Vale Court Care Home

Updated 14 October 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors.

Service and service type

Vale Court is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Vale Court is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

This inspection was unannounced on the first 2 dates and announced on the third date.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 12 members of staff including the nominated individual, registered manager, unit managers, registered nurses, senior care workers, carers and ancillary staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included 7 people’s care records, risk assessments and medication records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

We spoke with 5 residents and 4 relatives about their experience of the care received. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 14 October 2023

About the service

Vale Court is a residential care home providing nursing care to up to 59 people. The service provides support to older people and those living with dementia in one purpose-built building. At the time of our inspection there were 58 people using the service.

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

The governance of the service was not always effective. For example, people at risk of dehydration did not have their intake of fluids recorded accurately despite new recording systems being introduced a few months prior to our visit. This meant the service could not always evidence effective oversight to ensure people were not at risk.

Auditing systems had not identified safeguarding events and as a result been reported to other agencies for investigation. The provider responded by introducing new systems and safeguards to ensure this did not re-occur and had sent notifications to CQC retrospectively.

Daily records were not always specific for those living with dementia. Records made reference to “distraction techniques” in order to reduce distress in individuals yet there was no indication as to what these involved. Records also made reference to people being “non-compliant” in their support which did not take their dementia experience into account. Staff outlined recent dementia training had been received which the registered manager considered had been beneficial to better understand people.

People appeared to be safe and relaxed with the staff team. Nursing and senior care staff were clear about the processes they need to follow to escalate any safeguarding events to the registered manager.

Medication systems were safe with people receiving their medications in a timely manner. Recruitment processes were robust and staff were available to attend to the needs of people.

The building was well maintained, clean and hygienic throughout. 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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 27 July 2018).

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding incidents. A decision was made for us to inspect and examine those risks.

You can see what action we have asked the provider to take at the end of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence the provider needs to make improvements. Please see the safe and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Vale Court on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to governance systems at this inspection. We have made recommendations in relation to the provider sustaining new systems put into place for ensuring people are protected from abuse, monitoring where there are many conditions placed onto deprivation of liberty orders and in building staff knowledge in the needs of those living with dementia.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk