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CQC report explained · a nursing home, run by Jana Homes

Valley View Care Home Ltd

Maidstone Road, Rochester, ME1 3LT

Requires improvementpublished 15 September 2023, 2 years ago

Rated Requires improvement: inspectors found the service was not performing as well as it should and told it what to change.

The five questions inspectors ask
Safe?
Requires improvement
Individual risks had been assessed better, but staff did not always have clear guidance to prevent harm. Incident records were also incomplete, although medicines, staffing, recruitment and infection control had improved.
Effective?
Requires improvement
People received better healthcare support and staff training had improved. However, the home did not always follow the Mental Capacity Act, complete best-interest decisions or record conditions attached to liberty safeguards clearly.
Caring?
Good
This question was not inspected during this focused inspection. Its previous rating was used in calculating the overall rating.
Responsive?
Good
This question was not inspected during this focused inspection. Its previous rating was used in calculating the overall rating.
Well-led?
Requires improvement
The provider had introduced new monitoring systems, but they were not yet robust. Audits did not always identify unclear care plans, missing records or risks that needed action.
The latest report, explained

What inspectors found, September 2023

Rated Requires Improvement; inspectors found better medicines, staffing and healthcare, but risks, consent and management checks were still not reliable.

This was an unannounced focused inspection on 16 and 17 August 2023. Inspectors spoke with people, relatives and staff, observed care, and checked care, medicines, recruitment and management records.

The home had improved since its last inspection, when it was rated Inadequate and placed in Special Measures. Medicines were managed more safely, staffing had improved, and people received better support with their health needs. Staff also described a more supportive culture.

However, the home was still not consistently safe, effective or well-led. Some risks were not clearly assessed or managed, mental capacity and best-interest processes were not always followed, and quality checks did not reliably find problems. The overall rating changed to Requires Improvement, and the home left Special Measures.

What inspectors praised
  • Medicines

    The electronic medicines system had improved ordering, storage and administration. Inspectors found that medicine counts matched the records.

    People were now receiving their prescribed medicines safely.from the report
  • Staffing

    Staffing had improved and agency use was minimal. The regular agency staff knew people well, and people did not appear to wait for help.

    People told us they did not have to wait when they requested help.from the report
  • Healthcare support

    People were referred to health professionals more promptly when needed. Nursing staff also provided specialist care and arranged further advice.

    We found this had improved at this inspection and people had received the advice and healthcare they needed.from the report
  • Staff culture

    Staff no longer reported the bullying concerns found at the previous two inspections. They said management was approachable and teamwork had improved.

    Staff did not report this at this inspection and were now happier at work as this was not a concern anymore.from the report
What inspectors were concerned about
  • Unclear risk guidance

    serious

    Some important risks were not clearly highlighted for care staff. This included diabetes, choking and anxiety-related incidents, increasing the risk that staff might not prevent harm.

    The provider continued to fail to assess the risks to the health and safety of people or do all that was reasonably practicable to mitigate risks.from the report
  • Consent and best interests

    serious

    The home did not always complete mental capacity assessments or best-interest decisions for specific choices. This included decisions relating to CCTV and some conditions linked to liberty safeguards.

    The provider continued to fail to put into practice the requirements of the MCA.from the report
  • Weak quality checks

    serious

    Management checks did not reliably identify gaps in care plans, risk assessments and records. The provider had said care plans were audited monthly, but this was not happening.

    The provider continued to fail to operate a robust quality assurance process to understand and have oversight of the quality of the service and ensure any shortfalls were addressed.from the report
  • Incomplete incident records

    needs fixing

    Some falls and incidents involving anxiety or physical behaviour were not recorded fully. This limited the home's ability to spot patterns and prevent repeat incidents.

    Although accidents were recorded, such as falls, incidents were not always recorded to enable monitoring across the service, to learn lessons and prevent further occurrences.from the report
Questions to ask them, based on this report
  1. 01How will you make sure each person's key risks, including diabetes, choking and anxiety, are clearly highlighted for care staff?
  2. 02How will you complete and record mental capacity assessments and best-interest decisions for each specific decision?
  3. 03What consent process is now in place for CCTV in communal areas?
  4. 04How will you prove that care plans and incident records are being audited properly and that problems are acted on?
  5. 05How will staffing levels be checked before any new people are admitted?

This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 15 September 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.

The story over the years

Every inspection of Valley View Care Home Ltd

6 rated inspections over 6 years: the service has held its Requires improvement rating throughout.

  1. September 2023Requires improvementcurrent ratingup from Inadequate
    Safe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement

    Read what inspectors found at Valley View Care Home Ltd

  2. February 2023Inadequatedown from Requires improvement
    Safe: InadequateEffective: Requires improvementWell-led: Inadequate

    We are reading this report · the original is on cqc.org.uk

  3. December 2021Requires improvementstayed Requires improvement
    Safe: Requires improvementWell-led: Inadequate

    Read this report on cqc.org.uk

  4. December 2019Requires improvementstayed Requires improvement
    Safe: Requires improvementEffective: GoodCaring: Requires improvementWell-led: Requires improvement

    Read this report on cqc.org.uk

  5. November 2018Requires improvementstayed Requires improvement
    Safe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement

    Read this report on cqc.org.uk

  6. February 2018Requires improvement
    Safe: InadequateEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement

    Read this report on cqc.org.uk

  7. December 2016

    Registered with the Care Quality Commission on 23 December 2016.

Ratings and report dates from the Care Quality Commission. A service can also be visited without a new rating being published, so the timeline shows published inspections, not every contact the CQC has had with the service.

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