Parvale House

¿ Parvale House provides accommodation with personal care for up to six people. This is a service that specialises in supporting adults with a range of complex needs and behaviours associated with Prada-Willi Syndrome (PWS). This is a genetic condition that means people with the condition will have an abnormal, insistent desire for food which can make the person eat excessively. This has the potential to result in life threatening obesity. There were six people using the service at the time of our inspection.

People's experience of using this service:

¿ The staff and the management team were passionate about providing people with support that was based on their individual needs, goals and aspirations. We saw that people were at the centre of their care and each person was treated as an individual. As a result, their care was bespoke and tailored to meet their exact needs. Without exception, people spoke positively about their experience of the service and the successes they had been supported to achieve.

¿ Staff had an exceptional understanding of people's individual needs and supported them to achieve their hopes for the future, their wishes and aspirations. They worked as a close team and were driven in providing person centred support to enable people to achieve as much independence as possible. People and their families were central to the care planning process and felt listened to. Each person was respected as an individual, with their own social diversity, values and beliefs. People received care and treatment that was delivered in line with up to date best-practice guidelines in relation to Prader-Willi Syndrome.

¿ Staff viewed complaints and concerns as a process for driving improvement at the service. People, relatives and staff knew how to raise concerns and make a complaint if they needed. There were numerous forums where people could raise any concerns or complaints if they needed to. These included one to one meetings, a suggestion box and house meetings.

¿ The management had a clear structure and were knowledgeable about people's needs and key issues within the service. They had the skills, knowledge and experience to perform their roles, with significant experience in managing Prader-Willi Syndrome. The provider had clear visions and values about how they wished the service to be run and these values were shared with the whole staff team. Staff had clearly adopted the same ethos and enthusiasm and this showed in the way they spoke about people.

¿ People continued to receive safe care. Staff had been provided with safeguarding training to enable them to recognise signs of abuse and how to report them. There were risk management plans in place to protect and promote people's safety. Staffing numbers were appropriate to keep people safe and the registered provider followed thorough recruitment procedures to ensure staff employed were suitable for their role. There were systems in place to ensure people were protected from the spread of infections. People's medicines were managed safely and in line with best practice guidelines. If any accidents or incidents occurred lessons were learnt and action taken to reduce risk in future.

¿ People's needs and choices were assessed and their care provided in line with best practice that met their diverse needs. Staff received an induction process when they commenced work at the service and on-going training to ensure they were able to provide care based on current practice. Each person's food intake was closely monitored to ensure they maintained a healthy weight in line with best practice guidance in relation to Prader-Willi syndrome. Staff supported people to access health appointments when required, including opticians and doctors, to make sure they received continuing healthcare to meet their needs.

¿ 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.

¿ Staff were caring and had built open and honest relationships with people. They spoke of a family atmosphere at the service and demonstrated a genuine interest in people's wellbeing. People were happy with the care they received and felt valued by staff and the management team. People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted.

More information is in Detailed Findings below:

Rating at last inspection: Good (report published 18 August 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. At our last inspection we rated the service Good. At this inspection we found the service had improved to outstanding under the responsive and well-led domains. The overall rating for this service is Outstanding.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Parvale House provides accommodation with personal care for up to six people. There were six people in residence when we inspected.

Parvale House specialises in supporting adults with a range of complex needs and behaviours associated with Prader-Willi Syndrome (PWS). This is a genetic condition that predominantly manifests with early years onset of hyperphagia which is an abnormal unrelenting great desire for food driving the person towards excessive eating and, left unchecked, life threatening obesity. Other characteristics of PWS include, for example, learning disabilities that may range in severity, and challenging behaviours are a feature of PWS whether or not the person has a measured learning disability.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People were cared for by sufficient numbers of care staff that were experienced and had received the specialised training they needed to do their job safely when supporting people with PWS. The care staff worked well together as a cohesive and motivated team. They enabled the people they supported to successfully manage the constraints they faced as a consequence of PWS. People benefited from living in a safe, well structured environment that was conducive to individuals living with PWS to experience a healthy lifestyle.

People's care needs had been comprehensively assessed prior to admission. Each person had a person centred care plan that reflected their individual aspirations and the goals they set to enable them to live fulfilling lives. Care planning was in keeping with the provider’s values that each person should be empowered by the care staff team to experience achievements in their day-to-day lives. These achievements ranged from modest daily living successes through to life enhancing changes such as sustained weight loss transforming a person’s health for the better.

People's individual preferences for the way they liked to receive their support were respected. There were formal systems in place to assess people's capacity for decision making under the Mental Capacity Act 2005. Care staff were mindful that people with PWS experienced heightened anxieties that had a negative impact on their quality of life if day-to-day living lacked sustainable boundaries that people understood had a positive impact on their wellbeing. Care staff consistently ensured that people experienced a well-structured day that enabled individuals to thrive.

People's healthcare needs were met and they received timely treatment from other community based healthcare professionals when this was necessary. People's medicines were appropriately and safely managed. Medicines were securely stored and there were suitable arrangements in place for their timely administration.

People's individual nutritional needs were assessed, monitored and met with appropriate guidance from healthcare professionals with expertise in PWS. People had enough to eat and drink. They benefited from a menu that reflected their choices and preferences.

People benefited from receiving a service that had robust quality assurance mechanisms embedded into practice at Parvale House. The care staff team played their part in ensuring people received good quality care and they had confidence in the senior management team to provide them with the support and training they needed to do their job.

People, their families or significant others, were assured that if they were dissatisfied with the quality of the service they would be listened to and that appropriate action would be taken to try to resolve matters to their satisfaction.

We spoke with the relatives of three people. They all told us that they had been fully satisfied with the care their relatives received.

One relative said; 'we have always been very, very pleased with the care my daughter gets at the home'.

We had brief observations of the relationship between staff and people who lived in the home. These were found to be on friendly and encouraging.

This was a positive inspection. People we spoke with told us they were satisfied with the care provided. All the relatives we spoke with also said that they had no concerns. The essential standards we inspected were found to have been met.

There were a number of suggestions made; for head office to review the amount of paperwork that staff had to complete, as this took time away from spending with people. Another suggestion was for computer training to be arranged for staff that needed this, to support them to carry out their work. The manager said she would review these issues. There was a comment that trips out for people should be more frequent and all year round, rather than just for summertime. The issue of the home having a cat was raised. The manager said that she would discuss this with people.