We carried out an unannounced comprehensive inspection on 17 and 18 May 2018.

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

We met with and spoke to five people who used the service and looked at the care records of four people who used the service. We spoke to staff about the care given, their training and how supported they felt. We looked at other records and observed staff working with people. We saw that staff spoke to people in a way that demonstrated a good understanding of people's choices and preferences. We saw that the staff had a good understanding of people's individual needs and that they respected people’s privacy and dignity.

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 visited Valley View on the 10 November 2012. We met 16 people who used services, talked with four staff and checked the provider's records. We were also able to speak to eight relatives visiting the home and a visiting professional.

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”.

The inspection took place on 18 and 22 December 2015 and was unannounced. Valley View provides care and accommodation for up to 17 older people, some of whom are living with dementia. On the day of the inspection 17 people lived at the home.

The service had a registered manager 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.

A professional commented that Valley View was by far the best care home. Another recorded onto a survey that it was always nice to visit this home and see the highest standards of care to all “patients” living there and the level of respect given to them.

People and staff were busy preparing for Christmas and enjoying each other’s company. The service had a calm and relaxed atmosphere. People said they were happy living there. Comments included; “Staff are kind and caring.” Another said; “I love it here!”

People, relatives and visitors were very happy with the care staff provided. Professionals and relatives said Valley View knew people well and the staff were knowledgeable and competent at meeting people’s needs.

People were encouraged and supported to make their own decisions and choices whenever possible in their day to day lives. People’s privacy and dignity was maintained. We observed the staff supporting people with kindness and patience at all times.

People were protected by safe recruitment procedures. Staff were supported with an induction and ongoing training programme to develop their skills and staff competency was assessed. Everyone we spoke with felt there were sufficient staff on duty.

People had access to healthcare professionals to make sure they received appropriate care and treatment to meet their health care needs, such as district nurses and doctors. Professionals said the staff followed the guidance they provided. This ensured people received the care they needed to remain safe and well, for example people had regular visits by district nurses for insulin injections and to change dressings.

People’s medicines were managed safely. Medicines were managed, stored and disposed of safely. Senior staff administered medicines,had received medicines training and confirmed they understood the importance of safe administration and management of medicines.

The registered manager and staff had sought and acted upon advice when they thought people’s freedom was being restricted. This helped to ensure people’s rights were protected. Applications were made and advice sought to help safeguard people and respect their human rights. Staff had undertaken safeguarding training, they displayed a good knowledge of how to report concerns and were able to describe the action they would take to protect people against harm. Staff were very confident any allegations and incidents would be fully investigated. People told us they felt safe living in Valley View.

People were supported to maintain a healthy, balanced diet. People told us they enjoyed their meals and observed mealtimes did not feel rushed.

People’s care records were comprehensive and detailed people’s preferences. Records were regularly updated to reflect people’s changing needs. People and their families were involved in the planning of their care.

People’s risks were considered, managed and reviewed to keep people safe. One person told us they were “Safe and well looked after.” Where possible, people had choice and control over their lives and were supported to engage in activities within the home and trips out into the local area.

People and staff described the registered manager as being very supportive and approachable. Staff talked positively about their jobs and took pride in their work. Visiting professionals and staff confirmed the registered manager made themselves available and were very good.

The registered manager had an ethos of honesty and transparency. This reflected the requirements of the duty of candour. The duty of candour is a legal obligation to act in an open and transparent way in relation to care and treatment.

People’s opinions were sought formally and informally. Audits were conducted to ensure any concerns with the quality of care or environmental issues were identified promptly. Accidents and safeguarding concerns were investigated and, where there were areas for improvement, these were shared for learning.