Background to this inspection
Updated
10 November 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the home under the Care Act 2014.
This inspection took place on 17 August 2015 and was unannounced. This meant the provider did not know we were going to carry out an inspection on the day. The inspection was carried out by two adult social care inspectors, one nurse specialist advisor and two experts-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.
Prior to our inspection, we contacted seven stakeholders including the local authority joint commissioning unit, the local authority contracts team and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. Stakeholders we spoke with told us they had some concerns regarding infection control, staff training, records and medicines. This information was used so that we could check issues or concerns had been dealt with appropriately.
During our inspection we spoke with nine people who lived at the home and five of their relatives to obtain their views of the support provided. We spoke with 11 members of staff, which included the home manager, a registered nurse, care assistants and domestic staff.
We looked at documents including the care records of five people who lived at the home and the personnel records of five staff members including a nurse, a senior and three care assistants. We also looked at records relating to the management and monitoring of the home, including any audits carried out and reviews of care documents and policies.
Updated
10 November 2015
We carried out this inspection on 17 August 2015 and it was an unannounced inspection. This meant the provider did not know we were going to carry out the inspection. At the last full inspection carried out in July 2013, we found the home to be compliant with the regulations we inspected at the time.
Valley Park Care Home is registered to provide residential nursing accommodation for older people, including those living with dementia, for up to 57 people. The ground floor was a residential unit and the first floor was a nursing unit. The home is located in Wombwell, Barnsley and situated within landscaped gardens shared with two other care homes owned by Mimosa Healthcare. On the day of our inspection, there were 39 people living at the home, some who were living with dementia.
It is a condition of registration with the Care Quality Commission that the home has a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run. On the day of our inspection, the person managing the home was not registered as the ‘registered manager’ with CQC. The home manager and service manager confirmed that the home manager would register with CQC and we were made aware of the reasons for the delays in this taking place.
People and their relatives told us they felt the home was mostly safe but that there were some concerns with staffing levels. Comments made included; “I feel like [family member] is safe. I’ve never really had a reason to think they are not”, “ When a [care worker] goes off sick, the others are pulled out trying to see to everybody” and “ I can’t say it’s not safe, but when they’re short staffed these carers are rushing around and working even harder to get all the [people who lived at the home] sorted.”
The home followed safeguarding procedures and concerns and alerts were investigated and responded to. Some care records contained personalised and relevant information for staff to assist in providing personalised care and support, though others didn’t. Risk assessments and care plans were not always reviewed on a regular basis.
Staffing levels were, at times, too low to safely meet the needs of people who lived at the home. Some people who lived at the home, their relatives and staff members told us there were times when care assistants and nurses were stretched for time and could not meet people’s needs in a timely manner.
Medicines were not safely stored at the home, with temperatures in the treatment room, where medicines were stored, regularly exceeding the required 25C level. Some topical medicines, such as creams, were stored in people’s rooms, where no temperature checks were carried out to ensure they were stored safely.
There were no activities taking place on the day of our inspection and people who lived at the home and their relatives told us that this was the usual case. We spoke with the newly appointed activities co-ordinator, who walked around the home throughout the day and spoke with people to ask them what sort of activities they would like to take place at the home. The activities co-ordinator had lots of ideas on how to stimulate people, build relationships and enable people to avoid social isolation. We will check activities during our next inspection.
Staff told us they felt supported. However, we found staff supervisions and appraisals were not carried out on a regular basis. Training updates were not provided regularly and many of the staff members who worked at the home were out of date with their training requirements.
We found good practice in relation to decision making processes at the home, in line with the Mental Capacity code of practice, the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards, although staff knowledge in this area was limited.
Checks of the home and fire safety were carried out regularly. Regular audits took place at the home although action plans were not developed from these to evidence action was taken with any concerns or issues identified. There was no trend analysis carried out on accidents, incidents or complaints to identify any patterns that could assist with service improvement. There was a lack of regular meetings for people who lived at the home, their relatives and staff members. These meetings and the involvement of others would be useful in developing the service provided at the home.
We found breaches in three regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in; Regulation 12; Safe care and treatment, Regulation 17; Good governance; and Regulation 18; Staffing.
You can see what action we told the provider to take at the back of the full version of the report.