We carried out a review of the data available to us about Valdigarth on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Valdigarth, you can give feedback on this service.
Valdigarth is a residential care home providing personal care for up to 10 people living with a learning disability. There were 10 people living at the service at the time of this inspection.
People’s experience of using this service and what we found
The registered manager was not always clear about which incidents should be reported to the Commission. Services that provide health and social care are required to inform CQC of important events by submitting a statutory notification. We have made a recommendation about statutory notifications.
People and relatives told us they thought the service was safe. Staff understood their safeguarding responsibilities. Risks to people were appropriately assessed and clear guidance was in place for staff to manage risks. There were enough staff on duty to support people, and staff were recruited appropriately. People received their medicines as prescribed. Infection control policies and procedures were in place to help keep people safe.
Audits were regularly carried out to monitor the quality of the service for people. Leaders were approachable and people had confidence in the management. The service involved people, relatives and staff in a meaningful way. Feedback was encouraged and action taken in response to people’s views. Referrals were made to healthcare professionals in an appropriate and timely manner.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
Based on our review of the safe and well-led key questions, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
People were offered choice and encouraged to pursue their interests. People were supported to be independent where possible. Staff were knowledgeable about people’s individual characteristics and their preferred routines. People were treated with respect and spoke positively about the staff supporting them. The service had a person-centred culture, a positive atmosphere, and was open to suggestions, feedback and continuous improvement.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 15 November 2019).
Why we inspected
The inspection was prompted in part due to concerns received about allegations of financial abuse. A decision was made for us to inspect and examine those risks. These allegations are subject to a criminal investigation. As a result, this inspection did not examine the circumstances of the allegations.
The information CQC received about the allegations indicated concerns around the management of risk, safeguarding service users from abuse, submission of notifications, and oversight.
We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and well-led sections of this full report.
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.
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.
The overall rating for the service has remained the same. 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 Valdigarth on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Valdigarth provides residential care for up to 10 people living with a learning disability including autism. At the time of this inspection there were 10 people living at the service.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
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; 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. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People who used the service and their relatives were happy with the service they received. Their needs were met in a personalised way. People said staff were kind, caring and respectful and they had developed good relationships with them.
People’s care was based on detailed assessments and person-centred care plans. Risks to people’s safety and wellbeing were appropriately mitigated. People and those important to them had been involved in planning and reviewing their care.
Staff worked closely with other professionals to make sure people had access to health care services. People received their medicines safely and as prescribed. People’s nutritional needs were assessed and met.
Staff enjoyed their work and spoke positively about the people they cared for. They received the training, support and information they needed to provide effective care. The provider had effective recruitment and induction procedures to ensure only suitable staff were employed.
People’s independence was promoted. Staff ensured each person felt included and valued as an individual. People were engaged in meaningful activities of their choice. Staff ensured people maintained links with their friends and family.
The provider had a complaints procedure. People felt confident raising concerns. There were systems for monitoring the quality of the service, gathering feedback and making continuous improvements.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 1 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Valdigarth provides care and accommodation for up to ten people with learning disabilities. On the day of our inspection there were nine people using the service.
The service had a registered manager in place. 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.
We last inspected the service in December 2014 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.
Accidents and incidents were appropriately recorded and risk assessments were in place. The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.
Appropriate arrangements were in place for the administration and storage of medicines.
The home was clean, spacious and suitable for the people who used the service and appropriate health and safety checks had been carried out.
There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The registered provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff.
Staff were suitably trained and received regular supervisions and appraisals.
The registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and was following the requirements in the Deprivation of Liberty Safeguards (DoLS).
People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of visits to and from external health care specialists.
People who used the service were complimentary about the standard of care at Valdigarth.
Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.
Care plans were in place that recorded people’s plans and wishes for their end of life care and care plans were written in a person centred way.
Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.
The registered provider had an effective complaints procedure in place and people who used the service were made aware of how to make a complaint.
Staff felt supported by the management team and were comfortable raising any concerns. People who used the service and staff were regularly consulted about the quality of the service.
We carried out this inspection on 15 December 2014 and was unannounced.
Valdigarth provides care and support for up to ten people who have a learning disability. At the time of our inspection there were ten people living in the home.
At the time of our inspection the home had a registered manager in place. 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.
The provider had policies and procedures in place for recognising and reporting abuse. Staff we spoke with were able to describe to us the different types of abuse and how to report any concerns they may have.
Care plans we looked at contained appropriate risk assessments which had been completed in line with people’s care plans.
The home was clean and tidy with liquid soap and paper towels available throughout for visitors to the home as well as people who used the service and staff who worked there.
We saw robust recruitment and selection processes were in place. We found appropriate pre-employment checks had been made including written references, Disclosure and Barring Service (DBS) checks, and evidence of their identity had also been obtained.
The home had an appropriate medication policy in place. We saw staff who dispensed medicines had received training in the management and storage of medicines. We looked at the medication administration records (MAR) and found they were completed clearly and correctly.
Staff working in the home received regular supervisions and appraisals with records of discussions held recorded in their personal files.
Everyone who lived at Valdigarth received care and support that was personalised to their individual needs. Care plans were in place for all the people who used the service and were reviewed and updated regularly.
Medical reviews and tests were completed when needed and results were recorded in care records. Changes to medicines were made when necessary meaning people’s care was adapted to take account of their changing needs.
There was a formal complaints procedure in place which was displayed on notice boards in the home so it was visible to people who used or visited the service.
We saw a notice board in the home providing people who used the service with information. This included access to support services and how to make complaints. We saw some of the people in the home had accessed advocacy services and advocates were in place.
The provider had a quality assurance system in place which was used to ensure people who used the service received the best care.
We were able to observe the experiences of people who used the service. For instance, we spent time with people as they had their breakfasts and observed how staff supported and encouraged them. We saw staff encouraged people to make their own choices and decisions. We saw staff understood each person's different needs, for example, when they had not managed independently and so required some support.
We saw that staff supported people to make choices about how they spent their day and the activities offered. On the day of our visit some of the people who used the service went out to various day centres and clubs and two people were going out horse-riding that afternoon. We saw staff had supported people as they got ready to go out.
We saw that staff treated people with dignity and respect. We saw that people had freedom of movement around their home and could spend time in their bedrooms whenever they wanted. We saw that each person had their own bedroom which was personalised. We saw the provider had made suitable adaptations to meet the people's physical needs. We observed that staff respected people's privacy and knocked before they entered their rooms. We saw that the staff communicated well and appropriately with people in a way that was easily understood. We saw that the staff were attentive and interacted well with people. We learned more about how care and treatment was provided when we talked with staff, observed their practices and looked at the records of four people who used the service.
We found that before people received any care or treatment they were asked for their consent and the provider had acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.
'I am happy here. I like to cook and do things in the kitchen.'
'We do lots of activities and we have had some good trips.'
'The staff are nice.'
We found that people who used the service were protected and safe. We found that there was an effective infection control system in place and that the home had a clean and suitable environment.
We found that people who used the service had their care and welfare needs met.
We found that there were good systems in place for the involvement of other health or social care professionals.
We found that people's views were important and listened to. We found that there was an effective complaints system in place.
We saw the environment at the home helped to promote people's privacy. People had their own bedrooms and five rooms had an en-suite bathroom. All rooms were personalised with keepsakes. We saw staff knocked on doors before they entered rooms. They spoke with people respectfully and addressed them by their preferred name.
People were supported in promoting their independence and community involvement. We saw staff gave people opportunities to make choices about their daily lives. We looked at people's care plans in which their care needs, choices and preferences were recorded. This meant staff had clear information about how their needs should be met. The staff we spoke with were knowledgeable about the care plans and were using them to make sure people's care was personalised to each individual. This was confirmed by people who used the service.
We saw the home had a 'statement of purpose' and a 'service user guide'. These were brochures which told people about the service. We saw they provided people with lots of information about the services available, staffing arrangements, social activities, menu options, medicines support, the complaint procedures, religious services and visiting times. This meant people were able to find out about the service before deciding if this was the right place for them to live. The guide was available in a picture format, and this helped people to understand its contents.