Parvale House

Updated 26 February 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

This inspection was carried out by one inspector.

Service and service type:

Parvale House 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. The service accommodates up to six younger adults with learning disabilities and Prader-Willi Syndrome. At the time of our visit there were six people using the service.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.’

Notice of inspection:

This inspection was announced. We gave the service 48 hours’ notice of the inspection visit because the location was a small care home for younger adults who are often out during the day. We needed to be sure that they would be in.

The inspection site visit activity started on 20 December 2018 and ended on the 21 December 2018. We visited the service on the 20 December 2018 and looked at records, spoke with people using the service and staff and completed a tour of the premises. On the 21 December we spoke with two relatives over the telephone.

What we did:

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The provider returned the PIR and we took this into account when we made judgements in this report. We reviewed other information that we held about the service such as notifications. These are events that happen in the service that the provider is required to tell us about. We also considered the last inspection report and information that had been sent to us by other agencies. We also contacted commissioners who had a contract with the service.

During the inspection, we spoke with five people who used the service and one relative. We also had discussions with five members of staff that included the operations manager, the registered manager and three care and support staff.

We looked at the care and medication records of two people who used the service and observed information on display around the service such as information about safeguarding and how to make a complaint. We also examined records in relation to the management of the service such as staff recruitment files, quality assurance checks, staff training and supervision records, safeguarding information and accidents and incident information.

Updated 26 February 2019

About the service:

¿ Parvale House provides accommodation with personal care for up to six people. This is a service that specialises in supporting adults with a range of complex needs and behaviours associated with Prada-Willi Syndrome (PWS). This is a genetic condition that means people with the condition will have an abnormal, insistent desire for food which can make the person eat excessively. This has the potential to result in life threatening obesity. There were six people using the service at the time of our inspection.

People's experience of using this service:

¿ The staff and the management team were passionate about providing people with support that was based on their individual needs, goals and aspirations. We saw that people were at the centre of their care and each person was treated as an individual. As a result, their care was bespoke and tailored to meet their exact needs. Without exception, people spoke positively about their experience of the service and the successes they had been supported to achieve.

¿ Staff had an exceptional understanding of people's individual needs and supported them to achieve their hopes for the future, their wishes and aspirations. They worked as a close team and were driven in providing person centred support to enable people to achieve as much independence as possible. People and their families were central to the care planning process and felt listened to. Each person was respected as an individual, with their own social diversity, values and beliefs. People received care and treatment that was delivered in line with up to date best-practice guidelines in relation to Prader-Willi Syndrome.

¿ Staff viewed complaints and concerns as a process for driving improvement at the service. People, relatives and staff knew how to raise concerns and make a complaint if they needed. There were numerous forums where people could raise any concerns or complaints if they needed to. These included one to one meetings, a suggestion box and house meetings.

¿ The management had a clear structure and were knowledgeable about people's needs and key issues within the service. They had the skills, knowledge and experience to perform their roles, with significant experience in managing Prader-Willi Syndrome. The provider had clear visions and values about how they wished the service to be run and these values were shared with the whole staff team. Staff had clearly adopted the same ethos and enthusiasm and this showed in the way they spoke about people.

¿ People continued to receive safe care. Staff had been provided with safeguarding training to enable them to recognise signs of abuse and how to report them. There were risk management plans in place to protect and promote people's safety. Staffing numbers were appropriate to keep people safe and the registered provider followed thorough recruitment procedures to ensure staff employed were suitable for their role. There were systems in place to ensure people were protected from the spread of infections. People's medicines were managed safely and in line with best practice guidelines. If any accidents or incidents occurred lessons were learnt and action taken to reduce risk in future.

¿ People's needs and choices were assessed and their care provided in line with best practice that met their diverse needs. Staff received an induction process when they commenced work at the service and on-going training to ensure they were able to provide care based on current practice. Each person's food intake was closely monitored to ensure they maintained a healthy weight in line with best practice guidance in relation to Prader-Willi syndrome. Staff supported people to access health appointments when required, including opticians and doctors, to make sure they received continuing healthcare to meet their needs.

¿ 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 caring and had built open and honest relationships with people. They spoke of a family atmosphere at the service and demonstrated a genuine interest in people's wellbeing. People were happy with the care they received and felt valued by staff and the management team. People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted.

More information is in Detailed Findings below:

Rating at last inspection: Good (report published 18 August 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. At our last inspection we rated the service Good. At this inspection we found the service had improved to outstanding under the responsive and well-led domains. The overall rating for this service is Outstanding.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.