they required to carry out their role well. The registered nurses were supported by the provider to undertake training to ensure their professional development was a priority in order to keep their registration up to date.

People’s medicines were managed by registered nurses who used their professional expertise and training to ensure safe practices were used. Close liaison with health care professionals took place making sure people got the health advice and treatment they needed promptly.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. The manager had taken steps to comply with the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Restrictions imposed on people were only considered after their ability to make individual decisions had been assessed as required under the Mental Capacity Act (2005) Code of Practice. People were not being restricted and their rights were being protected.

People and their relatives said the staff had a caring approach and looked after them well. There was a calm and relaxed ambience and the staff were friendly and happy to chat. People appeared comfortable and were not calling out for assistance, everyone looked well cared for. There were good examples of people being treated with dignity and respect.

People’s nursing and care needs were assessed before moving into the home by registered nurses to ensure they were able to cater for their individual needs. Following assessment, the registered nurses developed a care plan to record how to provide person centred care, taking into account people’s individual preferences and choices.

Three activities coordinators planned a range of interesting activities for people to take part in if they chose. These were planned ahead and people were given information so they were able to decide what they might like to join in. Those who were ill and being nursed in bed were visited by the activities coordinators to help prevent social isolation.

Complaints were investigated and responded to well as were accidents and incidents. The registered manager and the provider took the opportunity to learn from complaints received and incidents that had happened to be able to improve the service provided.

Surveys were carried out each year to gain the views of people, their relatives and staff. The provider carried out an analysis of the results to provide feedback and to make improvements where necessary.

People, their relatives and the staff thought the home was well run and the manager was approachable and supportive. Many people said the registered manager had an ‘open door’ policy, inviting people to speak to her at any time. Positive feedback was also received about the registered nurses and the leadership of their teams, making sure people got good proactive care.

We saw that people appeared relaxed and comfortable, and many people waved or greeted us as we went into lounge areas or went past their bedroom doors. The home had a friendly atmosphere, and visitors were made to feel welcome.

We found that the staff carried out suitably detailed discussions with people during the admission process to provide them with relevant information, and to obtain their consent to different aspects of care and treatment.

We saw that care planning documentation contained appropriate information to enable staff to give effective care.

The home provided people with a variety of activities and entertainment, and encouraged people to follow their individual lifestyle preferences.

The manager and staff demonstrated a sound understanding of how to protect people from different forms of abuse.

We found that the home had reliable procedures in place for providing people with their medication.

All of the staff that we talked with spoke positively about the home, and said they felt supported in their job roles.

People's views were taken into account, and action was taken to improve the home where this was an appropriate response to their concerns.

The inspection was carried out by one Inspector over two hours. The home had a new manager in post, and she was present on the day of the visit. We provided her with feedback at the end of the inspection.

During the visit we talked with staff, viewed care plans and daily records, and viewed complaints logs. We also talked briefly with several people living in the home.

We found satisfactory evidence to show that the two areas of concern had been addressed appropriately.

At our last visit, we had found six standards which were not being met by the home. The home provided us with an action plan, stating that these would be met by the end of July 2012. We carried out this visit to follow up these standards and to see if the home was now compliant. During the course of our visit we found concerns in regards to managing complaints and record-keeping. We inspected these standards in addition to those which we were following up.

We visited all areas of the home, and talked with nine people in communal areas, and in their own rooms. We also talked with five relatives or visitors, and with seven staff.

People mostly spoke positively about the home. However, some people felt that concerns they had raised had not been fully addressed.

Comments from people living in the home included:

'The staff are 'tip-top'.'

'The staff are very helpful. I have been here for a few months now, and I feel quite settled here.'

'There are lots of things to do, but I only join in with things if I feel like it.'

'I have lived here for two years, and I could not wish for a better place.'

'I do not usually have to wait a long time to have my bell answered, I ring it and they come. But they are sometimes slower at night.'