Valley House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Staffing levels at the service were exceptional, meaning people had full control of when and how they utilised the staff support available to them. Staff were matched to people based on their likes and personalities. The management team inspired staff to be highly trained and motivated to support people in an exceptionally person-centred way. People were safeguarded from abuse and were supported to mitigate risks in their everyday lives as far as possible.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People were unable to verbally speak with us about how safe they felt. However, they showed us using signs and their interactions with us and the staff team that they felt relaxed and comfortable. One person gave us a ‘thumbs up’ indicating they felt safe within the environment. A relative said, ‘‘Since living at the service [family member] seems so much happier and more sure of themselves because they feel secure. I know the staff know what to do if anything ever happens and this is reassuring.’’

Staff were trained in safeguarding and spoke with us about what signs may indicate abuse. They knew how to report concerns both to the management team and externally to organisations such as the local authority safeguarding team and CQC. The management team showed us the processes they had in place to manage safeguarding incidents and how these were discussed with staff to see if any lessons could be learned for the future.

We observed the service during our site visit and people were kept safe. There were plentiful staff available to support people. The building was secure, and people were being supported to keep safe. For example, staff made sure people had the correct level of support whenever they left the service. Staff supported people in line with their risk assessments as discussed in the Involving people to manage risks quality statement.

The management team showed us the processes in place in relation to reporting safeguarding concerns to the local authority safeguarding team. They also showed us how potential safeguarding events were discussed with staff in supervision and team meetings to help see if anything could be done differently in the future. The management team regularly checked staffs understanding of safeguarding procedures to make sure they understood their responsibilities.

People were unable to verbally speak with us about how risks were managed. However, they showed us using signs and their interactions with us and the staff team that they safe being supported by the staff team. One person was visibly excited being speaking with staff about how to stay safe when using the stairs. This person gave staff a ‘high five’ and vocalised their happiness with doing this. One relative said, ‘‘I have been involved in all the care plans and risk assessments and they really are very detailed. I know the staff have everything they need to know to keep [family member] safe.’’

Staff were confident in explaining what people’s support needs were and explained in detail how to support people as safely as possible. Staff told us they used their training in areas such as using equipment or supporting people living with learning disabilities to maximise how safe people were when they supported them. The management team explained they reviewed risk assessments constantly and also considered any feedback from the staff team that may indicate people’s support needs had changed.

People were supported in line with their risk assessments. For example, staff made sure there were enough staff with people when they chose to leave the service. We observed staff communicating with people in line with their risk assessments to help make sure they did not become overwhelmed or worried. One person told us using signs and vocalisation about how when there were issues with the building staff made sure ‘men’ came to fix any issues.

The management team had ensured people’s risk assessments and care plans were very detailed and gave staff guidance about how to support people in line with their assessed risks. Staff completed health and safety, including fire checks of the environment to help ensure the environment was safe. People were supported to take positive risks and we discuss this more in the Caring key question.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People had fantastic control of how they spent their time due to the exceptional staffing levels at the service. People were able to leave the service or do what they wanted to do in the service as a result of the correct staffing levels being available to them at all times of the day. People were unable to verbally speak with us about staffing levels. However, they showed us using signs and their interactions with us and the staff team they had the staff to enable them to have access to support at any times they needed this. One person chose to change their mind frequently when it came to leaving the service. They required two staff to support them in the community. However, they were able to choose to leave the service multiple times in a day as staff were always available to support them. The management team also showed us a lot of evidence in the form of pictures, of people being supported to leave the service and be supported whenever they chose, thanks to staff always being available to support them. This had resulted in some fantastic opportunities for people who had been supported to do things they would otherwise not have been able to do. For example, go on holidays, swimming or out for leisure activities and meals. Relatives comments included, ‘‘[Family member] needs two staff at all times and this is always the case. All they have to do is get the car keys and off they go. It is superb.’’ and, ‘‘A big part of [family member’s] wellbeing being better is that staff are always around at all times of the day should they want to go out.’’

Staff told us they felt there were ‘more than enough’ staff to support people at any time. One staff member said, ‘‘There are plenty of staff here and we do not use agency staff so everything is very consistent. It is brilliant being able to do what people want all the time.’’ Staff spoke positively about their training and the impact this had on their job roles. One staff member explained, ‘‘The training about how to support people living with learning disabilities was brilliant. It really focused on what we can do to help people understand what we are saying to them and support them with their sensory support needs. As soon as I had the training I knew what I could do to help people understand me more easily.’’ The management team were dedicated and focused solely on making sure staffing levels were suitable for people. They also ensured staff were matched to people’s personalities and preferences as far as possible. The registered manager explained, ‘‘We make sure staff induction here is very thorough and staff will not work with people one on one until they have got to know them for a few months. We do a personality matching exercise with all our staff to see who they would be best suited to and this helps us work out a core team of staff for the person. They get to know the staff really well and the staff share their interests, making it easier for them to support the person as best as possible.’’

We observed there to be a fantastic level of staff available to support people when and if they chose to be supported. As well as people’s ‘core staff’ there were also several ‘float staff’ available for people to access if they chose to do something which required more staff support at short notice. These float staff worked in the office areas of the service keeping up to date with training or updating support plans, however, primarily were available to support people should the need arise. One person needed three staff to access the community safely. They decided to go swimming spontaneously and staff responded immediately to make sure the person was able to leave as fast as possible. The person needed this quick responsive approach to successfully access the community and it was excellent to see this level of staff available to support people at any one time. Another person became upset because of something that was out of their control and staff knew a change of face often helped the person feel better. As there were exceptional staffing levels at the service this was facilitated quickly and the person immediately felt more relaxed as a result. We observed staff training had been very effective and staff were confident and exceptionally competent in supporting people. For example when people became upset, staff used distraction techniques and calm but very structured communication with them, in line with their care plans and risk assessments to help them feel better. This had an immediate visual impact with people being happier almost immediately and showing this by smiling and ‘high fiving’ staff.

The registered manager and management team explained the processes they had in place to make sure staffing levels were beyond adequate. They explained that rotas and staffing levels were being consistently reviewed to make sure they met people’s individual needs as well as making sure staff were suitable trained and had the right personalities and work ethic to support people as effectively as possible. They said , ‘‘We have worked hard to find the right staff and make sure we cut our use of unfamiliar staff to the point where we have a completely consistent staff team now. We give bespoke training to make sure staff are the best they can be and truly listen to staff when we have meetings to make sure they are supported to have the most up to date knowledge available. We match staff to people as best as possible and the results of this are clear if you look at our staff retention rates.’’ The management team completed supervisions and meetings with staff to discuss training and any support needs they had. One member of the team told us staff identified a need for further training in using different communication methods and this was sourced immediately. Staff felt incredibly well supported and we discuss this further in the Caring key question. The provider had procedures in place to help ensure new staff were suitable for their job roles at the service.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.