Brighton & Hove City Council - Wayfield Avenue Resource Centre

Wayfield Avenue Resource Centre is a residential care home providing personal and nursing care for people aged 40 and over who have a range of functional mental health needs. The service is run directly by Brighton and Hove City Council. The service can support up to 24 people and was providing long term and respite care to 19 people at the time of inspection.

Wayfield Avenue Resource Centre is in a purpose-built building over three floors. People’s bedrooms are located on the first and second floor and there is a short-term admissions unit. There were no people staying in the admissions unit at the time of inspection. Dining areas, kitchenettes and lounges are available on each floor and ground floor communal areas are shared by everyone. The service has gardens and a patio area to the rear of the building.

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

We found that medicines were not always managed safely throughout the home. Fridge temperatures for medicine storage were monitored but the range of high and low temperatures were not recorded. Medicine stock checks were carried out but were not always accurately recorded. During and following our visit the manager reviewed the issues we found and took steps to improve how medicines were stored and checked by staff. We have made a recommendation about the management of medicines.

People told us they felt safe from harm and well cared for by staff who understood their needs and were kind and supportive. People were involved in their assessment of needs and risks and knew the staff and managers supporting them. We observed staff speaking respectfully with people and to promote their independence by offering choices and seeking their views.

Infection prevention and control measures were in place to limit risks of infection and transmission around the building. A self-contained admissions unit had been created for people to stay in when they initially moved in. This followed current government guidance about supporting people to self-isolate on admission to care homes.

People had options to manage their own food and drink or have meals prepared for them by the service. Staff consulted people about menu planning and most people felt happy with the menu options. People knew about resident meetings and how to contact staff and managers if they had questions, requests or concerns. Some people wanted more opportunities to give feedback to the service.

People were supported to maintain important relationships and have contact with the health and social care professionals in their lives. People felt staff were good at communicating with other professionals. Feedback from staff and visiting professionals confirmed that there was effective and timely communication about changes in people’s needs and about their progress.

Staff were recruited safely and received supervision, training and support to carry out their roles with confidence. Incidents and accidents were reported by staff and investigated by managers to find ways to reduce incidents occurring again.

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.

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 (10 April 2018).

Why we inspected

We received concerns in relation to the medicine management and administration. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained good. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements to how medicines are managed. Please see the safe section of this full report.

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.

Wayfield Avenue Resource Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Accommodation is provided over three floors with all bedrooms on the first and second floor. All the bedrooms are single occupancy with ensuite facilities. Each floor has shared facilities of a lounge with kitchen and dining area and assisted bathing facilities. People with mobility issues are accommodated in the service, with a passenger lift for level access throughout the building, and further work at the front of the service has further improved accessibility. People were also able to use a garden with seating areas in the better weather. The service is located near to local amenities.

Wayfield Avenue Resource Centre provides personal care and support for up to 24 people who have a diagnosed functional mental health need such as anxiety, depression, paranoia and schizophrenia. Care and support is provided to adults over 40 years of age, but predominantly to older people. Respite care is provided or a period of short-term transitional care/assessment. This is to enable a period of assessment of peoples care and accommodation needs, and can be used to assist people to move out of hospital prior to moving into more permanent accommodation, or to support people following a period of ill health or crisis. Staff will support people to help maximise their independence, choice and dignity. There were also three people receiving long term care who have lived in the service for a number of years, prior to the changes to the services admissions criteria. Staff in the service work closely with staff from the Sussex Partnership NHS Trust. Regular visits were made from visiting psychiatrists and a registered mental nurse (RMN) is seconded to work in the service and provide support and guidance for staff. There were 20 people living in the service on the day of our inspection.

At the last inspection on 11 November 2015 the service was rated overall Good. At this inspection we found the service remained overall Good. At the last inspection there were limited opportunities for people to join in social activities. At this inspection we found work had been undertaken to address this and improve the social activities people can participate in and access in the local neighbourhood.

Systems had been maintained to keep people safe. People told us they felt safe with the care provided. People’s comments received when asked if they felt safe and why included, “Yes I do. Everybody helped and no troubles”, and “Yes, Nothing is dangerous in my view.” They knew who they could talk with if they had any worries. They felt they could raise concerns and they would be listened to. People remained protected from the risk of abuse because staff understood how to identify and report it. Assessments of risks to people had been developed and maintained. Staff told us they had continued to receive supervision, and be supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. People told us care staff had the knowledge and skills to provide their care and support.

People's individual care and support needs continued to be identified before they received a service. A detailed care and support plan was in place to ensure consistent care had been provided. Care and support was personalised and based on the identified needs of each person. People told us they felt listened to, supported to be independent and they were involved in decisions about their care. Staff had a good understanding of consent.

People were happy with the care provided. People continued to be supported by kind and caring staff who treated them with respect and dignity. They were spoken with and supported in a sensitive, respectful and professional manner. The services own quality assurance questionnaires sent out in 2017 detailed the following comments had been received from people about the staff, ‘Treat people kindly,’ ‘Friendly, caring staff,’ ‘I feel all of the staff are very kind and understanding,’ ‘We are all individual, they forgive us for wrong behaviour,’ and ‘Looks after well.’

The provider continued to have arrangements in place for the safe administration of medicines. People were supported to get their medicine safely when they needed it. If needed, people were supported with their food and drink and this was monitored regularly. People continued to be supported to maintain good health.

People and staff told us the service continued to be well led. Staff told us the registered manager was always approachable and had an open door policy if they required some advice or needed to discuss something. One member of staff told us, “The senior team, the RMN and the manager are all very approachable. It’s a good team and good communication.” Senior staff carried out a range of internal audits, and records confirmed this. People and their relatives were regularly consulted about the care provided through reviews, a residents meeting and by using quality assurance questionnaires.

This told us that people were able to express their views and were involved in making decisions about their care and treatment. People told us they felt they were well cared for by staff who understood their care needs. Comments received included " Brilliant care here,' 'We had a lovely Christmas here,' 'A very nice place and my mother is looked after beautifully,' 'Staff always address problems,' and 'Staff go over and above their duties to help.'

Infection control policies and procedures were in place to protect people. All feedback received confirmed that the service was clean.

There were sufficient numbers of staff with the right skills and qualifications to meet the needs of the people who used the service.

Systems were in place to review and monitor the quality of the care provided.

This told us people had been asked for their consent for any care or treatment, and that care workers had acted in accordance with their wishes. People or their representatives had been involved in making decisions about their care and treatment.

People's care needs had been assessed, planned, reviewed and delivered in line with their individual care plan. One person commented 'I've lived in a few places and this is the best. The attitude of the management is very positive and staff are very helpful. If I have a problem I mention it to the staff and they are on it straight away. "

People were protected from the risks of inadequate nutrition and dehydration.

Appropriate arrangements were in place for the management of medicines.

Robust recruitment practices had been followed.

The records for the management of the home were accurate and complete.