Archived: Valley Supported Living

Valley Supported Living is a small registered charity providing care and support to adults with learning difficulties who live in their own homes. The organisation is run by a group of trustees including parent trustees. The aim of the service is to promote independent living through a range of services including assistance with personal care. The registered office premises were located in Bacup, Lancashire however there had been a recent move of office to Waterfoot, Rossendale. At the time of the inspection the service was providing support to seven people.

At the previous inspection on 21 and 22 October 2015 we found the service was not meeting all the standards assessed.

During this inspection our findings demonstrated there were breaches of eight regulations in respect of medicines management, risk management, support planning, data protection and record keeping, failure to notify, managing complaints, consent to treatment, staffing, safeguarding and quality assurance systems. You can see what action we told the provider to take at the back of the full version of the report.

The service was managed by a registered manager. However at the time of the inspection the registered manager had not been working at the service since the end of April 2017; an interim manager had been in post since late May 2017. 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.

Safeguarding adults' procedures were in place however staff had failed to follow safe procedures. This meant staff lacked an understanding of their responsibilities with regards to safeguarding vulnerable adults. There was also a lack of clarity about how people were supported with the management of their finances. The interim manager was clear about their responsibilities for reporting incidents and safeguarding concerns and was currently working in cooperation with other local agencies.

People considered there had been times when recently there had not been sufficient experienced staff to support them with their activities and with care and support. Changes to the staff and management team had created shortfalls and meant a high reliance on agency staff was necessary. This had impacted on people’s support and access to leisure activities and we were told visits had been missed. There had been a lack of communication with people about the sudden changes to what had previously been a stable management team; this had created unsettlement and anxiety for people.

The recent changes to the staff team had impacted on the provision of some planned activities. However people told us this was improving. We noted people were able to participate in a wide range of meaningful work and leisure activities in line with their interests and preferences. People attended local social clubs and groups where they could achieve more independence and make new relationships with people in the local community.

People's capacity to make their own decisions had not been assessed or recorded in line with the requirements of the Mental Capacity Act 2005. Staff had received training in this area. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

Each person had a detailed support plan although the information had not been kept up to date and any risks to people’s health and safety had not always been identified, assessed or managed safely. It was not clear whether people were involved in decisions about their care. People were supported to access health care and the relevant health and social care professionals provided advice and support when people’s needs changed.

People were aware of how to raise their concerns and complaints and were confident they would be listened to. However the management of people’s complaints and concerns needed improvement.

There had been limited oversight of the management of the service or of the registered manager’s practice which had created avoidable shortfalls in a number of areas as detailed in the main body of the report. The service had failed to notify us of important changes and people’s records were not always accurate and had not been stored safely or disposed of in line with legislation.

People told us they felt safe and were happy with the way they were treated by staff. They told us staff were caring and friendly. The interim manager and staff were observed to have positive relationships with people living in the home. People were relaxed in the company of staff and were supported to maintain contact with friends and relatives. During our visits we found staff were respectful to people and treated them with kindness. The atmosphere in each of the homes was happy and relaxed.

The recruitment process was being reviewed to ensure it was safe and fair. Arrangements were in place to make sure staff were suitably trained and supervised. We found further improvements were needed to how people’s medicines were managed.

People lived in comfortable, clean and well maintained environments. Appropriate aids and adaptations had been provided to help maintain their safety, independence and comfort.

We saw the service users were well looked after and supported by experienced support workers. The two people we spoke with said they were very happy with their living arrangement in a flat, and told us they had the right kind of support to keep them safe, but also independent. One person said, "The staff are fabulous; they deserve a gold star" and "I think she (a member of staff) is great". This person also said, "They help me cook safely". Another said, "I love it here; I feel safe".

We saw there were sufficient numbers of trained staff to support people. Those we spoke with confirmed they had undertaken relevant training. However we found that some of this training was in need of updating.

We judged the action plan to be satisfactory and at our recent inspection we checked to see whether or not the action had been completed according to their plan. We spoke to the registered manager, the deputy manager and the (new) nominated individual, and looked at the relevant records. We did not talk to people using the service as the areas we were concerned about at the inspection in 2012 were about the systems and procedures and not directly about the quality of care and support.

We found the service had taken sufficient action to comply with the three regulations concerned. However developments were still in progress to ensure full compliance with Regulation 10, Outcome 16 Assessing and Monitoring the Quality of Service Provision. Good progress had been made towards meeting this regulation but some developments had been delayed because the organisation was going through a period of difficult change. They told us what they will do in 2013 to fully comply with this regulation, and we were satisfied with their proposals. We felt sufficient progress had been made under the circumstances.