Valerie Manor

Updated 27 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is 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 service under the Care Act 2014.

The inspection took place on 15 and 16 August 2017 and was unannounced.

One inspector and an expert by experience undertook this inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We checked the information that we held about the service and the service provider. This included previous inspection reports and statutory notifications sent to us by the registered manager about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We used all this information to decide which areas to focus on during our inspection.

We observed care and spoke with people and staff. We spent time looking at records including five care records, three staff files, medication administration record (MAR) sheets, staff rotas, the staff training plan and other records relating to the management of the service.

On the day of our inspection, we met with nine people living at the service and spoke with seven relatives. We chatted with people and observed them as they engaged with their day-to-day tasks and activities. We spoke with a relative of the registered manager (who helped with activities), registered manager, the office manager, the deputy manager, the head chef, three registered nurses, the head of residential care, a care supervisor and a laundry assistant. We also spoke with the pharmacist who supplied medicines to the home, a visiting member of the clergy and a counsellor/supervisor.

Following the inspection, we received written feedback about the home from the pharmacist who we met at inspection, a GP, a nun from the local convent, an avoidance admissions matron and a hairdresser. All these people agreed their comments could be used as part of this report.

The service was last inspected on 1 and 3 July 2015. The service was published ‘Outstanding’ following that inspection.

Updated 27 October 2017

The inspection took place on 15 and 16 August 2017 and was unannounced.

Valerie Manor is a residential nursing home, registered to provide nursing care and accommodation for up to 23 people with a range of health and care needs, including physical frailty of old age and some people in the early stages of dementia. At the time of our inspection, the home was fully occupied. Valerie Manor is a 17th Century house with a purpose built nursing wing set within 1.4 acres of beautifully landscaped accessible gardens. All accommodation is on the ground floor. To access the nursing wing, there are a few steps and an open platform lift. Rooms in the nursing wing have en-suite facilities and overhead tracked hoists. Communal areas include a conservatory/living room, dining room, quiet lounge or snug and a library.

A registered manager was in post. 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.

Ensuring that people were and felt safe at Valerie Manor was of paramount importance. People were asked what would make them feel safe and actions were taken as needed. Safety was discussed at residents’ meetings and through annual surveys with people and their relatives. Staff had completed training in safeguarding and knew how to report any concerns. Some staff had received additional training to become champions in this field and provided expert advice and guidance to staff. Risks to people and premises were managed in a way that minimised and mitigated risks. Staff went out of their way to think of solutions when incidents happened, to prevent the risk of reoccurrence. People and staff felt there were sufficient staff to keep people safe and there were enough staff so they had quality time with people. Medicines were managed safely. A pharmacist worked closely with the home and commented very positively about the relationship they had with the home and of the pro-active approach to medicines management. People’s medicines were reviewed annually by their GP. Valerie Manor was spotlessly clean and maintained to a high standard.

As well as completing training in a range of mandatory areas, staff were supported through supervisions and team meetings. Reflective practice took place and this enabled staff to explore different ways of working and how improvements might be made in relation to providing effective care. Consent was gained in line with the legislation of the Mental Capacity Act 2005 and associated legislation, Deprivation of Liberty Safeguards. People felt actively involved in decisions relating to their care and the registered manager worked closely with people and their families to ensure they were listened to. The quality of the food on offer at the home was of an exceptionally high standard. People had a range of choices from menus which they helped to plan at residents’ meetings. Special social events were organised where people, relatives and staff could sample different types of foods which the catering staff had prepared. This enabled the head chef to provide a menu that met people’s likes and preferences. People had prompt access to a range of healthcare professionals and services. Healthcare professionals spoke highly of the care provided and said that their advice and guidance were followed by staff. People were involved in decisions relating to the environment; their views were acted upon and the home reflected people's choices.

The care provided at Valerie Manor was exemplary and this included the care that people received at the end of their life. Staff were dedicated and passionate about providing a high standard of quality care. They knew people well and nothing was too much trouble to ensure people had a full and meaningful life. People and relatives commented on the excellent care provided and the empathy that staff had with people and their relatives. People and their relatives were involved in all aspects of their care and were treated with dignity and respect by staff. Staff were sensitive to people’s needs and provided a high level of support to people and their relatives during difficult times and through bereavement. Staff had access to a qualified counsellor who could provide additional support during emotional times, whether professional or personal.

The care provided at Valerie Manor was completely responsive to people’s needs and wishes. Staff knew people extremely well and provided personalised care. Staff had time to listen to people and ensure that the care they provided was appropriate, discreet and respected people’s privacy. Care plans provided detailed information and guidance to staff and included people’s life stories and histories. It was clear that staff knew people and their families extremely well and had meaningful conversations with people. Activities were provided at the home and a range of external entertainers visited too. Outings were available into the community if people wished. People enjoyed the beautifully landscaped gardens and there were places where they could sit with their families and/or staff. People in the community also visited the home and provided entertainment for people which was enjoyed. Complaints were managed in line with the provider’s policy.

People spoke highly of the care provided at Valerie Manor and of the talented, skilled and professional staff, including the management team. People felt actively involved in all aspects of developing the home through residents’ meetings and provided feedback through annual surveys. Staff felt valued by the managers and spoke positively of the support they received which enabled them to do their jobs well. Staff said how much they enjoyed working at the home and of the family feel and pleasant surroundings. Staff were asked for their views through formal surveys and their suggestions were listened to and actioned if appropriate. The home worked in partnership with other agencies and had forged relationships with people in the local community. A range of detailed audits measured and monitored the quality of the care delivered and the service overall. This ensured that people received the best of care and that any improvements identified could be acted upon. Continuous improvement was at the heart of the home and people were central to every aspect of how the home was run. People and their relatives were effusive in their comments about the environment, the staff, the care and of the overwhelming passion for the home demonstrated by the owners and managers. Valerie Manor and its staff were held in high esteem and had developed an outstanding reputation to deliver high quality care.