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Quality Reliable Care Limited Good

Reports


Inspection carried out on 27 November 2019

During a routine inspection

Quality Reliable Care Limited is a residential care home providing personal care and support for up to 12 people. The home accommodates people in one adapted building in a rural setting and is registered to support people with physical disabilities. At the time of the inspection there were 11 people living at the home. People were living with a range of needs including acquired brain injuries, autism and mental health needs.

People’s experience of using this service and what we found

People continued to be supported by kind and caring staff who knew them well. Staff understood people’s needs and respected their preferences and choices. Staff treated people with respect and supported them to remain as independent as possible, protecting their dignity and privacy.

Risks to people were assessed and managed, and staff understood their responsibility to safeguard people from abuse. There were enough suitable staff to care for people safely and there were safe systems in place for managing people’s medicines. Incidents and accidents were monitored and analysed to ensure that lessons were learned. A person told us, “It’s a safe place, we can feel relaxed here.”

Staff had received the training and support they needed, and people told us they had confidence in the staff. One person said, “The know what they are doing.” 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.

People had enough to eat and drink and were receiving the support they needed. They told us they enjoyed the food on offer and their food choices were respected. Staff supported people to access healthcare services when they needed them and worked effectively with staff from other organisations.

People were receiving personalised care and were involved in developing their care and support plans. One person told us, “We wrote the care plan together.” Staff took account of people’s diverse needs and preferences and their views were reflected within their care plans. Staff knew people well and provided support in a personalised way. People were supported to retain links with the people and communities that were important to them. Communication needs were assessed, and information was provided in accessible formats. People were supported and encouraged to maintain their interests and activities reflected people’s individual preferences.

Management systems were effective in managing risks to the quality of the service. Leadership was clear and visible. Staff understood their roles and spoke highly of the support they received. People and staff were engaged with developments at the service and their views were welcomed and encouraged. There was a complaints system in place and people told us they knew how to complain and would raise any concerns with staff. The registered manager used quality assurances systems to identify shortfalls and to drive improvements. People and staff described a homely atmosphere. One person told us, “It’s brilliant here, we are very well looked after, and it feels like home.”

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 7 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 6 February 2017

During a routine inspection

Quality Reliable Care (QRC) provides care and accommodation for up to 14 people. There were 9 people living at the home at the time of the inspection. People living at the home were living with acquired brain injuries following illness such as stroke, multiple sclerosis or accidents. People required a range of support in relation to their mobility and personal care needs. Some people had a degree of memory loss associated with their age and disability. There was a physiotherapy room at the home and a private physiotherapist was available to people who wished to use their services. People were able to live at QRC permanently or on a respite basis.

The home is a converted barn overlooking the countryside. Most of the accommodation is on the ground floor with one bedroom on the first floor. There is no lift at the home so this room is used for people who are able to mobilise independently. All the bedrooms have an en-suite shower room and a private patio area.

There is a registered manager at the home. 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. This was an unannounced inspection which meant the provider and staff did not know we were coming. It took place on 6 and 7 February 2017.

People were supported by staff who were kind and caring. They knew people well and had a good understanding of people’s individual needs and choices. This enabled staff to provide good person-centred care. They were committed to ensuring people were happy and enjoyed their life.

People’s care plans were personalised and reflected people’s individual needs and choices. People were regularly asked for their feedback about the service. There was a friendly atmosphere at the home where people were supported by staff and each other.

There were systems in place to monitor the management and quality of care provided in the home. Staff understood the risks associated with supporting people and knew what they should do to help people remain staff without limiting their independence. People were supported by staff who had been appropriately recruited and pre-employment checks had been completed.

People were protected against the risk of abuse and there were procedures in place to safeguard people. There were enough staff who worked at the home. The manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People received care from staff who had received the appropriate training to provide the care and support people needed. There was an ongoing program of supervision and staff told us they were well supported.

Nutritional assessments were in place and people were involved in planning the menus. They were supported to maintain a healthy diet of their choice. Staff ensured people had access to a range of external healthcare professionals when they needed it.

The registered manager had created an open culture where he knew people and staff well. There was clear leadership and staff were aware of their roles and responsibilities. Staff were aware of their individual roles and responsibilities and knew who they could contact if there were any concerns.

Inspection carried out on 8 and 11 January 2016

During a routine inspection

Quality Reliable Care (QRC) provides accommodation for up to 14 people. There were 9 people living at the home at the time of the inspection. People living at the home were living with acquired brain injuries following illness such as stroke, multiple sclerosis or accidents. People required a range of support in relation to their mobility and personal care needs. Some people had a degree of memory loss associated with their age and disability. QRC offered some rehabilitation for people following their injury to help them maintain and develop skills. There was a physiotherapy room at the home and an occupational therapist was employed to work a few hours a week, or more dependent on people’s assessed needs. People were able to live at QRC permanently or on a respite basis.

The home is a converted barn overlooking the countryside. Most of the accommodation is on the ground floor with one bedroom on the first floor. There is no lift at the home so this room is used for people who are able to mobilise independently. All the bedrooms have an en-suite shower room and a private patio area which people are able to access.

At the time of the inspection there was no registered manager at the home, however there was a manager in post who had applied to the Care Quality Commission to become 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.

This was an unannounced inspection which meant the provider and staff did not know we were coming. It took place on 8 and 11 January 2016.

Staff knew people really well; they had a good understanding of people’s individual care and support needs. They supported people to make choices and respected their right to make decisions. People were looked after by staff who were kind and caring. They were treated with dignity and staff demonstrated an interest in their welfare and views. However, people did not always receive care that was responsive to their needs in relation to their rehabilitation. There were no goals set to guide staff to work with people to help them achieve their independence.

There was an audit system in place which had identified the shortfalls we found throughout the inspection in relation to care plans and record keeping. There was an action plan was in place and work had commenced to address this.

There were risk assessments in place and staff had a good understanding of risks associated with supporting people and what steps they should take to mitigate the risks. People were supported to maintain a healthy diet; they chose what they wanted to eat and were involved with the planning of menus. People had access to healthcare professionals which included the GP, district nurse, optician and dentist whenever they required it.

There were enough staff with the appropriate experience, skills and character employed to work at the home and to meet people’s individual care needs

There was an open and relaxed atmosphere within the home, where people were encouraged to express their feelings. People told us that when they had a problem or were worried they were happy to talk with any of the staff. Whenever people had raised concerns or issues prompt action had been taken to address them.

Inspection carried out on 4 November 2013

During an inspection in response to concerns

We spoke with three people who lived at Valley View Barn, three of their relatives, two members of staff, the manager and the deputy manager. We looked at four sets of records for people who used the service, the service's policies and procedures, and four sets of personnel files.

People's support plans were written, reviewed and updated appropriately to ensure appropriate delivery of care and treatment. One relative said, "The service keeps me informed and I am confident that full care is provided". Another relative said, "We are completely satisfied with all aspects of the service"

We saw the meals provided were well balanced and nutritious. The food was ordered and provided in sufficient quantity. A person who lived in Valley View Barn told us, "The food is great, I have no complaint at all".

We found there were effective recruitment and selection processes in place. Recruitment was on-going and newly recruited staff were trained and encouraged to become qualified as soon as possible.

There were enough staff to meet people's needs. One person told us, "There is always someone around if we need help".

Staff were supported to carry out their roles. Two members of staff told us, "We have to do a lot of training and we are encouraged to join the studies programme and get good support" and, " I always feel that I can raise any concern at all or suggests anything to management and will be listened to".

Inspection carried out on 17 April 2013

During a routine inspection

We spoke to the manager, three members of staff, two people who used the service and four relatives. We also looked at five set of records for people who used the service. Their care plans reflected people's individual care needs. One person who used the service told us: "They take good care of me here�. A relative of someone who used the service told us �The staff are very kind�. Another relative told us: �The staff are doing very well and are very patient�.

People were provided with a choice of suitable and nutritious food and drink. People were consulted during menu planning and were offered alternatives. Food menus were varied and accommodated individual food preferences. People told us "The food is good, if we don't want it we get to choose something else". A relative told us "The food always appears well presented, hot and in a good quantity".

The service had a robust safeguarding policy with clear procedures in place. We found that the service had provided their complaint procedures to people and their family before admission to the service. A member of staff told u "I do not hesitate to complain about anything that needs to be addressed". A relative told us "I am fully aware of the complaint procedure.

We saw that the provider kept personalised support records secure and confidential for each person who used the service. Personnel and recruitment files were stored securely. Records were updated and archived appropriately in a dedicated location.

Inspection carried out on 9 August 2012

During an inspection looking at part of the service

The purpose of this visit was to review the steps taken by the provider to address shortfalls that were identified during the previous inspection undertaken on 12 April 2012.

During this visit we were unable to talk with service users who were asleep or resting after lunch.

Inspection carried out on 12 April 2012

During a routine inspection

People spoken with told us they were very happy living at Valley View Barn, one person told us �I love my room, the view is wonderful�

Inspection carried out on 24 June 2011

During an inspection in response to concerns

People told us that they liked the home and the care and support provided. The following comments were made ��everything is very good,�� ��I am happy with everything and I am learning something every day��.

Reports under our old system of regulation (including those from before CQC was created)