About the service:

Valley Road provides short respite accommodation to people who have learning disabilities and complex health needs. The care home is a ground floor building and is registered to provide care for up to four people. However, a maximum of three people could currently stay at the service due to ongoing maintenance work. Nobody resides at the care home on a permanent basis. At the time of our inspection visit there were two people staying at the service. The service is currently provided to fifteen people.

People’s experience of using this service:

• Improvements had been made since our previous inspection to the way the quality and safety of the service was managed and processes were improved for people in accordance with the Mental Capacity Act 2005 (MCA).

• People felt safe using the service.

• Staff recognised the risks to people’s health, safety and well-being and understood how to recognise and report abuse.

• People had access to support from staff when needed.

• Staff recruitment processes included a check of their background to review their suitability to work at the service.

• People received support with the medicines. Regular checks were undertaken to ensure people received the correct medicines by staff who were competent to support them.

• Staff understood and practised infection control techniques and had access to protective equipment to promote this.

•The registered manager ensured people’s care was based on best practice and staff had training to meet people’s needs.

• Staff training was reviewed and guidance on people’s needs was also shared through supervision meetings and group staff meetings.

• People were supported to have enough to eat and drink to maintain their well-being.

• People were supported to obtain advice from healthcare professionals, which was incorporated into people’s care.

• Staff worked within the principles of the MCA. People were supported to have 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.

• The service applied the principles and values of 'Registering the Right Support' and other best practice guidance.

• Staff understood the importance of supporting people with empathy and compassion and provided reassurance when people became anxious.

• People were treated with dignity and their independence was promoted wherever possible.

• People and those important to them, were involved in planning their care with support.

• Staff supported people with activities that reflected their interests and were encouraged to explore new opportunities for people to experience.

• People and their families understood how to complain if they wanted to.

• A new manager was in post since our last inspection and staff recognised there had been changes in the way the service was managed.

• Relatives and staff worked together to ensure people’s care was continually monitored, reviewed and reflected people’s needs.

• Senior staff worked with external organisations to develop the service they provided.

We found the service met the characteristics of a 'Good' rating in all areas; More information is available in the full report.

Rating at last inspection:

Requires Improvement with breaches of the Health and Social Care 2008 (HCSA 2008) Regulations 11 and 17 (29 March 2018)

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The inspection was to monitor improvements to the service the provider had promised to make to address breaches of regulations 11 and 17 HSCA 2008 (Regulated Activities) Regulations 2014.

Follow up:

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

The inspection site visit took place on 24 and 29 January 2018 and was announced.

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

The service provides short respite accommodation to people who have learning disabilities and complex health needs. The care home is a ground floor building and is registered to provide care for up to four people. Nobody resides at the care home on a permanent basis. At the time of our inspection visit there were three people receiving a respite service on both days of our inspection. The service is currently provided to twenty people.

At the last inspection in November 2015, the service was rated Good overall. However at this inspection we found improvements were required in relation to how the service assessed, monitored and improved the quality and safety of the service for people. Therefore the rating has changed since our previous inspection, from Good to Requires Improvement overall. This is the first time the service has been rated Requires Improvement.

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.

The registered manager was in the process of making improvements to the service. However, we found medicines were not always managed safely and checks had not identified where improvements were required. Risks to people’s safety were not always properly managed. We found processes to monitor the quality of service were not always effective and improvements were required in the way the service assessed, monitored and improved the quality and safety of the service for people.

The registered manager did not always work within the principles of the Mental Capacity Act 2005 [MCA]. Improvements were required to ensure people’s capacity was assessed, best interest decisions were recorded and consents were obtained in accordance with the MCA.

People were protected from the risks of harm or abuse because staff were trained in safe-guarding and understood their responsibilities to raise any concerns with the registered manager. The registered manager made sure there were enough suitably skilled, qualified and experienced staff to support people safely and effectively.

Care plans were personalised and easy to understand. However information was missing in some care plans, for example, some identified risks had not been assessed.

People knew how to complain, however improvements were required in the way complaints were managed. We found there were limited ways people could share their experiences of the service and information was not always accessible to people with complex needs.

The provider checked staff’s suitability to deliver care and support during the recruitment process. Staff were trained to meet people’s needs effectively and people were supported to maintain their health. People were supported to eat and drink enough to maintain a balanced diet that met their needs and preferences.

People told us staff were caring. Staff knew people well and understood their likes, dislikes and preferences for how they wanted to be cared for and supported. Staff respected people’s right to privacy.

We found breaches of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Valley Road provides a respite service for up to three people with a learning disability. There were two people staying at the service at the time of our inspection.

We inspected the service on 3 November 2015. The inspection was announced. This was to ensure the registered manager and staff were available when we visited, to talk with us about the service.

The service has 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.

People and their relatives told us they felt safe using the service. Staff demonstrated they understood the importance of keeping people safe. They understood their responsibilities for reporting any concerns regarding potential abuse. Risks to people’s health and welfare were assessed and support plans gave staff instructions on how to minimise identified risks, so staff knew how to support people safely.

There were enough staff on duty to meet people’s needs. The recruitment process checked staff’s suitability to deliver care safely. Staff received training and support that ensured people’s needs were met effectively. Staff supported people with kindness and compassion, and treated people in a way that respected their dignity and promoted their independence.

Management and staff understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and supported people in line with these principles. The registered manager had made a DoLS application where a potential restriction on a person’s liberty had been identified. The application had not yet been authorised. People did not have mental capacity assessments recorded on their support plans. However people’s families or representatives were involved in decisions regarding their care and treatment.

People were encouraged to maintain their independence and were involved in planning how they were cared for and supported. Care was planned to meet people’s individual needs and preferences.

People were encouraged to share their opinions about the quality of the service and we saw improvements were made in response to people’s suggestions.

The registered manager maintained an open culture at the home. There was good communication between staff members and staff were encouraged to share ideas to make improvements to the service. People said the registered manager was visible and accessible in the service.

The registered manager was dedicated to providing quality care to people. There were processes in place to ensure good standards of care were maintained for people. However there was no process in place to regularly check the accuracy of people’s support plans.