Avenues South East - 492 Maidstone Road

Avenues South East - 492 Maidstone Road is a residential home providing care and support for four adults living with multiple learning disabilities. People who lived in the home had autism, cerebral palsy, communication difficulties, visual impairment, challenging behaviour and PICA, which is the persistent eating of substances with no nutritional value such as fabric and foliage. The service is part of a group of homes managed by the Avenues Trust. At the time of our visit, there were four people living in the home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service

Appropriate staffing levels were not always maintained to ensure people’s needs were met. Staff were not always supported through training and supervision in line with the provider's policy. The systems used to assess and monitor the quality of the service were not always effective to drive improvement. Records were not always consistent and updated when required to prevent the risk of unsafe care and support.

The home environment appeared clean and without any odours; however, hygiene levels required to be improved to prevent the risk of infection. The home environment was designed to meet people’s needs; however, this required to be refurbished.

Relatives were complimentary about the service and told us their loved ones were safe and their needs were being met. People were protected from the risk of abuse, and risks to people had been identified, assessed and had appropriate risk management plans in place. Accidents and incidents were reported and recorded, and any lessons learnt were used to improve the quality of the service. People were supported with their medicines safely.

People were supported by staff who treated them with kindness, compassion and respect. People's privacy and dignity was respected, and their independence promoted. People's communication needs had been assessed and information was presented in formats that met their needs. People were supported to participate in activities that were of interest to them and build relationships with those important to them to prevent social isolation. Relatives knew how to make a complaint if they were dissatisfied with the service but told us they had nothing to complain about.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People's needs were assessed, and care and support planed and delivered to meet individual needs. People were supported to eat healthy amounts for wellbeing and supported to access healthcare services where required. The service worked in partnership with key agencies and health and social care professionals to plan to and deliver care and support that met individual needs.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was good (published 16 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to staffing levels, supporting staff and systems used for assessing and monitoring the quality of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Avenues South East - 492 Maidstone Road is a residential home providing care and support for four people with severe learning disabilities. People who lived in the home had autism, cerebral palsy, communication difficulties, visual impairment, challenging behaviour and PICA, which is the persistent eating of substances such as dirt or paint that have no nutritional value. The service is part of a group of homes managed by the Avenues Trust. At the time of our visit, there were four men living in the home.

At the last Care Quality Commission (CQC) inspection on 01 July 2015, the service was rated Good in all domains and overall.

At this inspection we found the service remained good.

People continued to be safe at 492 Maidstone Road. Staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. Staff recognised the signs of abuse and what to look out for. There were systems in place to support staff and people to stay safe.

Medicines were managed safely and people received them as prescribed.

There were enough staff to keep people safe. The registered manager had appropriate arrangements in place to check the suitability and fitness of new staff.

Each person had an up to date, personalised support plan, which set out how their care and support needs should be met by staff. These were reviewed regularly. Staff received regular training and supervision to help them to meet people's needs effectively.

People were supported to eat and drink enough to meet their needs. They also received the support they needed to stay healthy and to access healthcare services. Staff encouraged people to actively participate in activities, pursue their interests and to maintain relationships with people that mattered to them.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The provider and staff understood their responsibilities under the Mental Capacity Act 2005.

Staff were caring and treated people with dignity and respect. People's privacy was maintained particularly when being supported with their personal care 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.

The registered manager made it certain that the complaints procedure was made available in an accessible format if people wished to make a complaint. Regular checks and reviews of the service continued to be made to ensure people experienced good quality safe care and support.

The registered manager provided good leadership. They checked staff were focussed on people experiencing good quality care and support. People and staff were encouraged to provide feedback about how the service could be improved. This was used to make changes and improvements that people wanted.

Further information is in the detailed findings below.

We looked at the care records for two out of the four people who used the service. We saw that each person had a set of care records that were individual to their needs and contained information about their mental and physical health needs.

We looked at staffing and recruitment records and spoke with staff. We saw that managers had carried out relevant checks for new staff when they joined the service to ensure that they were suitable for the role.

We looked at how the service monitored quality. We saw that there were systems in place at a local and corporate level. The service also took on board the comments from people who used the service to make improvements.

We looked at records of compliments and complaints that had been received by the service. We saw that staff had recorded what actions had been taken to follow up on comments that they had received and how they had fed back to the person making the comments.

People who use the service appeared happy and relaxed in the home. They told us that they liked living there and got on well with the staff.

People told us that they were able to give staff their feedback about the service on a daily basis.