Valmark House

Updated 25 November 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 team consisted of 1 inspector.

Service and service type

Valmark House 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. Valmark House 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

The inspection was unannounced.

Inspection activity started on the 13 September 2023 and ended on 6 October 2023. We visited the service on the 13 and 18 September 2023.

What we did before the inspection

We reviewed information we had received about the service since we last inspected. 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 used information gathered as part of a CQC monitoring activity that took place on 25 July 2023 to help plan the inspection and inform our judgements. This included discussion with a relative. We used all this information to plan our inspection.

During the inspection

We visited the service, to gain a view of the service’s routines and spend time with the 2 people living at Valmark House. We observed staff interactions with people throughout the visit. We looked around the house and gardens. We spoke with the registered manager and 2 senior staff.

We reviewed a range of records. This included the 2 people’s care records, medicines records, and risk assessments. We also reviewed 2 staff recruitment records, staff rosters, staff training records and records relating to the quality assurance of the service, including audits, and fire risk assessments. The provider’s recent August/September 2023 quality questionnaires provided feedback from both people’s relatives, a social care professional and specialist health professional, on their views of the service.

Following the inspection

We contacted the provider, and the commissioner of the service, to clarify information around the staffing levels and related risk assessments.

Updated 25 November 2023

About the service

Valmark House is a residential care home providing personal care. The service can support up to 4 people, at the time of the inspection 2 people were using the service. Valmark House is a semi-detached property with single occupancy bedrooms located over three floors. People have access to a kitchen, lounge/diner, and sensory garden.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

Valmark House does not look like a care home and merges in well with the other properties forming part of a local community. People had a choice about their living environment and were supported by staff to personalise their rooms. For 1 person this included the use of interactive and sensory objects to provide a stimulating environment.

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

Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.

Within the house and gardens, people were being supported to do individual activities of their choice. Staff supported people to go out, shopping and visiting the local area. However, with the recent reduction in staffing levels to reflect occupancy, we found people were not always being given the opportunity to pursue individual interests outside the service. The registered manager said they would take action to support this happening and look at opportunities for people to try new activities to enhance and enrich their lives.

Staff enabled people to access specialist health and social care support in the community.

The service worked with people and health professionals to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative. Staff knew how people preferred to take their medicines to achieve best possible health outcomes.

Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs.

Right Care:

People received kind and compassionate care by staff who knew them well. Staff promoted and respected people’s privacy and dignity. Staff understood and responded to people’s individual needs.

Staff received an induction and on-going training, which supported them to get to know the people they were supporting and meet their changing needs.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

We saw people could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. People's care, treatment and support plans reflected their range of needs, and this promoted their wellbeing and enjoyment of life.

Right Culture

Governance systems were in place but the oversight of these was not always effective. During the inspection, we identified shortfalls in risk management, and infection control. Although action was taken by the registered manager at the time, it demonstrated a weakness in their checks and audits, which could impact on people’s safety.

Since the last inspection we found the provider had not kept updated with current best practice. The impact of the registered manager working ‘hands on,’ and providing cover for another of the provider’s services had not been assessed. No protected time was in place to support them and the provider to jointly review the quality of the service against best practice and regulations, as part of developing the service.

People benefited from having lived at Valmark House for many years. This had enabled staff to develop a good understanding of people’s communication to support them having a voice. Relatives, stakeholders and staff were all positive about the service and the quality of care people received.

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 good (published 19 March 2018).

Why we inspected

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

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Enforcement and Recommendations

We have identified a breach in relation to governance procedures at the service.

We have made 2 recommendations in relation to health and safety and infection control, to ensure the staff’s knowledge is up to date.

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

Prior to this inspection we recognised that the provider had failed to have a registered manager in post. This was a breach of regulation and we issued a fixed penalty notice [FPN]. The provider accepted the FPN and paid this in full. There was now a registered manager in post.

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.