CQC report explained · a nursing home
What the CQC found at Vale View Heights
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and reviewed, medicines were given as prescribed, premises were safely managed and there were enough staff to meet people's needs.
- Effective?
- Good
- Care plans contained information about people's needs, staff had appropriate training and supervision, and people were supported with food, drink and healthcare.
- Caring?
- Good
- Caring was not covered by this focused inspection. The report says the rating used for this question was carried over from the previous inspection.
- Responsive?
- Good
- People received personalised care and had choices about their routines. The home provided activities, outings and support to maintain relationships and interests.
- Well-led?
- Requires improvement
- Quality monitoring systems were developing, but frequent management changes, staff turnover and unclear communication with health professionals had affected leadership and partnership working.
What inspectors found, June 2023
Rated Good overall; inspectors found safe, effective and responsive care, but leadership and communication still required improvement.
Inspectors made an unannounced focused inspection visit on 25 May 2023. They spoke with people, relatives, staff and health professionals. They reviewed care records, medicines, recruitment, training, premises, complaints and quality checks.
The home was rated Good for Safe, Effective and Responsive. Inspectors found that risks were reviewed, medicines were managed safely, staffing levels met people's needs, care plans had improved, and people had varied activities and personalised support.
Well-led remained Requires Improvement. There had been several management changes and concerns about leadership, staff turnover and communication with health professionals. A new manager was appointed during the inspection, and people, relatives and staff reported that things were improving.
The overall rating improved from Requires Improvement at the previous inspection in January 2022 to Good. The provider was no longer in breach of the regulations identified at the previous inspection. Caring was not assessed during this focused inspection, so its previous rating was carried forward when calculating the overall rating.
Improved risk management
Risks were assessed and reviewed. Care plans gave staff clearer information about clinical conditions, equipment and pressure-area care.
“People's risks were assessed and regularly reviewed. Care plans accurately reflected people's level of risk.” from the report
Safe medicines support
Inspectors found that medicines systems were well managed and people received their medicines as prescribed.
“Medicine administration systems were well managed, and people received their medicines as prescribed.” from the report
Good activities and relationships
People could join group and individual activities, use the minibus for outings and continue personal interests. Activities were available throughout the week.
“Two dedicated activity co-ordinators ensured there were a range of both group and one to one social opportunities available to people 7 days a week.” from the report
Food and choice
People and relatives spoke positively about the quality and variety of meals. People could suggest meals and choose where they ate.
“The food is excellent, and they ask us to recommend meals we like, for us to add them on the menu.” from the report
Frequent management changes
needs fixingSeveral managers had left or changed roles. Relatives said this had affected leadership, although the report says the new manager and recent changes were bringing improvement.
“There had been several changes within the management team since our last inspection.” from the report
Some end of life plans lacked detail
minorEnd of life care plans were in place, but some did not contain enough information about people's wishes. Staff had recorded reasons where more detail was not yet available.
“Some contained specific details about people's wishes, whilst others had less information.” from the report
- 01Who is the registered manager now, and how long have they been in post?
- 02How are you making sure health professionals know who to contact and receive information promptly?
- 03What improvements have been made to leadership and staffing stability since this inspection?
- 04How will you make sure each person's end of life wishes are recorded in enough detail?
- 05How are you checking that the improvements to care plans and risk management continue?
This was a focused inspection covering Safe, Effective, Responsive and Well-led; Caring was not inspected and the other rating was carried forward from the previous inspection. This explanation was written from the published report of 21 June 2023 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, January 2022
Rated Requires Improvement; inspectors found kind care and some progress, but serious gaps remained in safety, consent and management.
This was an unannounced follow-up inspection on 17 and 25 November 2021. Inspectors spoke with people, staff, managers and health professionals. They observed care and checked care plans, medicines records, staff files, audits and building safety records.
People were treated with kindness and respect. Staff knew people well, responded courteously and supported people to make everyday choices. People and families generally said they felt safe. There were enough staff and recruitment checks were completed.
However, important records and checks were not reliable. Risks such as pressure damage were not always clearly recorded or monitored. Repositioning records, prescribed cream records and care plans were incomplete. The home had also not consistently followed the law when making decisions for people who may lack capacity.
The overall rating was Requires Improvement. Caring was rated Good. Safe, Effective, Responsive and Well-led were rated Requires Improvement. The home had improved from the previous inspection in some areas, but it remained in breach of regulations and the provider was still required to improve.
Kind and respectful staff
Inspectors saw warm relationships between staff and people. Staff asked permission before helping and responded promptly and courteously.
“We observed many instances of genuine warmth between staff and people.” from the report
People felt safe
People and families said they felt safe. Staff had safeguarding training and knew how to raise concerns.
“People and their families told us they felt safe at Vale View Heights.” from the report
Improved training
The home had introduced a training matrix, regular face-to-face training and supervision. Staff had completed essential training and more clinical training was being developed.
“Staff had completed a range of essential training to ensure they were able to meet people's needs safely.” from the report
Improved infection control
Inspectors were assured that the home had suitable arrangements for preventing and managing infections, including visitors, protective equipment and testing.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Positive leadership changes
The new manager and provider had been open with inspectors and the local authority. People, families and staff reported that the home felt better than before.
“Significant changes had been made to the operation and leadership of the service in order to drive improvement.” from the report
Risk records were not reliable
seriousCare plans did not always explain how to manage clinical risks. Repositioning records were missing for long periods, so inspectors could not confirm that people had been assisted often enough.
“There were a number of occasions with no repositioning recorded for over seven hours, and on one occasion for over 23 hours.” from the report
Medicines records were incomplete
seriousThe application of prescribed creams was not consistently recorded. There were also unclear records for some medicines that had to be given at specific times.
“There were no body maps in place to indicate where creams should be applied, or clear instructions as to how often.” from the report
Mental capacity processes were not followed
seriousCapacity assessments had not been completed for some people before applications to restrict their liberty or decisions about medicines. Inspectors raised a safeguarding alert concerning eight people.
“The provider was not working within the principles of the MCA.” from the report
People did not always get care based on their choices
needs fixingFour people said they could not have a bath or shower when they wanted one. Some people also said activities did not suit their interests.
“Four people we spoke to raised concerns that they were not able to have a bath or shower when they wanted one.” from the report
Quality checks missed problems
seriousAudits did not identify missing capacity assessments, care plan errors or gaps in daily records. Some people had several days without care notes.
“Care records were not being consistently completed, and so it was not possible to audit them effectively.” from the report
End of life plans lacked detail
needs fixingCare plans contained limited information about people's wishes near the end of life. Most staff had not completed end of life training.
“Care plans contained limited information about people's wishes as they neared the end of their life.” from the report
- 01How have you checked that every resident's capacity has been assessed before decisions are made about care, medicines or restrictions on liberty?
- 02How do you now monitor repositioning, pressure damage risks and prescribed creams, and can you show us recent completed records?
- 03What has changed to make sure care plans contain each person's clinical needs, communication methods and personal preferences?
- 04How do residents choose their bathing and shower times, and what action has been taken in response to the concerns raised?
- 05What conditions has the CQC placed on the provider's registration, and how are you reporting progress against them?
This was an unannounced follow-up inspection covering all five key questions, with infection prevention and control also checked under Safe; it followed an earlier inspection where the home had not made enough sustained improvement. This explanation was written from the published report of 27 January 2022 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 View Heights
4 rated inspections over 7 years: the service has held its Good rating throughout.
- June 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2022Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2021Inspected but not ratedSafe: InadequateEffective: Requires improvementWell-led: Inadequate
- October 2020Inspected but not ratedSafe: GoodWell-led: Good
- January 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2016GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- August 2019
Registered with the Care Quality Commission on 30 August 2019.
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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