Valkyrie Lodge

Valkyrie Lodge is a care home providing personal care to people who require support with their mental health. At the time of our inspection there were 5 people receiving care. The service is set in the community in an adapted building over 3 floors with a garden.

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

People we spoke with were happy living at the service and felt supported by staff.

We have made recommendation in relation to safeguarding, staff training and support and recruitment processes.

Care and treatment was not recorded in detail or in a person centred way to provide safe support to people. Care plans and risk assessments did not contain enough guidance to staff to mitigate risks to people. More robust recruitment practices needed to be implemented in line with the providers policies. Improvements were needed with medicine documentation and evidence if staff were competent to safely administer medicines.

Care documentation needed to be more person-centred and regularly updated to ensure people received the correct care and support. Staff required more frequent training to keep them up to date with best practice. Nutritional assessments should be in place to ensure people had the correct level of support with nutrition and hydration.

The registered manager needed to keep themselves and staff up to date with best practice guidance to ensure people living at the service were empowered and had positive outcomes. Better governance systems needed to be implemented to monitor and improve care delivery.

There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to access healthcare from other professionals such as the GPs and mental health services.

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

Rating at the last inspection was good (published 30 January 2018). The rating at this inspection has changed to requires improvement.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

The service had a registered manager. 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.

The service was safe. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. There were systems in place to minimise the risk of infection. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. Medication was dispensed by staff who had received training to do so.

The service was effective. People were cared for and supported by staff who had received training to support people to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. 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 were supported to eat and drink enough as to ensure they maintained a balanced diet.

The service was caring. Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care. Staff always worked hard to promote people’s independence and to treat people with respect and dignity.

The service was responsive. People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and also when there was a change in care needs. People were supported to follow their interests and participate in social activities. The registered manager responded to complaints received in a timely manner.

The service was well-led. The service had systems in place to monitor and provide good care and these were reviewed on a regular basis.

This is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

We saw that people were safe and were consenting to their treatment. The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although there were no current applications needed to be submitted. The appropriate staff had been trained and knew when to submit an application. This meant that people were safeguarded as required.

The service was safe, clean and hygienic and there were appropriate infection control policies in place. Staff were trained and supported with the correct skills to provide care to people.

Is the service effective?

People told us they could contact an advocate if needed. This meant people had independent support when required. People were involved in planning their care needs and this enabled them to maintain their independence.

Is the service caring?

We saw that people were relaxed in the company of each other and staff. We saw that staff were attentive to people's needs. Staff we spoke with were able to demonstrate they knew people well. One person told us: "I love it here, I have fallen on my feet."

We saw that people were invited twice a year to complete a satisfaction survey which was discussed in community meetings with people and with staff. This told us people were involved in their care and environment.

Is the service responsive?

People were supported to pursue their own interests and hobbies including joining the library, attending yoga and leisure trips in the community. People told us they could talk to the manager if they had a complaint. We saw there were regular community meetings where people could discuss any concerns and the running of the home.

Is the service well-led?

There were systems in place to monitor the quality of service provided. We saw staff had regular meetings and supervision with management to discuss the running of the service. Staff told us they felt supported and had received adequate training.

We looked at three care plan files and found that people's individual needs had been considered and plans detailed the support required. We found that there were systems in place to gain people's consent to care and treatment.

We also found systems in place for assessing and monitoring the quality of service provision however some systems were lacking regarding cleanliness and infection control procedures.

A person told us, 'The home is good and the best place I could come to.' Another person said that staff, 'are all approachable and professional.' A person told us, 'If you want to do something, they [staff] help you.'

During our inspection we saw that people received good care and that staff treated them with respect. We found that staff were trained in safeguarding vulnerable adults and worked in ways that kept people safe.

We found that people were cared for by staff that were supported to deliver care and treatment safely to an appropriate standard. Not all quality assurance systems in place were effective in monitoring and improving the service.