We carried out a review of the data available to us about Ventress Hall Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Ventress Hall Care Home, you can give feedback on this service.
Ventress Hall Care Home provides personal and nursing care for up to 106 people, some of whom are living with dementia. The home is set over three floors, situated in its own grounds, with a range of communal areas for people to use. At the time of the inspection there were 68 people living in the home.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
At the time of the inspection, the location did not care or support anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
People’s experience of using this service and what we found
People felt safe living in the home and spoke fondly of the staff. Comments included, “The staff are wonderful, very helpful and they remember things. I have trust in the staff here, they know their job. I’m very comfortable and happy” and, “They [staff] really push the boat out to give the residents a nice time with such personal care and attention.”
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.
Risks to individuals and the environment were managed. People were safeguarded from abuse. Staff administered and managed people’s medicines safely. The provider learned from accidents and incidents to mitigate future risks. There were enough staff to meet people’s needs. Infection control processes were embedded into the service and staff followed government guidance in relation to infection control and prevention practices, in particular, relating to COVID-19.
The home was well managed. People and relatives were complimentary about the home and the care people received. The provider had an effective quality assurance process in place which included regular audits. People, relatives, staff and health professionals were regularly consulted about the quality of the service through regular communication, surveys, meetings and reviews.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection
The last rating for this service was requires improvement (published 26 August 2021).
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 29 June 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
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 requires improvement to good. This is based on the findings at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ventress Hall Care Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Ventress Hall Care Home is a residential care home for up to 106 people who require nursing or personal care. Some people who used the service were living with a dementia type illness. The home is set over three floors, situated in its own grounds, with a range of communal areas for people to use. There were 75 people using the service at the time of our inspection.
People’s experience of using this service and what we found
Risks around skin integrity and wound management were not always safely managed. Systems were not in place to monitor the progression of wounds, and procedures were not always robust enough to record if people had received appropriate care. This placed people at risk of harm. Medicines were not always administered as prescribed, and systems to manage medicines were not always robust.
Quality assurance measures were not always effective and did not pick up the issues we identified on inspection. Leaders did not always demonstrate the necessary knowledge, experience and oversight to ensure the safety and wellbeing of people who used the service. Relatives and professionals told us communication could be improved.
People told us they felt safe and well cared for. One person told us, “I love it here, the staff are all fantastic. It feels like home and staff treat me well.” Staff were recruited safely. The service was appropriately preventing and controlling infection. There was a positive atmosphere in the service and we were told how the team had pulled together throughout the pandemic. Staff, people and relatives had opportunities to provide feedback.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 3 November 2017).
We carried out an infection prevention and control (IPC) inspection on 29 January 2021 and were assured with the service’s IPC policies, procedures and practice.
Why we inspected
The inspection was prompted in part by concerns received about medicines and in part by notification of a specific incident, following which a person using the service sustained a serious injury.
The information CQC received about the specific incident indicated concerns about the management of skin care and wounds. This inspection examined those risks.
We have found evidence that 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.
This was a focused inspection looking at the key questions of safe and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ventress Hall Care Home on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.
We have identified breaches in relation to safe care and treatment, and governance, at this inspection.
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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We found the following examples of good practice.
¿ Systems were in place to prevent visitors from spreading and catching infection. Only essential visits could take place at the time of inspection and risk assessments were in place for these. There was a thermal imaging camera at the point of entry into the building which recorded temperatures of visitors and staff.
¿ The home had effectively implemented isolation, zoning and cohorting measures. People who had tested positive for COVID-19 were isolated in their rooms. Staff were allocated to one unit of the home wherever possible to reduce the risk of cross infection. People were supported by staff to maintain social distancing.
¿ The home had sufficient supplies of personal protective equipment (PPE). All staff were observed to be wearing appropriate PPE and were bare below the elbow. Fully stocked PPE stations and hand sanitisers were located throughout the home. Foot operated pedal bins were used to dispose of worn PPE.
¿ People were tested on a monthly basis or sooner if they displayed symptoms of COVID-19. Where people lacked capacity, best interests decisions were in place. Dementia friendly signs were on the wall which explained to people why staff were wearing masks.
¿ The home was clean, tidy and well ventilated. Windows were open wherever possible. The home had a robust cleaning schedule in place which included additional cleaning of frequently touched areas such as door handles. The home had a fogging machine which assisted the home with deep cleaning.
¿ Management supported the wellbeing of staff. Staff had access to wellbeing resources including a wellbeing contact. Management informed us that staff had worked hard and pulled together as a team throughout the pandemic.
¿ The home had comprehensive and up to date infection prevention and control (IPC) policies in place. Staff had completed IPC and hand hygiene training. Management carried out daily walkarounds to ensure staff compliance with the home’s policies.
At this inspection we found the service remained Good.
Ventress Hall is a care home for 106 people who require nursing or personal care. Some people who use the service were living with dementia. The home is set over three floors, situated in its own grounds with two enclosed garden areas. Ventress Hall has a range of communal areas for people and their relatives to use. There were 77 people using the service at the time of our inspection.
The service had a registered manager. 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.
There were systems in place to keep people safe. Staff knew about safeguarding processes and how to raise concerns if they felt people were at risk of abuse or poor practice. Accidents and incidents were recorded and monitored as part of the manager’s audit process.
There were robust recruitment processes in place with all necessary checks completed before staff commenced employment.
The provider used a dependency tool to ascertain staffing levels. We found staffing levels to be appropriate to needs of the service, these were reviewed regularly to ensure safe levels.
Medicines were administered by trained staff who had their competencies to administer medicines checked regularly. Medicine administration records (MAR) were completed with no gaps. Medicine audits were completed regularly.
The provider ensured appropriate health and safety checks were completed. We found up to date certificates to reflect fire inspections, gas safety checks, and electrical wiring test had been completed.
Staff training was up to date. Staff received regular supervision and an annual appraisal.
People’s nutritional needs were assessed and we observed people enjoying a varied diet, with choices offered and alternatives available. Staff supported people with eating and drinking in a safe, dignified and respectful manner.
People were supported to maintain good health and had access to healthcare professionals when necessary and were supported with health and well-being appointments.
People were supported by kind and attentive staff, in a respectful dignified manner. Staff discussed interventions with people before providing support. Staff knew people's abilities and preferences, and were knowledgeable about how to communicate with people.
Advocacy services were advertised in the foyer of the service accessible to people and visitors.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Care plans were individualised and person-centred focussing on people's assessed needs. Plans were reviewed and evaluated regularly to ensure planned care was current and up to date. Processes and systems were in place to manage complaints.
The provider had an effective quality assurance process in place to ensure the quality of the care provided was monitored. People and relatives views and opinions were sought and used in the monitoring of the service. People, relatives and staff told us the service was well managed.
People had personal emergency evacuation plans (PEEPs) in place that were available to staff in case of an emergency.
At the last unannounced, comprehensive inspection on 4, 5, 6 and 12 February 2015, we identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 Safety and Suitability of Premises. We asked the registered provider to take action to make improvements. We asked the registered provider to ensure they were preventing the risk of cross infection by having the appropriate equipment and policies in place and by taking action to the premises to ensure people were safe.
The registered provider wrote to us to say what they would do to meet legal requirements in relation to these breaches.
We undertook this comprehensive inspection to check that the registered provider had followed their plan and to confirm that they now met legal requirements.
Ventress Hall care home provides nursing and personal care to 106 people with medical and nursing care needs, including people living with a dementia. The home is located in a residential area close to Darlington town centre, with local amenities and public transport. At the time of our visit, 64 people were receiving care at the service.
The service had a registered manager in place. 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.
At the last inspection we saw that there were risks to people’s safety in the premises. On this visit we saw that storage had improved by converting a bedroom into a hoist storing area which meant hoists and slings were stored safely and cleanly. An area of the home previously referred to as Thornville where one person previously resided had been de-commissioned. We saw that access to areas of risk such as maintenance areas, sluices and other storage areas had now been secured with key code locks meaning that people using the service could not accidentally access them.
We found the premises to be clean and tidy. Areas had been re-decorated and some new furniture had been purchased. There was an ongoing plan for re-decoration. There were no obvious signs of dirt or odours in any areas of the service that we visited.
At our last inspection we saw that electronic records were not always completed and staffing deployment meant there were times when there was not always enough staff to meet the needs of the service. On this visit we saw that both electronic records, recording charts and care plans were well completed.
There were systems and processes in place to protect people from the risk of harm. The care staff understood the procedures they needed to follow to ensure that people were safe. They were able to describe the different ways that people might experience abuse and the right action to take if they were concerned that abuse had taken place.
Staff told us that they felt supported and had regular and productive meetings with their line manager. Staff told us that they were up to date with their mandatory training and had completed training that was relevant to the service
Staff and management had an understanding of the Mental Capacity Act (MCA) 2005. The senior management had a good knowledge of the principles and their responsibilities in accordance with the MCA and how to make ‘best interest’ decisions. We saw that appropriate documentation was in place for those people who lacked capacity to make best interest decisions in relation to their care. We saw that a multidisciplinary team and their relatives were involved in making such a decision and that this was recorded within the person’s care plan.
We looked at the arrangements that were in place to ensure that staff were recruited safely and people were protected from unsuitable staff. We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.
Appropriate systems were in place for the management of medicines so that people received their medicines safely. We saw that medicines had been given as prescribed.
There were positive interactions between people and staff. We saw that people were supported by staff who respected their privacy and dignity. Staff were attentive, showed compassion, were encouraging and caring.
People told us they were provided with a choice of healthy food and drinks which helped to ensure that their nutritional needs were met.
People told us they had good access to their GP, dentist and optician. Staff at the service had good links with healthcare services and people told us they were involved in decisions about their healthcare. This meant that people who used the service were supported to obtain the appropriate health and social care that they needed.
Assessments were undertaken to identify people’s health and support needs. People’s independence was encouraged and there was activities taking place in the service.
The provider had a system in place for responding to people’s concerns and complaints. People and the relatives that we spoke with during the inspection told us they knew how to complain and felt confident that staff and manager would respond and take action to support them.
Records looked at during the inspection informed that audits were in place to monitor and improve the quality of the service provided. The service had responded to requirements and recommendations from the previous CQC visit in February 2015 and a clear record of actions was recorded and reviewed on a weekly basis by the manager and regional manager.
This inspection took place on 4, 5, 6, 12 February 2015 and was unannounced. This meant the staff and provider did not know we would be visiting.
At our last inspection in April 2014 we found the provider was not compliant with Regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 Safety and Suitability of Premises. Following the inspection we asked the provider to send us an action plan detailing what they were going to do to improve the premises. The provider sent us their action plan and prior to this inspection we asked for an updated action plan which they gave us. They said they would be compliant by 31 August 2014. Whilst we saw progress had been made there continued to be issues of concerns regarding the safety and suitability and cleanliness of the premises.
Ventress Hall is a care home which provides nursing and personal care for up to 106 people with medical and nursing care, including people living with a dementia. At the time of our inspection there were 66 people living in the home.
Ventress Hall had a registered manager 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.
We saw each person had a detailed set of care plans and these were written in a person centred way. We saw people had assessments of risk and actions in place for staff to follow to mitigate those risks. We observed people were given their medicines appropriately and suitable arrangements were in place for the storage of people’s medicines.
We found the provider had undertaken safe recruitment procedures to ensure vulnerable people were supported by appropriate staff. We found evidence that staff had undertaken induction training and all files contained details of the specific Ventress Hall induction which included the ‘Orientation and Induction’ programme. We saw staff were provided with further training once recruited. This meant staff were supported to undertake further learning.
People told us they liked the food in Ventress Hall. We observed staff supporting people to eat.
We found the premises were in need of redecoration. Skirting boards were chipped, wall paper was found to be coming of the walls. We were told a decorator would be appointed to address the décor.
We found people who lived in the home and staff who worked there identified issues with staffing levels which impacted on the level of care people received. The management team used a dependency tool which calculated the hours required in the home. The tool used by the management team showed us they were providing more hours than what was required.
We found there were risks to people’s safety in the premises including access to a metal staircase and a cluttered office where people had access to and therefore would be put at risk of trips and falls.
We found parts of the home required cleaning and there were risks to people of cross infection. We saw people’s ensuite bathrooms were cluttered which made cleaning difficult. We found stained commode pans and chairs where the arms were dirty.
There were clear records of involvement by other professionals, including SALT, Tissue Viability staff, Palliative Care Team (St Teresa’s), Medical Staff, Continence Advisor and the Dietetic Service. This meant the staff in the home were working with other services to meet people’s needs.
We saw there was a range of activities in place for people to do. Although at times some activities were limited to small numbers of people, for example visits out of the home.
None of the relatives we spoke with told us they had raised concerns with the registered manager but they felt the registered manager and staff were approachable
We found the regional director undertook monthly quality audits of the home and set action plans for review to improve the service.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
People were involved in decisions about their care and support. Staff made appropriate referrals to other professionals and community services. We saw staff understood people's care and support needs, were kind and thoughtful towards them, and treated them with respect.
Care plans were individual to people and were reviewed regularly. This meant that information was accurate and up to date.
Medicines were only handled by people trained to do so. Good practices were in place for the handling and storage of medication.
We saw that adequate maintenance of the premises was not carried out to maintain the safety and suitability of the premises which breached the Health and Social Care Act 2008 and associated regulations
The home regularly monitored the quality of the service. Audits were carried out to minimise the risks available to people and actions were put in place when needed, however we were not always sure if these had been addressed.
People and staff had access to forums where they could voice concerns or complaints which they had.
People and staff felt well supported at the home.
The inspection team who carried out this inspection consisted of three inspectors. During the inspection, the team worked together to answer five key questions which are outlined below.
Is the service safe?
Everyone we spoke with told us they felt safe and secure living at the home. Staff we spoke to understood the procedures which they needed to follow to ensure that people were safe.
Good systems were in place for medication. Staff were up to date with training and regular competency assessments were undertaken.
The security of the building was well maintained and people we spoke to told us that they felt safe living at the home. However we found that the maintenance checks needed to ensure the safety of the building we not up to date and as required by the Health and Social Care Act. This meant the provider could not demonstrate that people were protected from the risks of unsafe or inappropriate care because maintenance checks were not up to date. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.
Procedures for dealing with emergencies were in place and staff were able to describe these to us. People had a copy of the fire evacuation procedure in their own rooms, however the people we spoke to were unsure of the fire evacuation procedure.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care home. Recent applications had needed to be submitted and proper policies and procedures were in place. Relevant staff had been trained to understand where an application should be made, and how to submit one.
Is the service effective?
People all had an individual care plans which set out their care needs. People we spoke with told us they had been involved in the assessment of their care needs and care planning.
It was clear from our observations and from speaking with staff that they had a good understanding of the people's care and support needs and that they knew them well.
People had access to a range of health professionals. People were escorted to appointments as needed.
Is the service caring?
People were treated with dignity and respect and were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people.
Everyone we spoke with during our inspection expressed satisfaction with the care and support which they received.
Is the service responsive?
We saw the home provided a range activities both inside the home and out in the community. The home had access to their own transport which meant that people had enjoyed many days outside.
Relatives told us they were able to visit when they wanted to and could take people out into the community. This meant people were encouraged to maintain relationships with family and friends.
Staff responded quickly when people's needs changed and ensured that referrals to appropriate health professionals were carried out when needed.
People told us that they knew how to make a complaint if they needed to.
Is the service well-led?
The service worked well with other agencies and services to make sure people received the most appropriate care and support for their needs.
The home had a system in place to assure the quality of the service they provided. The way the service was run was regularly reviewed. Actions were put in place when needed, however we were unable to see if these actions had been addressed.
Staff were dedicated to the home and had a good understanding of the ethos of the home. Staff were very clear about their roles and responsibilities and were very positive about the team they worked in.
What people said
During the inspection we spoke with five people, two relatives, one visitor and nine staff. People who were able to express their views told us that they were satisfied with the care and support they received.
People we spoke with told us, 'The care couldn't be better. The staff bend over backwards for you. I am really grateful,' and 'It's like a big happy family. The staff are really good and I believe this is the best place in town.
Relatives we spoke we told us, 'We are pleased with the treatment our relative is getting here' and 'Staff are nice.' One person and their relative told us, 'The staff are good. I get very well looked after. They are nice.' and 'I am absolutely happy with the care I receive.'
A visitor told us, 'The staff are always busy and always on the move. I have no concerns about the home.' One staff member told us, 'It's a good place to work.' Another told us, 'We give people lots of choice.'
One staff member told us, 'It's a good place to work.'
People had been individually assessed to see if they could make their own decisions. Care records had enough information so staff would be able to know how to support each person in the right way. We saw on the day of our visit, there were sufficient qualified, skilled and experienced staff to meet people's needs. The provider had a system for checking the quality and safety of the service and records were maintained and held securely.
Those people living in the home we spoke with, said that they were happy with the service provided by the staff. One person told us 'Things are really good here' and that they 'Trusted the staff' which made them feel 'safe'. another said 'The staff are really good' and told us that 'They do things with a smile'. While we asked a relative of a person living in Ventress Hall what they thought of the service the person told said to her visitor 'They are very kind to us'.
One visitor told us she that she thought the service was 'Everything that they wanted' and she was 'Really pleased' and that it was 'All down to the staff'. Another visitor, when asked about the care being given to their relative, said 'The staff asked about me about the kind of things that my relative liked to do and the kind of food she likes'. All of the relatives we spoke with had been involved in developing the care plan intitially and were happy with the content of the documents.
A visiting General Practitioner told us that they had 'no concerns' about the way that people were being cared for. They said that they visited the home regularly (about once a week or fortnight) and the staff were always helpful and had followed any instructions given to them about peoples care.
We spoke with a small group of people who were sitting in one the lounges. They told us they were very happy with the service and how much they appreciated the staff and the manager. The told us the food was 'Excellent' and one suggested that 'If I get the chance I should have lunch as it's really nice'.