CQC report explained · a nursing home
What the CQC found at Vale House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, good safeguarding arrangements, appropriate risk checks, safe medicines management and effective infection control.
- Effective?
- Good
- This was not assessed during this focused inspection. The previous rating was used in calculating the overall rating.
- Caring?
- Good
- This was not assessed during this focused inspection. The previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This was not assessed during this focused inspection. The previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found clearer management arrangements, better quality assurance, improved electronic care records and stronger oversight from the trustees and registered manager.
What inspectors found, August 2021
Rated Good; inspectors found safe care and strong improvements in medicines management, records and leadership.
This was an unannounced focused inspection on 1 and 7 July 2021. Inspectors looked mainly at whether the home was safe and well-led. They spoke with people, relatives, staff and healthcare professionals, and checked care records, medicines records and the home.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safe recruitment, suitable infection control measures and medicines being given and recorded correctly. Staff understood safeguarding, risks and what to do when something went wrong.
The home had made significant improvements since its previous inspection, when it was rated Requires Improvement and breached Regulation 17 on good governance. Quality checks, care records and management oversight had improved, and the home was no longer in breach.
This inspection did not reassess Effective, Caring or Responsive. Their previous ratings were carried forward when calculating the overall Good rating.
Medicines were safer
Earlier problems with recording prescribed creams and lotions had been addressed. Inspectors saw medicines being given as prescribed and recorded accurately.
“At this inspection, improvements had been made around the management of topical medicines and people received their medicines as prescribed.” from the report
Enough staff
Inspectors saw people attended to promptly and staff did not appear rushed. Staffing levels were reviewed as people's needs changed.
“The service had enough staff to meet people's needs. We saw people were attended to in a timely manner and staff were not rushed.” from the report
Better quality checks
The home had introduced electronic records and more effective audits. These gave managers better oversight of care, medicines and safety checks.
“The provider's quality assurance systems had significantly improved.” from the report
Supportive leadership
Relatives, staff and healthcare professionals gave positive feedback about the management. Inspectors found clear roles and good teamwork.
“There was a clear management and staffing structure and staff were aware of their roles and responsibilities.” from the report
Infection control
Inspectors were assured that the home had suitable arrangements for visitors, testing, personal protective equipment, isolation and managing outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you now check that topical medicines, such as creams and lotions, are recorded correctly every time?
- 02How are the electronic care records and real-time audits checked to make sure they remain accurate and up to date?
- 03How do staff record checks on people who remain in bed and cannot use the call bell?
- 04What are the current staffing levels, and how often do you use agency staff?
- 05What were the ratings for Effective, Caring and Responsive at the last comprehensive inspection, and what has changed since then?
This was an unannounced focused inspection of Safe and Well-led following an earlier breach; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 6 August 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2021
Rated Requires Improvement; inspectors found caring staff and good infection control, but medicines records and quality checks were not reliable.
This was a focused inspection of the home’s Safe and Well-led areas. The inspection visit took place on 15 January 2021, with other inspection activity between 13 January and 9 February 2021. Inspectors reviewed care and medicines records, recruitment files, management records and infection control arrangements. They also spoke with relatives and staff.
People were supported by enough staff who understood their needs. Relatives said people were safe, and inspectors found effective infection prevention and control systems. Staff followed people’s risk plans in most cases, and inspectors saw medicines being given as prescribed.
However, records did not always show that prescribed creams had been applied. Checks on staff medicines competence were not regular, and one person’s welfare checks had not been included in a new monitoring system. The home’s own quality checks had failed to identify these problems and other training shortfalls.
The overall rating remains Requires Improvement, as do Safe and Well-led. The home has had this rating for the last three inspections. There was no evidence that anyone had been harmed, but the provider was still in breach of Regulation 17 and received a warning notice.
Enough knowledgeable staff
Inspectors found that staffing levels were being achieved. Staff knew people’s needs and had time to spend with them.
“People were supported by sufficient staff who were knowledgeable about their needs and had time to spend with them.” from the report
Infection control
Inspectors were assured that the home had measures covering visitors, distancing, protective equipment, testing, hygiene and managing outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Working with professionals
Records showed that the home sought advice and made referrals promptly to support people’s care needs.
“Advice was sought, and referrals were made in a timely manner which ensured there was continuity of care.” from the report
Medicines records and checks
seriousElectronic records did not clearly show whether prescribed creams had been applied. Regular checks of staff competence in giving medicines were also not in place.
“We found no evidence that people had been harmed however, systems were either not in place or robust enough to demonstrate risks in relation to medicines were identified and mitigated.” from the report
Quality checks missed problems
seriousThe home’s audits did not identify concerns about medicines recording, welfare checks or staff competence. Manual handling training was also not up to date.
“The provider's quality assurance systems had not identified these shortfalls.” from the report
Welfare checks
needs fixingA new monitoring system had not included routine checks needed by one person. The manager acted during the inspection to reduce this risk.
“We found no evidence during this inspection that this person had experienced harm from this concern.” from the report
- 01How do you now check that prescribed creams and other medicines have been recorded correctly?
- 02How often are staff’s medicines administration competencies checked, and what happens if a staff member is not competent?
- 03How are routine welfare checks recorded and audited for every resident who needs them?
- 04What action has been taken to make sure manual handling training is up to date?
- 05What progress has been made on the action plan following the warning notice for Regulation 17?
This was a focused inspection of Safe and Well-led only; the other key question ratings from the previous comprehensive inspection were carried forward. This explanation was written from the published report of 16 March 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Vale House
5 rated inspections over 5 years: the service has slipped, from Outstanding to Good.
- August 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- December 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- November 2018Requires improvementdown from OutstandingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2016OutstandingSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Good
- July 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- February 2012
Registered with the Care Quality Commission on 7 February 2012.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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