This inspection took place on 1 March 2017 and was unannounced. This meant the staff and registered provider did not know we would be visiting.

Valdigarth provides care and accommodation for up to ten people with learning disabilities. On the day of our inspection there were nine people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We last inspected the service in December 2014 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.

Accidents and incidents were appropriately recorded and risk assessments were in place. The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.

Appropriate arrangements were in place for the administration and storage of medicines.

The home was clean, spacious and suitable for the people who used the service and appropriate health and safety checks had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The registered provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff.

Staff were suitably trained and received regular supervisions and appraisals.

The registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and was following the requirements in the Deprivation of Liberty Safeguards (DoLS).

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of visits to and from external health care specialists.

People who used the service were complimentary about the standard of care at Valdigarth.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

Care plans were in place that recorded people’s plans and wishes for their end of life care and care plans were written in a person centred way.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.

The registered provider had an effective complaints procedure in place and people who used the service were made aware of how to make a complaint.

Staff felt supported by the management team and were comfortable raising any concerns. People who used the service and staff were regularly consulted about the quality of the service.

We carried out this inspection on 15 December 2014 and was unannounced.

Valdigarth provides care and support for up to ten people who have a learning disability. At the time of our inspection there were ten people living in the home.

At the time of our inspection the home had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 provider had policies and procedures in place for recognising and reporting abuse. Staff we spoke with were able to describe to us the different types of abuse and how to report any concerns they may have.

Care plans we looked at contained appropriate risk assessments which had been completed in line with people’s care plans.

The home was clean and tidy with liquid soap and paper towels available throughout for visitors to the home as well as people who used the service and staff who worked there.

We saw robust recruitment and selection processes were in place. We found appropriate pre-employment checks had been made including written references, Disclosure and Barring Service (DBS) checks, and evidence of their identity had also been obtained.

The home had an appropriate medication policy in place. We saw staff who dispensed medicines had received training in the management and storage of medicines. We looked at the medication administration records (MAR) and found they were completed clearly and correctly.

Staff working in the home received regular supervisions and appraisals with records of discussions held recorded in their personal files.

Everyone who lived at Valdigarth received care and support that was personalised to their individual needs. Care plans were in place for all the people who used the service and were reviewed and updated regularly.

Medical reviews and tests were completed when needed and results were recorded in care records. Changes to medicines were made when necessary meaning people’s care was adapted to take account of their changing needs.

There was a formal complaints procedure in place which was displayed on notice boards in the home so it was visible to people who used or visited the service.

We saw a notice board in the home providing people who used the service with information. This included access to support services and how to make complaints. We saw some of the people in the home had accessed advocacy services and advocates were in place.

The provider had a quality assurance system in place which was used to ensure people who used the service received the best care.

During the inspection we were able to observe the experiences of the eight people who used the service. We also spoke with people who used the service, the deputy manager and the three staff members on duty. One person who used the service told us, “It’s alright here, I love it, and the staff will always help me”. Another person told us that, “I really like it here. I enjoy going out during the week. I do like the staff”. Most of the people at Valdigarth had learning disabilities which limited their ability to communicate and some could not tell us their views.

We were able to observe the experiences of people who used the service. For instance, we spent time with people as they had their breakfasts and observed how staff supported and encouraged them. We saw staff encouraged people to make their own choices and decisions. We saw staff understood each person’s different needs, for example, when they had not managed independently and so required some support.

We saw that staff supported people to make choices about how they spent their day and the activities offered. On the day of our visit some of the people who used the service went out to various day centres and clubs and two people were going out horse-riding that afternoon. We saw staff had supported people as they got ready to go out.

We saw that staff treated people with dignity and respect. We saw that people had freedom of movement around their home and could spend time in their bedrooms whenever they wanted. We saw that each person had their own bedroom which was personalised. We saw the provider had made suitable adaptations to meet the people’s physical needs. We observed that staff respected people’s privacy and knocked before they entered their rooms. We saw that the staff communicated well and appropriately with people in a way that was easily understood. We saw that the staff were attentive and interacted well with people. We learned more about how care and treatment was provided when we talked with staff, observed their practices and looked at the records of four people who used the service.

We found that before people received any care or treatment they were asked for their consent and the provider had acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

“I am happy here. I like to cook and do things in the kitchen.”

“We do lots of activities and we have had some good trips.”

“The staff are nice.”

We found that people who used the service were protected and safe. We found that there was an effective infection control system in place and that the home had a clean and suitable environment.

We found that people who used the service had their care and welfare needs met.

We found that there were good systems in place for the involvement of other health or social care professionals.

We found that people’s views were important and listened to. We found that there was an effective complaints system in place.

People’s privacy and dignity were respected.

We saw the environment at the home helped to promote people's privacy. People had their own bedrooms and five rooms had an en-suite bathroom. All rooms were personalised with keepsakes. We saw staff knocked on doors before they entered rooms. They spoke with people respectfully and addressed them by their preferred name.

People were supported in promoting their independence and community involvement. We saw staff gave people opportunities to make choices about their daily lives. We looked at people's care plans in which their care needs, choices and preferences were recorded. This meant staff had clear information about how their needs should be met. The staff we spoke with were knowledgeable about the care plans and were using them to make sure people’s care was personalised to each individual. This was confirmed by people who used the service.

We saw the home had a ‘statement of purpose’ and a ‘service user guide’. These were brochures which told people about the service. We saw they provided people with lots of information about the services available, staffing arrangements, social activities, menu options, medicines support, the complaint procedures, religious services and visiting times. This meant people were able to find out about the service before deciding if this was the right place for them to live. The guide was available in a picture format, and this helped people to understand its contents.