The inspection took place between the 8 and 11 May 2018 and was an announced inspection.

This service provides a combination of support as a domiciliary care agency and supported living service. It provides personal care to people living in their own houses and flats in the community and specialist housing. The supported living service provides care and support to people living in 'supported living' settings, so that they can live in their own home as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support. At the time of the inspection there were 110 people receiving a service.

Not everyone using Valleywood Care Ltd receives the regulated activity of 'personal care'; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

There was 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.

At the last comprehensive inspection on 20 April 2016, the service was rated 'Good'. At this inspection we found the service was now rated overall 'Requires Improvement'. This is the first time the service has been rated 'Requires Improvement'.

Overall people were very positive and complimentary about the service they received.

Where appropriate people’s consent to the care and support was sought. However, the service was not always compliant with Mental Capacity Act 2005 (MCA). This was a breach of Regulation 11 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

There were enough staff to meet people's individual care and support needs and recruitment processes were generally robust. People told us that the service was reliable and that they felt safe with staff. Staff had received training in safeguarding and were confident the management team would take concerns seriously. Some improvements had been made to the process for reporting and recording safeguarding concerns, but further improvements were required to ensure that all concerns were recorded.

There were individual and general risk assessments in place. However whilst we found that staff had taken action to mitigate risks, appropriate assessments were not always recorded.

People were assisted to take their medication as prescribed. However information within people's care plans over whether people were able to manage their medication themselves or required staff assistance needed to be clearer.

Staff had the appropriate skills and knowledge to support people effectively. Records showed us that staff undertook a range of training which was refreshed annually. Regular supervisions and appraisals were carried out with staff.

We saw evidence of staff working effectively to deliver positive outcomes for people. People were supported by staff to maintain their health and wellbeing through access to a wide range of community healthcare services and specialists.

Staff assisted people in a caring, patient and respectful way. People's dignity and privacy was promoted and maintained by the staff members supporting them. People were also supported to maintain their independence.

People had care plans in place which documented their needs. These plans informed staff about how a person would like their care and support to be given. They contained information about people’s history, likes and preferences. Staff were knowledgeable about people’s needs. People were given choices about their support.

The service promoted inclusion

We inspected Valleywood Care Limited on 20, 21 and 22 April 2016. As this was a supported living and domiciliary care agency service, we contacted the registered manager 48 hours before the inspection. This was so that they could let the people who lived there know we were coming. At the last inspection in December 2013 we found the service met all the regulations we looked at.

At the time of our inspection, the service was supporting 15 people in seven 'supported living' properties. Supported living describes the arrangement whereby people are supported to live independently with their own tenancies. In addition to supported living, the service also provided personal care for 100 people in their own homes.

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.

We found that people were very positive and complimentary about the service that they received. People using the service told us they felt safe and the relatives we spoke with also agreed people were safe. We found that people were protected from the risk of harm and abuse. All staff spoken with had a good understanding of safeguarding, the signs of abuse, and how to report it. However, the provider did not have a system in place to record safeguarding referrals and the outcomes of these. There had been no safeguarding concerns over the past 12 months.

Staff rotas were based upon the number of hours of support people had been assessed as needing. People, their relatives and carers told us they thought there were enough staff to meet people's needs. The rotas demonstrated that staffing levels were planned and organised, so that people received consistent care staff. Safe recruitment practices were evidenced.

People’s medicines were administered safely. However we found that protocols for as and when required (PRN) medications had not always been recorded in people’s care plans.

Risk assessments were in place and detailed. They were reviewed on regular basis. We found that it had not always been recorded when risk assessments had been reviewed if there had been no changes and it was therefore difficult to evidence that they had been reviewed.

Staff were skilled and knowledgeable. We found that staff completed an induction prior to starting work in the service. Staff received regular and ongoing training.

We found that staff had some awareness and had received training in the Mental Capacity Act 2005 (MCA). However we found that records did not demonstrate that the service had taken account of people’s mental capacity during assessments. It was unclear whether best interest decisions had been made and recorded for people who lacked capacity to consent to aspects of their care and support.

Staff were kind, caring and compassionate. People told us that staff treated them with dignity and respect. We found that staff had developed effective caring relationships with people.

Care plans were in place. They provided sufficient details and were regularly reviewed and updated. The care plans and risk assessments provided person centred information, some were very detailed and included people’s preferences and choices. We found that people were supported to maintain as much independence as possible.

People had access to the complaints procedure and told us that they knew how to make a complaint should they need to. There had been no formal complaints. We found that the management team had regular contact with people and dealt with any issues and concerns as they arose.

The service was well led. People told us that the provider was “excellent” and people felt that the registered manager was approachable. Staff told us that they were well supported. Ther

We spoke with three people who used the service. All the people we spoke with were positive about the care and treatments provided. We were told: “They provide a quality service and respect my dignity”. “I have never had carers before. I’m really pleased with them”. And: “I can’t fault them. They are absolutely wonderful”.

We spoke with two professionals about the care provided by Valleywood Care Ltd. All were positive about the service provided and the staff.

We found that care files were well maintained, easy to read and contained detailed person centred information about people who used the service. Care plans had been regularly reviewed and updated.

People told us that they received their medication in a safe manner. Care staff had received medication training as part of the induction programme provided by the service and regular updates had been completed.

We found that staff we spoke with were happy with the company and felt well supported to perform their role.

We were shown the company's complaints policy and found that people who used the service had been given information on how to make a complaint.