20 November 2018
During a routine inspection
Following the last inspection, we met with the registered provider to discuss their action plan which showed what they would do and by when to improve the key questions, safe, effective, responsive and well-led. The registered provider employed the services of a consultant to provide support to the management team. At this inspection, we found improvements had been made in all areas.
Valley View Residential Care Home is a ‘care home’. 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.
Valley View is a purpose-built residential care home. The accommodation provides single rooms with en-suite toilet and shower facilities for up to 59 people. At the time of our inspection, 50 people were living at this home. There are four units; Rose, Poppy, Bluebell and Orchid unit. Poppy unit is dedicated to caring for people living with dementia.
Without exception, people told us they felt safe living at this home. Staff had received safeguarding training and appropriate action was taken in response to allegations of abuse. One safeguarding incident had not been reported to the Care Quality Commission (the Commission), although this had been reported to the local safeguarding authority and all other notifications had been submitted to the Commission. Safe recruitment practices had been followed which reduced the risk of unsuitable staff being employed.
The storage, administration and disposal of medicines was safely managed at this inspection. We discussed an exception with the registered manager and they took immediate action.
Individual risks to people had been identified, assessed and were regularly reviewed. Risk assessments included guidance for staff to follow. The management of infection control, the building and equipment staff used was effective.
Staffing levels had increased since our last inspection and a dependency took was used to ensure this continued to be a valid assessment of need. Extra staff were suitably deployed to areas of the home where people had greater needs.
Lessons were learned from events which did not go as planned and these outcomes were discussed with staff.
A dedicated training and development coordinator was responsible for the training programme which showed high levels of completion. Staff had received a recent supervision and appraisal and spot checks were taking place to ensure good standards of care were provided.
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 registered manager used a tracker to ensure these authorisations continually remained up-to-date.
Care plans we looked at showed advice was sought from healthcare professionals when required. People confirmed staff made medical appointments for them as needed.
Staff knew how to maintain people’s privacy and dignity at all times and people confirmed this happened. Staff were seen working at eye level with people, communicating effectively with them and providing reassurance where it was needed. Staff knew people well including their care preferences. People’s equality, diversity and human rights were respected and their religious needs were being met.
Care plans were being developed and improvements had been made to make these easier to use. People and their representatives had been invited to be part of care plans and reviews.
Complaints were dealt with effectively through investigation and formal responses being provided. The registered provider sought feedback through their satisfaction survey and through meetings. We saw action had been taken in response to the feedback provided.
Activities were regularly taking place both inside and outside the home. People, including those who stayed in their own room, received a variety of activities, which helped them avoid social stimulation.
The registered manager’s audits were effective in identifying concerns and demonstrating appropriate action had been taken.
The management team were approachable and since our last inspection, the registered manager had been able to focus on their oversight of the home as they were capably supported by their senior team.
Strong links had been made with a number of organisations from the local community which we were able to see positively affected people’s lives.
People had a positive mealtime experience and drinks and snacks were available throughout the day. We recommended the home calculates fluid targets for people based on guidance from the National Institute for Health and Care Excellence (NICE).