CQC report explained · a residential care home
What the CQC found at Valmark House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found several environmental risks, inconsistent infection control, a recruitment check that had not been fully completed, and a medicines record that did not match the prescribed instruction. The manager acted during the inspection to reduce these risks.
- Effective?
- Good
- Care assessments and plans reflected people's needs and communication methods. Staff had relevant training, supported people's choices about food and activities, and worked with health and social care professionals.
- Caring?
- Good
- Staff treated people with warmth, kindness, dignity and respect. They understood people's communication styles and encouraged independence.
- Responsive?
- Good
- Care was personalised and people were supported to make choices and keep relationships with family and others. Inspectors found that some preferred activities, including swimming and trampolining, had not taken place for some time.
- Well-led?
- Requires improvement
- The provider's governance checks did not identify several risks and there was no effective service improvement plan. The report says this was a breach of Regulation 17 on good governance.
What inspectors found, November 2023
Rated Requires Improvement; inspectors found kind, personalised care, but weaknesses in safety checks and leadership oversight.
This was an unannounced inspection. One inspector visited the home and spent time with the two people living there. They observed care, looked around the house and gardens, and checked care plans, medicines records, staff records, risk assessments and quality checks.
The home provided kind and personalised care. Staff knew people well, supported their choices and communication, and helped them access health services and the local community. The ratings for Effective, Caring and Responsive were Good.
The Safe and Well-led ratings were Requires Improvement. Inspectors found missed environmental risks, inconsistent infection control, a medicines record that did not match an instruction, and weaknesses in the provider's checks and improvement planning. The overall rating fell from Good at the previous inspection, published in March 2018.
Kind and respectful care
Staff knew people well and provided compassionate support. Relatives and professionals also gave positive feedback about the care.
“People received kind and compassionate care by staff who knew them well.” from the report
Choice and independence
People were supported to make decisions, personalise their rooms and do tasks they could manage themselves. Staff used the least restrictive approach.
“People were supported to have maximum choice and control of their lives and in the least restrictive way possible and in their best interests” from the report
Consistent staff team
There was low staff turnover, so people were supported by staff they knew. Staff received induction, training and regular supervision.
“People benefited from a low turnover of staff, which meant they received consistent support from staff they knew.” from the report
Environmental safety checks
seriousInspectors found uncovered radiators, an unsecured cupboard containing cleaning fluids and wardrobes that had not been checked for a falling risk. These issues were corrected during the inspection.
“On the first day of our inspection, not all radiators had covers on to protect from the potential risk of skin burns when in use.” from the report
Infection control practice
needs fixingStaff were not always following effective infection control practice because textile towels were being used instead of paper towels. A paper towel dispenser was installed during the inspection.
“However, staff were not always following effective IPC, where they were using textile towels, rather than paper, as part of their IPC.” from the report
Medicines records
needs fixingA person's prescribed dose was correct, but the medicines administration record did not reflect the medicine being given. The manager corrected the record during the inspection.
“However, although the person was receiving the right dosage medicine, it did not reflect what was being given on the person's medication administration record [MAR].” from the report
Planned activities
minorPeople had spontaneous choices and outings, but some individual interests had not been supported for some time. The manager said they would look at restarting activities such as swimming and trampolining.
“Although this provided spontaneity, more planned activities were needed, ensuring enough staff cover, to support people's individual interests.” from the report
Management oversight
seriousQuality checks had not identified several risks. There was no service improvement plan, no effective emergency staffing plan, and the manager did not have enough protected time for management duties.
“The provider's systems and processes that assessed, monitored, mitigated risk and keep them updated on best practice were not fully effective.” from the report
- 01What checks are now completed to identify risks from radiators, cleaning fluids, furniture and other parts of the environment?
- 02How do you check that infection control procedures are followed every day, including the use of paper towels?
- 03How are medicines records checked against prescribers' instructions after any dose change?
- 04Which individual activities have been restarted, and how do you make sure there is enough staff cover for them?
- 05What is the current improvement plan, and how much protected time does the registered manager have to monitor safety and quality?
This inspection covered all five CQC questions, the care provided and the home environment, including infection prevention and control; the inspection activity ran from 13 September to 6 October 2023, with visits on 13 and 18 September. This explanation was written from the published report of 25 November 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, March 2018
Valmark House is rated Good; inspectors found safe, kind and personalised care, with some follow-up needed on water safety and management registration.
This was an unannounced inspection on 9 and 16 February 2018. One inspector reviewed care records, medicines records, staff records, safeguarding information and the service's management systems. They spoke with one person, two relatives, the house manager, two senior staff and the provider.
All five areas were rated Good: safe, effective, caring, responsive and well-led. Inspectors found enough staff, safe medicines management, detailed care plans and kind, respectful support. People were supported with health appointments, food, activities, communication and maintaining relationships.
The home did not have a registered manager during the inspection. The house manager was applying for registration. Inspectors also noted that a risk assessment for Legionnaires' disease was not yet in place, although the provider later said an external company had carried out an assessment.
The overall rating stayed Good, as it had been at the previous inspection. The report says there was no evidence of serious risks or concerns and that identified shortfalls were addressed in a timely way.
Safe medicines
Inspectors found that medicines were stored and managed safely. Records showed medicines had been given as prescribed.
“Medicines administration records (MARs) contained no gaps or omissions in signings, which indicated people received their prescribed medicines as required.” from the report
Personalised care
Care plans described people's needs, preferences, communication and abilities in detail. This helped staff support people in their preferred way and promote independence.
“Care plans were detailed and person centred.” from the report
Kind and respectful staff
Staff knew people well and understood their wishes, including when people had difficulty communicating. Inspectors saw people relaxed with staff and found that privacy and dignity were respected.
“People were treated with kindness and respect from staff who knew them well.” from the report
Activities and choice
People were supported to choose activities inside and outside the home, take part in daily living and have holidays.
“People were encouraged and supported to join in activities both inside and outside the service.” from the report
Water safety assessment
needs fixingAt the inspection, there was no risk assessment covering the risks linked to Legionnaires' disease. The provider later said an external company had carried out an assessment.
“The provider did not have a risk assessment in place to ensure adequate measures were in place to mitigate and control the risks associated with Legionnaires' disease.” from the report
No registered manager at inspection
minorThe home did not have a registered manager during the inspection. The house manager was completing an application to register, with support from the provider.
“The service did not have a registered manager at the time of our inspection.” from the report
DoLS applications being prepared
needs fixingThe provider had begun steps to apply for Deprivation of Liberty Safeguards because people needed staff support at all times when accessing the community. Families should ask what happened with these applications.
“The provider told us they had recently discussed each person in full with the local authority and was now taking steps to send in DoLS applications for the people that lived in the service.” from the report
- 01Has the Legionnaires' disease risk assessment been completed, and what actions were identified?
- 02Is the house manager now registered with the CQC, or when is the application expected to be completed?
- 03What was the outcome of the Deprivation of Liberty Safeguards applications for each person?
- 04How will you make sure care plans continue to reflect changes in communication, behaviour, health and preferences?
- 05How are people involved in choosing activities, meals and holidays?
This was an unannounced inspection covering all five key questions and the overall rating; the report says the Good rating continued from the previous inspection. This explanation was written from the published report of 17 March 2018 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 Valmark House
3 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- November 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 25 November 2010.
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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