Archived: Valley View

Valley View is a care home providing residential care in one adapted building for 20 people aged 65 and over. At the time of the inspection the service was supporting 16 people. Nursing care was provided by the community nursing team.

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

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.

Since our last inspection improvements had been made in how risks to people were assessed, monitored and managed. The registered manager successfully maintained an open and transparent culture which contributed to staff work satisfaction and in turn the staff delivered good care for people.

The provider, registered manager and staff were clear about their roles and responsibilities. Quality assurance checks were in place to monitor the quality of the service provided.

Medicines were managed safely, and people received their medicines as prescribed. People were supported to maintain good health and to meet their nutritional needs.

People living at Valley View told us they received safe care from skilled and knowledgeable staff. Staff knew how to identify and report any concerns. The provider had safe recruitment and selection processes in place. There were sufficient staff deployed to meet people's needs and staff recruitment was on-going.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 4 August 2021) and there were breaches of regulation. 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 inspection of this service on 16 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 risk management, medicines management and governance arrangements.

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.

We undertook this focused inspection to check they had followed their action plan and to confirm they met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective 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.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Valley View 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.

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

People told us staff were kind and caring.

People’s records were not detailed enough so staff could always provide safe, personalised care. Staff were able to describe how they would meet some people’s care needs but these were not recorded.

Risks associated with people’s needs that staff needed to be aware of were not updated to ensure staff had the most up to date information available.

Aspects of people’s medicine management and administration also needed to improve.

People currently living at the service had the ability to consent to their care and treatment. People were supported to have maximum choice and control of their lives and staff supported in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There was enough staff deployed and staff were trained to meet people’s needs. The provider is strengthening their online training with face to face sessions now that Covid- 19 restrictions have allowed this to take place. Putting staff supervision and support in place has been a priority for the new manager to help ensure the culture of the service is based on continuous learning.

The provider’s systems and oversight had not ensured they identified there were concerns at the service. They also did not identify their systems and process were not being operated effectively nor highlighted the issues we found.

Aspects of fire safety were not being monitored that have now been but in place. This included ensuring everyone had their individual needs assessed and that the fire safety equipment was in good working order.

The service had not experienced an outbreak of Covid 19. However, aspects of how the service was managing and implementing the current guidance needed to improve. We signposted the provider to the local authority and support has been offered by the lead infection control nurse to support them achieve this.

Professionals and relatives told us they felt improvements were already in process and, we found the provider and manager were responsive to concerns raised during the inspection. In feedback during and following the inspection, they have been proactive in addressing the points raised.

Rating at last inspection and update

The last rating for this service was Good (published 16 June 2018).

Why we inspected

The inspection was prompted in part due to concerns received about people’s records not being complete and people’s range of health needs were being met. A decision was made for us to inspect and examine those risks.

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.

The overall rating for the service has changed from Good to Requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Valley View 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 and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment and, how the service was being managed 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

Valley View Residential Home provides care and accommodation for up to 20 people. On the day of our inspection there were 15 people living at the service. The home provides residential care for the elderly and people living with dementia.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

There was 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. One of the providers is also the registered manager.

At the last inspection on the 18 December 2015, the service was rated Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated good:

We met and spoke with most of the people living in the service during our visit. However, some people were not able to fully verbalise their views, so staff used other methods of communication, for example by providing visual prompts. Others were able to tell us about the care and support they received. Due to people’s needs we spent time observing people with the staff supporting them.

People remained safe at Valley View. People who were able to said they felt safe living at the service. One person said; “I feel very safe here and the carers are all fine.” Staff said people were safe; “We go and check people all the time.” Healthcare professionals also commented that people were safe and well looked after in the service.

People received their medicines safely by suitably trained staff. People were protected by safe recruitment procedures to help ensure staff were suitable to work with vulnerable people. People, relatives and staff agreed there were sufficient staff to keep people safe. Staff said they were able to meet people’s needs and support them when needed.

People’s risks were assessed, monitored and managed by staff to help ensure they remained safe. Risk assessments were completed to enable people to retain as much independence as possible.

People continued to receive care from staff who had the skills and knowledge required to effectively support them. Staff had completed safeguarding training. Staff without formal care qualifications completed the Care Certificate (a nationally recognised training course for staff new to care). The Care Certificate training looked at and discussed the Equality and Diversity and Human Rights policy of the company.

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. People’s end of life wishes were documented. People's healthcare needs were monitored by the staff and people had access to a variety of healthcare professionals.

People’s care and support was based on legislation and best practice guidelines, helping to ensure the best outcomes for people. People’s legal rights were upheld and consent to care was sought. Care plans were person centred and held full details on how people’s needs were to be met, taking into account people’s preferences and wishes. Information held included people’s previous history and any cultural, religious and spiritual needs.

People were observed to be treated with kindness and compassion by the staff who valued them. The staff, many who had worked at the service for a number of years, had built strong relationships with people. All staff demonstrated kindness for people through their conversations and interactions. Staff respected people’s privacy. People or their representatives, were involved in decisions about the care and support people received.

The service remained responsive to people's individual needs and provided personalised care and support. People’s equality and diversity was respected and people were supported in the way they wanted to be. People who required assistance with their communication needs had these individually assessed and met. People were able to make choices about their day to day lives. The provider had a complaints policy in place and records showed all complaints had been fully investigated and responded to.

The service continued to be well led. People lived in a service where the provider’s values and vision were embedded into the service, staff and culture. People, relatives and staff said the providers were approachable.

The registered manager and provider had monitoring systems which enabled them to identify good practices and areas of improvement.

People lived in a service which had been designed and adapted to meet their needs. The service had recently increased their number from 17 to 20 bedded service. The new build was completed to a very high standard. The provider monitored the service to help ensure its ongoing quality and safety. The provider’s governance framework, helped monitor the management and leadership of the service. The provider and registered manager listened to feedback and reflected on how the service could be further improved.

We met and spoke with two visitors during our visit. Comments included 'Absolutely brilliant, I do feel dignity is totally respected.', 'Any concern raised are dealt with promptly, I always feel really re-assured and fully informed', 'Nothing is ever a bother' and 'They are actually brilliant, I haven't had any issues, Mum wasn't well the other night, I was told they had rung the doctor and I was kept informed.'.

We saw that people's personal support plans described their needs and how those needs were met. We saw records that showed that multi-agency professionals had been promptly sourced to enhance individual wellbeing. A District Nurse spoken to after the inspection said of the staff and registered manager, 'One of the best homes we have, they have been excellent at looking after people who need end of life care'.

We saw that medicines were administered by suitably trained staff. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to administer and record medication.

All the staff we spoke to said that they felt well supported by their colleagues and management. We saw staff received the training they required to carry out their roles. One staff member said, 'I feel very supported here, it's like a family and it's become part of my life'.

The people we spoke with felt the staff fully respected them and understood their needs. One person said 'the staff encourage me to try and do things for myself, but they are always there if I need them', another stated 'One member of staff would sing to me whilst I do my exercises at night, it reminds me of my late wife, which is very comforting'.

We saw people's privacy and dignity were respected and staff were helpful. Comments from people who lived in the care home included "Give them 10 out of 10" and 'Look after me well.'

We saw and heard staff speak to people in a way that demonstrated a good understanding of people's choices and preferences. We looked in detail at the care three people received. We spoke to staff about the care given, looked at records related to them, met with them, and observed staff working with them. We saw that the staff had a good understanding of people's individual needs and that they were kind and respectful. They took time to work at people's own pace.

We observed that people were supported to make decisions about their lives and be as independent as possible. One person said, 'I helped do the potatoes for dinner'. We saw that people's care records described their needs and how those needs were met.

We saw that people's mental capacity was assessed to determine if they were able to make particular decisions. As part of the quality monitoring system, people who live in the home, and their relatives, were sent surveys to complete, that asked their views of the home.

One person said, 'Couldn't have picked better'.