Valley Road - Resource Centre

Valley Road – Resource Centre 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 Road – Resource Centre is situated in Northallerton. The home provides respite care and support for up to seven people whose main needs are associated with a learning disability. At the time of this inspection only six bedrooms were in use.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Safeguarding policies and procedures were in place and these had been followed. Staff had a thorough understanding of the different types of abuse and action they should take to report any concerns. People told us they felt safe.

Safe recruitment processes had been followed and new staff completed an induction to the service. Staff received appropriate training and support to ensure they had the skills and knowledge to carry out their roles.

Risk management plans were in place and contained relevant information to enable staff and people to manage risks safely. These had been regularly reviewed and updated when changes occurred. Servicing certificates were in place where required. Accidents and incidents had been recorded and action was taken to reduce the risk of reoccurrence.

People’s medicines had been stored and administered safely. The service was clean and tidy throughout and staff followed good infection control practices.

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. Staff were observed to gain consent before providing support to people.

People selected meals of their choice. Staff were familiar with people’s preferences and supported people to eat out in the community if they wished. People were encouraged and supported to attend their regular day care provisions.

People had access to health professionals when required. Care records clearly recorded other professionals who were involved in people’s care and support. Care plans contained person-centred information which included people’s communication needs.

People and relatives told us staff were kind and caring in their approach. Staff were familiar with people’s likes, dislikes and preferences and treated people with dignity and respect.

Systems to monitor and improve the service were in place. People and relatives were asked to provide regular feedback on the service provided to encourage continuous improvement. A complaints policy and procedure were in place and available in easy read.

Staff told us management were open, honest and approachable. Staff received regular support from the registered manager and regular staff meetings had taken place to ensure staff were kept up to date with any changes or concerns.

Further information is in the detailed findings below

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to this requirement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Valley Road – Resource Centre on our website at www.cqc.org.uk’

Valley Road – Resource Centre is registered to provide respite care services for up to seven people who have a learning disability. The centre is run and owned by North Yorkshire County Council. The service is situated close to the centre of Northallerton. At the time of the inspection there were four people using the service.

The home had a registered manager in place. 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 registered manager was absent from work at the time of this inspection.

At this focussed inspection on 2 June 2017 we found the provider had followed their plan and legal requirements had been met.

Checks of the building and maintenance systems were undertaken to ensure health and safety. Maintenance records were readily available and well maintained. Fluid balance records were available for the two people who used the service who needed to have their fluid intake monitored.

Hard copies of recruitment records were available. In addition recruitment records were held electronically and could be accessed whenever they were needed. Medicine audits were readily available for us to look at during the inspection.

We looked at records which confirmed that checks of the building and equipment were carried out to ensure health and safety. Tests of the fire alarm, bed rails and equipment were undertaken to confirm they were in safe working order.

The registered manager understood their role and responsibilities, and had notified us of events or incidents, in line with their legal responsibilities to do so.

At this inspection we found the provider’s systems to assess, monitor and improve the quality of the service were effective.

Valley Road - Resource Centre is a care home registered to provide personal care and accommodation for up to seven people, including people living with learning disabilities or autistic spectrum disorder, old age, physical disability and/or sensory impairment. The service is not registered to provide nursing care. The home provides residential respite and short stay services to people who usually live in their own homes within the community. At the time of our inspection five people were actually in the home using the respite service. A total of 29 people used the Valley Road - Resource Centre for respite services, each with an assessed and planned allocation of respite stays.

The registered provider is North Yorkshire County Council. 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.

People who used the service, relatives and professionals all told us the service was well managed and providing good quality, person centred care. However, we identified that we had not always been told about incidents or events that the service had a legal responsibility to 'notify' us about. We also found that there were some gaps in some records that should have been available during the inspection. Effective internal quality checks should have identified these issues and ensured they were put right.

People who used the service and relatives told us that the service was safe. People were protected by staff who were aware of safeguarding procedures. People who used the service, relatives and staff also told us that the registered manager and management team listened and acted on any feedback.

Safe arrangements were in place for staff recruitment, with people who used the service being involved in the recruitment process. Respite services were booked and planned in advance so that suitable staffing arrangements could be made. Staffing recognised and took into account the changing needs of people who used the respite service.

The service had health and safety related procedures, including emergency plans, in place. Systems for reporting and recording accidents and incidents, including detailed reviews and actions, were in place.

Safe systems were in place for assisting people with medicines. Records and discussions with staff evidenced that that staff were trained and checks took place to ensure medicines were being given safely.

Staff had been provided with training and support to help them carry out their role. This included specialist training relevant to the needs of the people staff were supporting. Staff told us they were well supported by the registered manager.

The support people needed with eating and drinking was detailed in their care plan. Different dietary needs were catered for, with clear information available to staff.

People’s care records included detailed information about their care and support needs and preferences. People, their families and other relevant professionals had been involved in assessments and care planning. Arrangements were in place to support people who were 'transitioning' between different services and to introduce people gradually to the respite service. This helped to ensure that distress and anxiety was minimised and respite placements were successful.

People and their relatives told us that staff were caring and treated them well. Staff were able to describe how they worked to maintained people’s privacy and dignity.

We saw an example of the service responding well when a person expressed that something was wrong. People and their relatives told us that staff were approachable, listened and responded if any issues were raised.

We identified a breach of regulation. You can see the action we asked the registered provider to take in the full version of this inspection report.

A single inspector carried out this inspection. During the inspection, the inspector focussed on answering the five questions: is the service safe, effective, responsive and well-led?

At the time of the inspection there were four people living at the home. Some people were unable to tell us what they thought about the care and support they received. We observed their experiences to support our inspection. We spoke with the two care staff, one domestic, three people who used the service and the registered manager.

Below is a summary of what we found. The summary describes what people who used the service, and staff told us, and the records we looked at, if you would like to see the evidence that supports our summary please read the full report.

Is the service safe?

Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood the home's responsibilities under the Mental Capacity Act 2005 and DoLS. The registered manager showed us one deprivation of liberty application had been submitted to the local authority in line with the provider's policy and procedure.

We saw the service was safe, clean and hygienic. The home had an effective infection control system. Equipment was well maintained and serviced regularly, so preventing any unnecessary risks. All the staff told us how they worked to prevent infection and told us how they would manage an outbreak at the home so the risk of infection spreading could be reduced.

Is the service effective?

Comments from people included, 'It's cool living here' and 'I am very happy here.'

We saw people were asked by staff if they needed help or assistance and how they would like it provided. One person told us, 'I have a good holiday when I come here.'

We saw people were supported with health care appointments and to attend any monitoring clinics. We saw that people had been visited by various professionals who supported their health and social care needs. Staff told us they had good relationships with other professionals which assisted them in their work to support people.

Is the service caring?

We saw staff treated people with respect and dignity. All the people we spoke with told us they were very happy with the care they received.

Staff communicated well with people and were able to explain things in a way which could be easily understood. People were not rushed when care was delivered and we saw how staff interactions with people were caring.

Is the service responsive?

All the people we spoke with told us staff would respond to any of their requests for support. One person told us, 'I like to go out a lot.'

All the people we spoke with told us they were involved in decisions about their care. They said staff were flexible and responded to their requests promptly. We saw staff responded to people's requests for help in a timely manner.

People's care needs had been reviewed at least every six months. When people's requirements had changed the provider had responded appropriately and altered the care and support they delivered in line with these changes. Care records had been updated to reflect the person's current needs.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service well-led?

The service had a registered manager. They showed us there was an effective system to regularly assess the quality of service people received. We found the views and opinions of people, relatives and staff had been regularly gathered, recorded, analysed and responded to.

We saw the home had systems in place which ensured managers and staff learnt from any accidents, complaints, whistleblowing reports or investigations. This helped reduce the risks to people and helped the service to continually improve.

Staff told us they understood their roles and responsibilities. Staff had a good understanding of the ethos of the service and quality assurance processes were in place. This helped to ensure people could receive good quality care at all times.

Staff told us they felt settled and happy in their jobs, and were well supported by their manager. They said that they were provided with training that was relevant to the job they were performing.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately, people were supported to raise concerns and air their views if they were unhappy with the service provided.

People said they knew they could ask the staff at any time if they wanted something. They also said the staff knew them well and how best to help and support them in their everyday life.

Staff told us they felt settled and happy in their jobs, and were well supported by their manager. They said that they were provided with training that was relevant to the job they were performing. One member of staff said 'We are totally supported to do our jobs properly by the manager. She is very good.'

There was an effective complaints system available. Comments and complaints people made were responded to appropriately, people were supported to raised concerns and air their views if they were unhappy with the service provided.