Valley View Court

Updated 14 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out on the first day by 3 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. On the second day of the inspection 1 inspector visited the service. Another Expert by Experience also carried out telephone calls with relatives and other people who are important to people using the service.

Service and service type

Valley View Court is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Valley View Court is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 10 July 2023 and ended on 27 July 2023. We visited the service on 10 and 11 July 2023.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed information we had received about the service and sought feedback from the local authority commissioners and safeguarding team. We used all this information to plan our inspection.

During the inspection

We spent time with people in the communal areas observing the care and support provided by staff. We spoke with 11 people who used the service about their experience of the care provided and 10 relatives. We spoke with 6 members of staff including the registered manager, deputy manager, senior staff, care staff. We reviewed a range of records. This included 12 people's care records and multiple people's medication records. We looked at 6 staff recruitment files and a variety of records relating to the management of the service, including policies and procedures. We continued to seek clarification from the provider to validate evidence found following the inspection.

Updated 14 September 2023

About the service

Valley View Court is specialist care home service without nursing. They provide personal care and rehabilitation for older people, some of who are living with dementia. Valley View Court provides support to people living with dementia through the short-term cognitive impairment assessment beds, as well as rehabilitation support through the rehabilitation and escalation beds they have available. The care home accommodates people across 5 separate wings, each of which has separate adapted facilities. At the time of inspection 2 of the wings were closed to admissions. The service is registered for up to 50 people and the time of inspection there were 26 people using the service.

People’s experience of using this service and what we found

People were not always safe. People were at risk of harm as the provider had not always identified, assessed or mitigated risks. Medicines were not managed safely. The lack of appropriate care placed people with high nutritional needs at risk of harm.

Management and oversight of the service had failed to robustly identify improvements needed to ensure safe care. Systems and processes were not always effective in assessing, monitoring and mitigating risks to the health, safety and welfare of people using the service. The provider had multiple quality monitoring processes in place, but these did not always identify and address the issues we found during the inspection. This placed people at risk of harm.

Inconsistent and ineffective care assessment meant people did not always receive person-centred care and care records did not fully reflect their needs. This was compounded by the provider and on site health care professionals having different electronic care recording systems. Whilst staff were kind and caring care records produced were task focused.

Recruitment processes prior to employment were safe and new staff received an induction programme. Most staff had completed a range of training which gave them the skills and knowledge to care for people.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests.

People and their relatives generally told us they liked the service.

We noted the provider was still in the process of addressing concerns we found at our last inspection. However, the registered manager took action to update practice following feedback we highlighted during the inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate ( 6 January 2023) and there were breaches of regulation.

At the last inspection, the provider was in breach of 5 regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last 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 inadequate based on the findings of this inspection. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Valley View Court on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to medicines, managing risk, mental capacity, assessment principles, and good governance at this inspection. We have made recommendations about; recording and monitoring of staff training, care settings for people living with dementia, activities that are socially and culturally relevant to reablement and care planning.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.