Archived: Avenues South East - 1a Spencer Way

Avenues South East – 1a Spencer Way (Spencer Way) is a residential care home providing accommodation or personal care for up to seven people with a learning disability and/or autism. At the time of our inspection, five people were 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.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to seven people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service and what we found

People appeared happy and relaxed in their home and in the company of staff. Their relatives told us they felt their family member felt safe living at Spencer Road. Risks to people’s safety had been assessed and measures implemented to keep them safe. A positive approach to risk taking was followed to ensure people’s independence was maintained. Staff were aware of their responsibilities in safeguarding people from abuse and had developed open and trusting relationships with people.

Staff had received training and support from healthcare professionals with regards to people’s individual health needs. This had enabled staff to provide people with individualised support in these areas. People’s family told us their family member enjoyed their food and they were offered choices in how they spent their time.

People’s relatives told us staff were caring and treated their family members with respect. Staff had worked at the service for many years and positive relationships had been developed between people and staff. There was a warm and homely atmosphere and people were clearly comfortable living at Spencer Way.

People received a personalised service and were involved in developing their care plans. Staff knew people’s life histories, preferences and routines. Activities were based around people’s choices and people were supported to take part in the running of their home.

There was a positive culture within the service where people, staff and relatives felt listened to. The registered manager felt supported by the provider and this flowed through the service. Quality assurance systems were in place which ensured high standards were maintained.

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.

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 18 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 1A Spencer Way on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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 inspected Avenues South East - 1a Spencer Way on 1 December 2016. The inspection was unannounced. The service was last inspected in December 2013 when it was found to be not meeting the requirements of the regulations.

People told us they felt safe at the service and with the staff who supported them. For example we were told: “I like it here – yes, feel safe, yes I do. I know carers are there for me,” and a relative told us: “He’s very happy there – he seems secure and I feel he is safe, yes. He is very well looked after.”

People told us they received their medicines on time. Medicines administration records were kept appropriately and medicines were stored and managed to a good standard.

Staff had been suitably trained to recognise potential signs of abuse. Staff told us they would be confident to report concerns to management, and thought management would deal with any issues appropriately. A member of staff told us: “I would have no hesitation in raising concerns about anything to do with safety – I understand about whistle blowing – we have that in the training.”

Staff training was delivered to a good standard, and staff received updates about important skills such as moving and handling at regular intervals. Staff also received training about the needs of people with learning disabilities. Staff told us “Training is good. It has helped me broaden my knowledge.”

Recruitment processes were satisfactory as pre-employment checks had been completed to help ensure people’s safety. This included written references and an enhanced Disclosure and Barring Service check, which checked if a person was suitable to work with vulnerable adults.

People had access to medical professionals such as a general practitioner, dentist, chiropodist and an optician. People said they received enough support from these professionals.

There were enough staff on duty and people said they received timely support from staff when it was needed. For example we were told “There’s always enough staff for residents to have their planned one to one time.” We observed any requests for assistance being responded to quickly, and staff always being attentive to people’s needs.

Care was provided appropriately and staff were viewed by people and their relatives as caring. For example a relative told us: “We’re very pleased with the quality of the care, and the staff are always welcoming,” “I watched the staff at the big BBQ they have each year – they were really attentive, and they did treat everyone with respect,” and: “I think they’re wonderful – (our relative) is so happy there – they are kind and caring.”

People had opportunity to participate in a wide choice of activities. People were busily involved in a range of activities on the day we visited. People were able to attend several different centres locally, which offered up a wealth of things to do. They also have the opportunity to go on an annual holiday if they want to. One person said: “I like the cookery – that’s my best. I like the cycling too. And I like the jigsaws – like doing the jigsaws with X (staff member).” Relatives told us: “They have lots of activities – a great busy life really. There is lots on, and in the evenings they sometimes have music, I think. Or they will get together maybe with the other house too,” and: “If they don’t want to do what’s on the plan, they’re not made to. So, then they might go for a walk, or a bus ride, so they get out a lot.”

Care files contained information such as a care plan and these were regularly reviewed. The service had appropriate systems in place to assess people’s capacity in line with legislation and guidance, for example using the Mental Capacity Act (2005).

People were happy with their meals. Everyone said they always had enough to eat and drink and were provided with a choice of meals. People received enough support when they needed help with eating or drinking. For example, we were told: “We know what they like, and what they don’t like – we change the menus, introduce new things – and there’s always a choice if they are not in the mood for what’s on the menu.”

People we spoke with said if they had any concerns or complaints they would feel confident discussing these with staff members or management, or they would ask their relative to resolve the problem. They were sure the correct action would be taken if they made a complaint. For example, we were told: “I am sure they would listen – I have no reason to think otherwise, but have had no cause to complain at all,” and “I haven’t had to complain, and in my job I’m used to having to do that, so would be fine with raising things if necessary.”

People felt the service was well managed. We were told the registered manager and assistant manager were approachable and friendly, and appeared to be “hands on”. We were told: “They are a well led set-up – and professional – they really want the best for the people we support, and they are prepared to listen,” and: “The team seem well managed now – yes, I think they are – it’s not an easy job, the residents are quite a complex group of people with individual needs!”

Staff and relatives told us they had residents meetings every three months, and relatives had been asked for their feedback about the service on a regular basis. We were told: “We have a survey at least once a year, maybe twice this year actually. I give feedback all the time anyway,” “Yes, I do get questionnaires / surveys to fill in, and I reply,” and: “They don’t have relatives’ meetings, no, but they have events like the BBQ and we’re always asked for any feedback and ideas about improving things.”

This is what we have been told is that: People who use the service were being treated in a way that respected their privacy, dignity, and human rights. The provider told us that staff had been retrained in order that they provided care in a way that acknowledged, recognised or protected the right to privacy and dignity of the people who lived at the service. The service took remedial environmental action and had fitted self-closing devices on all bathroom doors to maximise the privacy of people accessing these facilities.

The provider also told us that they had addressed the dignity concerns when first identified Regulation 17.'(1)(a) (2)(1)(a)(h).

People who used the service also told us the food was nice and they got enough to eat. They said they liked their rooms and they were warm enough.

Two people told us if anyone upset them they would tell a named but different member of staff.

People told us they were looking forward to the birthday party planned for that evening for a fellow resident. People were also very excited about Christmas and talked about those plans too.

Our visit was unannounced and early in the morning at 8:18 AM and we found the building fresh and clean and saw that people were usually treated with respect and dignity.

We saw that although staff generally treated people with respect and dignity, this was not always the case because staff did not always provide care in a way that acknowledged, recognised or protected their right to privacy and dignity or address dignity concerns when first identified.

We found the home did have suitable arrangements in place to obtain, and act in accordance with, the consent of people who use the service, or the consent of another person able lawfully to consent to care and treatment on that persons behalf; or where the person lacked capacity, establishing and acting in accordance with the best interests of the person in line with the Mental Capacity act 2005.

We saw people experienced care, treatment and support that met their needs and protected their rights and there were contingency procedures in place to plan for all foreseeable emergencies.

We found that people who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.

We spoke with two people who used the service. People we spoke said that they were happy with the care that they received. They said staff "gets them to do things for themselves if they can".

Another one person told us, that they "were happy with the staff and they looked after me and care about me" they continued to say that they "know all the staff and they are all nice".

People told us that they enjoyed the activities which they could choose to participate in or not. We observed staff sitting beside people and they assisted them with their chosen activities in a sensitive way.

We observed staff interacting with people in a friendly and caring manner.