Valor Care Services improved from Requires Improvement to Good at this focused inspection, with previous breaches of Regulation 18 (staffing) resolved through better recruitment and an electronic visit-monitoring system. A recommendation was made about auditing staff recruitment records after two incomplete employment applications were identified.
Concerns (2)
minorRecord keeping: “two staff had incomplete applications. Following our on-site visit the registered manager ensured that staff provided the missing information to complete the forms.”
minorGovernance: “The registered manager recognised that the need for this action reflected a shortfall in the provider's auditing processes.”
Strengths
· Sufficient staffing levels with no missed visits since last inspection
· Electronic care monitoring system alerts manager to late visits within 15 minutes
· Staff trained in safeguarding, medicines, infection control and dementia awareness
· People felt safe and praised staff's caring attitude
· Regular supervision and induction including shadowing for new staff
Quality-Statement breakdown (15)
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies; supporting people to access healthcareNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
well-led: Promoting a positive, person-centred cultureNot rated
well-led: Managers and staff clear about roles, quality performance, risks and regulatory requirements; duty of candourNot rated
well-led: Engaging and involving people, public and staffNot rated
well-led: Continuous learning and improving care; working in partnership with othersNot rated
Valor Care Services was rated Requires Improvement overall, with a breach of Regulation 18 (Staffing) due to inadequate training, supervision and appraisal of staff, alongside recruitment failings and persistent late visits. Caring and responsive remained Good, with people praising kind, person-centred staff and respectful treatment, but governance systems failed to detect these issues.
Concerns (7)
criticalStaff training: “most staff had not received or updated their training in relation to safeguarding adults, moving and handling, food hygiene, infection control, Mental Capacity Act 2005”
criticalSupervision / appraisal: “staff had not had individual or group supervision meetings with the registered manager on a regular basis, nor had their overall work performance been appraised yearly”
criticalOther: “one new member of staff's file did not include an update DBS check... had recently allowed one new member of staff to start working unsupervised”
moderateMissed or late visits: “We're never sure when staff are coming…They're all very nice, but their time keeping is very poor.”
moderateStaffing levels: “staff time keeping continued to be a problem, which had been made worse by having a large number of staff vacancies”
moderateSafeguarding: “Staff knew how to recognise and report abuse, despite not having completed up to date safeguarding training.”
moderateGovernance: “these governance systems were not always operating effectively because they had failed to pick up a number of issues we identified during our inspection”
Strengths
· Staff treated people with respect, dignity, kindness and compassion
· People received their prescribed medicines safely with no recording errors found
· Care plans were personalised, person-centred and up to date
· Effective infection prevention and control with PPE provided
· Continuity of care from a small group of familiar staff
Quality-Statement breakdown (23)
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Using medicines safelyNot rated
safe: Learning lessons when things go wrongNot rated
safe: Preventing and controlling infectionNot rated
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated