This inspection took place on 04 and 05 December 2017 and was announced. We gave the provider 48 hours’ notice that we would be visiting the service. This was because the service provides domiciliary care to people living in their own homes and we wanted to make sure staff would be available. At the last inspection on 07 and 08 December 2016, we found that the provider was ‘good’ under the key questions of effective, caring and responsive. However, we found the provider required improvement under the key questions of safe and was not meeting all the regulations under well-led. This was because systems in place to assess and monitor the quality of the service were not always used to identify where improvements were needed. The provider submitted an action plan detailing how they intended to improve the service.

Pleasant Valley Care Limited is a domiciliary care agency registered to provide personal care to people living in their own homes. At the time of the inspection the service supported 35 people ranging in age, gender, ethnicity and disability.

There was a registered manager in post at the time of the inspection. 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.

During this inspection we found the provider had not always reported notifiable incidents as required to do so by law. This was a breach of the Care Quality Commission (Registration) Regulations 2009.

Although the service had made sufficient improvement to meet the conditions of the breach identified at the last inspection; systems in place to assess and monitor the quality of the service provided to people were not always used effectively and required further improvement. Some care plans had not contained information to support staff and audits to identify or manage risks also required improvement.

Full information about CQC's regulatory response to issues and concerns found during inspections are added after any representations and appeals have been concluded.

Some people had experienced late and/or missed calls. We found there were still a number of occasions where calls were late and the time management of staff required further improvement. However, the provider had recently implemented an electronic call monitoring system which provided some assurance that calls would not be missed.

People felt safe in their homes with staff. Relatives believed their family members were kept safe. Staff understood the different types of abuse and knew what action they would take if they thought a person was at risk of harm. Risks to people were assessed and people were supported by staff that was provided with guidance on how to manage people’s specific medical conditions.

People were supported by sufficient numbers of staff that had been safely recruited. People were supported with their medication by staff that had received appropriate training. Staff members were equipped with sufficient personal protection equipment to reduce the risk of infection and cross contamination when supporting people with their personal care.

People’s needs were assessed to ensure the care and treatment provided was individual to the person. People were supported by staff that felt they had the skills and knowledge to care and support people in their homes. Where appropriate, people were supported by staff to access health and social care professionals.

People were supported to make choices and were involved in the care and support they received. The provider was taking the appropriate action to protect people’s rights.

People told us staff members were caring and treated them with dignity and respect. People’s choices and independence were respected and promoted and staf

This announced inspection took place over two days on 07 and 08 December 2016. We gave the provider 48 hours’ notice that we would be visiting the service. This was because the service provides domiciliary care and support to people living in their own homes and we wanted to make sure staff would be available to talk with us about the service. At our last inspection on 09 December 2015, we found the service to be requires improvement in two of the areas inspected. These related to the Safe and Well-led domains.

Pleasant Valley Care Limited was first registered August 2014 to provide personal care and support for adults in their own homes. At the time of our inspection the service provided care and support to 25 people.

At the last inspection the service did not have a registered manager in post. The service is required to have a registered manager in post. At this inspection there remains no registered manager in post. However, the provider was actively involved in the management of the business and was present throughout the site visit. The provider has recruited a care manager and it is intended to submit an application for the care manager to become the registered manager in January 2017. 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. At the last inspection, it was found there were insufficient numbers of staff working for the provider. People were not always protected from the risk of unsafe practice because risks associated with some medical conditions had not been appropriately assessed. The provider’s quality assurance and audit systems were not always effective because their processes did not identify action taken or what measures were put in place to recognise trends and prevent re-occurrences of events. We found at this inspection there had been some improvement but further improvement was required.

Systems in place to assess and monitor the quality of the service provided to people were not used effectively and required further improvement. Care plans had not been consistently reviewed; audits to identify or manage risks had not been consistently conducted. The procedures in place to ensure that potential new staff had background checks completed were not always robustly applied and also required improvement. You can see what action we have told the provider to take at the end of this report.

Most people had experienced late and some missed calls at short notice when unplanned staff absences occurred. There was some inconsistency with staff informing the office they were going to be late which made it difficult for the provider to inform people their calls would be late. Although the provider used an electronic call monitoring system which provided some assurance that calls would not be missed, we found staff did not consistently use the system and at least one missed call had not been identified. People told us it was important to them to see the same staff member(s) and they felt this had improved and that the provider tried to achieve this where possible.

People felt staff had the skills and knowledge to care and support them in their homes. The provider required new staff complete a two day induction training programme. New staff spent time shadowing an experienced staff member until they were deemed competent to work unsupervised. Staff explained they had completed their training although we found the provider had not maintained the staff training records to reflect completed training by staff and this required improvement.

Staff was caring and treated people with dignity and respect. People’s choices and independence was respected and promoted and staff responded to people’s support nee

This inspection took place on 10 December 2015 and was announced. We gave the provider 48 hours’ notice that we would be visiting the service. This was because the service provides domiciliary care and we wanted to make sure staff would be available. This was the first inspection for this location following registration with us in August 2014.

Pleasant Valley Care Limited is a domiciliary care agency registered to provide personal care to people living in their own homes. The service currently provides care and support to 14 people, ranging in age, gender, ethnicity and disability.

There was no registered manager in post at the time of the inspection. 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 were not always protected from the risk of unsafe practice because risks associated with some medical conditions had not been assessed. Staff did not always have sufficient guidance on how to support people with specific medical conditions.

There were insufficient staff numbers consistently available to meet people’s needs in a timely manner. There were ineffective systems in place to cover for holiday and unplanned absences.

The provider was taking the appropriate action to protect people’s rights to ensure their liberty was not being deprived. However staff knowledge about what would constitute a deprivation of somebody’s liberty was lacking.

The provider had quality assurance and audit systems in place to monitor the care and support people received. Systems were not always effective and required improvement. Processes did not record what action was required, what measures were taken to recognise any trends and prevent a re-occurrence of similar errors.

People were left safe and secure in their homes. Relatives believed their family members were kept safe. Staff understood the different types of abuse and knew what action they would take if they thought a person was at risk of harm. The provider had processes and systems in place that kept people safe and protected them from the risk of harm.

People were supported by staff that were safely recruited and had received appropriate training so that they were able to support people with their individual needs.

People were supported to take their medicines as prescribed.

People felt staff had the skills and knowledge to care and support them in their homes. Staff were trained and supported so that they had the knowledge and skills to enable them to care for people in a way that met people’s individual needs and preferences. Where appropriate, people were supported by staff to access other health and social care professionals.

Staff were caring and treated people with dignity and respect. People’s choices and independence was respected and promoted and staff responded to people’s support needs.

People felt they could speak with staff about their worries or concerns and they would be listened to and have their concerns addressed.