We carried out a review of the data available to us about 23 Valley Road 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 23 Valley Road, you can give feedback on this service.
23 Valley Road is a residential care home providing personal care to four people at the time of the inspection. The provider is registered to accommodate up to five people and there are multiple shared spaces for people to access. They predominately support people living with learning disabilities and / or autism and mental health conditions.
People’s experience of using this service and what we found
People told us they felt safe and liked living at the home. People knew who they could talk to if they had any worries or concerns. There were appropriate policies and systems in place to protect people from abuse. Staff knew how to recognise abuse and protect people. People were involved in managing their own risks whenever possible. Staff anticipated and managed risk in a person-centred way, there was a culture of positive risk taking.
Risks to people were mostly recorded in their care plans. However, care plans and risk assessments had not always been updated to reflect changes in people’s support. The provider had identified this and were prioritising updating records. Staff demonstrated their knowledge of people and how to support them to manage their individual risks. Fire systems, maintenance, and services were in place, with checks in relation to health and safety. However, we found that these checks were not always consistently completed. During the inspection the provider took action to address this.
We were assured that the provider effectively managed or prevented infection outbreaks. People told us they were able to contact their family members and friends when they wanted to. The provider facilitated visits for people living in the home in accordance with government guidance.
People and staff told us there were enough staff to meet people’s needs. We observed safe staffing levels throughout the inspection and staff appeared unhurried and responsive to people. Safe recruitment processes were in place.
People received the correct medicines at the right time. Staff mostly followed systems and processes to safely administer, record and store medicines. People received care and support which met their needs. People had confidence in the ability of staff and felt they were well trained. People told us they were supported to access healthcare services when they needed it.
People were able to input into choosing their food and planning their meals. People told us they chose their food, planned meals and ate and drank when they wanted. People told us they had been involved in the decoration of the service. We found that there was some required maintenance that once completed would enhance the environment.
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. Staff were knowledgeable about how to protect people's human rights. During the inspection we observed staff respecting people’s decisions.
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.
The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture. The ethos, values, attitudes and behaviours of the management and staff provided support in the way each person preferred and enabled them to make meaningful choices. The needs and quality of life of people formed the basis of the culture at the service. Staff undertook their role in making sure that people were always put first. They provided care that was genuinely person-centred and directed by each person.
People were positive about the quality of care and support they received. People told us they were involved in making decisions about their care, were treated with respect and their privacy was respected. People, and those important to them, could raise concerns and complaints easily and staff supported them to do so.
We observed staff were friendly and caring when supporting people. Staff spoke with genuine warmth, empathy and compassion when referring to the people they cared for. Staff understood people’s different communication support needs.
The provider's vision and values focused on person-centeredness, being passionate about making a difference to people's lives and ensuring positive outcomes for people. We observed that staff understood and cared for people in a manner that was in keeping with these principles.
People, and those important to them, worked with managers and staff to develop and improve the service. There were a number of systems and processes in place for monitoring the quality of care and used to plan improvements. Where issues were identified remedial action was taken. Staff felt respected, supported and valued.
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 requires improvement (published 24 May 2021).
Why we inspected
This was a planned inspection based on the previous rating. We undertook this inspection to provide assurance that the service is applying the principles of right support, right care and right culture.
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. This included checking the provider was meeting COVID-19 vaccination requirements.
You can read the report from our last inspection, by selecting the ‘all reports’ link for 23 Valley Road on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
23 Valley Road is a specialist residential service for people aged 18 plus who may be living with learning disabilities, mental health needs, behaviours that may challenge and dementia.
The property itself has six bedrooms; five in the main house and one in the purpose-built annexe for someone with mobility restrictions. All bedrooms are bespoke and centre on the person’s needs and preferences. The property also comprises of a large garden which can be accessed by all.
People’s experience of using this service and what we found
Safeguarding systems did not consistently protect people from the risk of financial abuse. Governance systems required time to be embedded. The management of medicines required improvement to ensure people received their medicine when they needed it.
Records relating to people’s care were detailed, up to date and reviewed after incidents where behaviours challenged others. Staff received appropriate training and were supervised effectively. Relatives felt appropriate care was provided. The provider implemented effective infection control procedures which were followed by staff and visitors.
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.
This service was not able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• We could not be assured the model of care and setting maximised people’s choice, control and
Independence.
Right care:
• We could not be assured care was person-centred and promoted people’s dignity, privacy and human rights.
Right culture:
• We could not be assured the ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.
The provider took action via their governance systems to drive improvement in relation to the right support, right care and right culture.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
We previously carried out an Infection prevention and control inspection on 18 December and were assured their procedures were safe.
Why we inspected
We received concerns in relation to the possibility of financial abuse. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. 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. The overall rating for the service is requires improvement. This is based on the findings at this inspection.
You can see what action we have asked the provider to take at the end of this full report.
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. The service is purpose built to provide specialist accommodation and rehabilitation facilities for those with acquired brain injury and associated neurological conditions.
We found the following examples of good practice.
On arrival at the home visitors had their temperature taken and were asked to sign a health declaration to confirm they had no symptoms of COVID-19. All visitors were advised to wear face masks and able to wash their hands before entering the communal areas of the home.
New admissions to the home were carefully considered. One admission had taken place during the pandemic and this person was able to be isolated safely in an annexe of the home for the required period before being able to access the communal areas of the home.
Social stories had been developed for people living in the home to support their understanding of the pandemic and importance of social distancing and the wearing of masks.
The registered manager and staff team had communicated with families and friends from the beginning of the pandemic. They ensured there were twice daily calls for people with updates on activities and how people were. There were also weekly video calls with family and friends. Usually on a Sunday, which was a more relaxed day following a roast lunch. The registered manager emphasised the importance of regular communication to maintain wellbeing. One person had been distressed by the telephone calls so the registered manager and staff arranged for the person's relative to record stories of the person's childhood so they could listen to them in the privacy of their own room. This had supported the person's wellbeing.
The registered manager had taken the decision early in the pandemic to ensure that agency staff only worked at their home. This had ensured that agency staff did not work between different services.