Archived: Avenues South East - 39 Beresford Gardens

People’s experience of using this service:

• The home applied the principles and values of Registering the Right Support and other best practice guidance. These ensured people who live at the home can live as full a life as possible and achieve the best possible outcomes that include control, choice, inclusion and independence.

• People with complex health needs received personalised care and support specific to their needs and preferences; were supported by caring staff who knew their needs well, and were encouraged to remain as independent as possible.

• The environment had been tailored to meet people’s needs and preferences and risks were mitigated to ensure peoples safety.

• The provider promoted a culture at the home of the least restrictive approach which had led to less behaviour that challenged and positive outcomes for people. For example, less use of ‘as required’ medicines and more engagement with staff.

• People were supported with their communication needs to enable them to have as much choice and control of their lives as possible and staff worked in partnership with other agencies to achieve this.

• The registered manager was proactive in making improvements to the home and people’s quality of care.

• The home continued to meet the characteristics of Good in all areas.

Rating at last inspection: Good (Last report published 3 August 2016).

Why we inspected: This was a comprehensive planned inspection.

Follow up: We will continue to monitor this home and plan to inspect in line with our reinspection schedule for those services rated Good.

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

Avenues South East - 39 Beresford Gardens provides accommodation and personal care for up to four people with a learning disability. The service is a converted house. There were three people living at the service at the time of our inspection.

The registered manager was no longer leading the service. They had applied to the Care Quality Commission (CQC) to be deregistered. An acting manager had been appointed and was leading the service. They had applied to us to be registered as the manager of the service and were awaiting the outcome of their application. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff were kind and caring to people and treated them with dignity and respect at all times.

The acting manager and registered provider had oversight of the service. Staff felt supported by the acting manager and were motivated. The acting manager and staff shared the provider’s vision of a good quality service.

There were enough staff, who knew people well, to meet their needs. People’s needs had been considered when deciding how many staff were required to support them to complete different activities. Staff were clear about their roles and responsibilities and worked as a team to meet people’s needs.

Checks had been completed to make sure staff were honest, trustworthy and reliable. Disclosure and Barring Service (DBS) criminal records checks had been completed. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.

Staff had completed the training and development they needed to provide safe and effective care to people and held recognised qualifications in care. The acting manager met regularly with staff to discuss their role and practice. They supported staff to provide good quality care.

People’s care and support was planned and reviewed with them and others who knew them well, to keep them safe and help them be as independent as possible. Possible risks to people had been identified and were managed to keep them as safe as possible, while supporting them to be independent. People enjoyed a variety of activities, with support when needed.

Plans were in place to keep people safe in an emergency. Staff knew the signs of abuse and were confident to raise any concerns they had with the acting manager or provider. Systems were in place to manage complaints received.

People received the medicines they needed to keep them safe and well. Action was taken to identify changes in people’s health, including regular health checks. People were offered a balanced diet that met their individual needs.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). Arrangements were in place to apply to the supervisory body for a DoLS authorisation when necessary. People were not restricted and went out when they wanted to.

The requirements of the Mental Capacity Act 2005 (MCA) had been met. People’s capacity to make decisions had been assessed when this was needed. Staff supported people to make decisions and respected the decisions they made. When people lacked capacity to make a specific decision, systems were in place to make the decision in people’s best interests with people who knew them well.

The acting manager worked alongside staff and checked that the quality of the service was to the required standard. They also completed regular checks on the quality of the service. Any shortfalls found were addressed quickly to prevent them from happening again. People, their relatives, visiting professionals and staff were asked about their experiences of the care.

Accurate records were kept about the support people received and the day to day running of the service care. These provided staff with the information they needed to provide safe and consistent care to people.

There were three people using the service at the time of our inspection.

We observed how people reacted and responded to see if people indicated they were happy, bored, discontented, angry or sad.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

Staff told us and records showed how people's health needs were supported and that the service worked with health and social care professionals to maintain and improve people's health and well-being. We saw that care plans were regularly reviewed for their effectiveness and kept up to date to reflect the changing needs of the people using the service. However, the care and support folders contained old information which was no longer relevant and therefore it was not easy to find up to date information.

The house where the people lived was clean and free from offensive odours but it was not adequately maintained. Areas needed redecorating and some furnishings needed replacing.

We found that there were enough qualified, skilled and experienced staff to meet people's needs.

Systems were in place to monitor the service that people received to ensure that the service was satisfactory and safe.

We used a number of different methods to help us understand the experiences of people using the service. This was because the people had complex needs which meant they were not able to tell us their experiences.

We observed the interactions between people and staff. We observed how people reacted and responded to see if people indicated they were happy, bored, discontented, angry or sad.

People who use the service indicated that they were happy at the home. They were relaxed and responsive in the company of staff. They were able to let staff know what they wanted and we saw staff respond in a caring and positive way. Records showed that people had the care and support they needed to remain well and healthy.

We saw that the provider had measures in place to help safeguard people from abuse. We saw that there were measures to check that people were reliably provided with the facilities and services they needed.

Staff engaged with people in a warm and positive way and supported people where needed. Staff told us that they felt supported in their work and that they received sufficient training.

We saw evidence that staff had their work quality checked by the manager on a regular basis.