Avery Park Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider ensured people’s person-centred needs were assessed prior to them moving into the service, people and their relatives were involved in this process. This meant that the provider could be sure they had appropriate support available to be able to meet the persons needs and keep them safe. Further reviews of care took place to ensure that the service remained a suitable setting.

As well as an assessment, people could visit the service to get used to the environment prior to moving in and some people had initially stayed on respite to ensure they liked the service and their needs could be met.

The provider had a good understanding of the current legislation, national standards and evidence-based good practice guidance, however, this was not consistently followed by staff. For example, one person was assessed as being at risk of malnutrition, they had experienced weight loss and had a poor appetite. Their weights were checked and recorded monthly, but the malnutrition universal screening tool [MUST] had not been reviewed for 2 months to monitor risk. We discussed this with the registered manager who advised this was a nurse error and they would ensure this was corrected.

Another person was assessed as at risk of constipation, their care plan included good guidance for staff including what the persons normal toilet routine was. Staff had not recorded a bowel opening for 9 days and there was no evidence of any action taken. More detailed notes showed regular pad changes but still no record of bowels opening. We discussed this with the deputy manager who knew the person well and was confident this was a recording issue that they would address with staff, they were confident this would have been included in staff handover if there was an issue. The person was well with no sign of pain or discomfort.

Fluid charts did not have a target daily intake based on people’s weight for staff guidance and to ensure they received an appropriate amount of fluids daily. We observed people were offered and supported regularly with drinks and intake was good. The registered manager updated fluid records by the end of the assessment to include daily fluid targets.

We found no evidence of impact or harm to people as a result of our findings.

Choking risks to people were well managed, the provider and staff were following national guidance, care plans detailed what consistency people’s food should be prepared to, the kitchen had clear guidance on people’s needs and people were supported safely. Staff used nationally recognised tools to monitor people for signs of health deterioration, this resulted in prompt response for support when needed.

The provider and staff worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Systems were in place for sharing of information when required, this included sharing with GP’s and other health care professionals such as emergency services. Families were involved in transition between services and making decisions where required.

Records evidenced that where professional advice was given this was followed. For example, where people had been assessed by speech and language therapists’ [SALT] advice on modified diets had been recorded, shared with staff across different departments and followed.

The provider worked in partnerships with other professionals. For example, local authority safeguarding teams to ensure concerns were investigated and people were safe.

People were well supported to manage their health and wellbeing. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. The provider had a good relationship with other professionals and ensured that people could access services such as GP, podiatry and speech and language therapists [SALT] as required. A person told us, “They [staff] got the doctor out when I wasn’t feeling well and got some antibiotics sorted, so I didn’t have to go to hospital after all.” There was a visiting optician for those that preferred to see one in the service. One person told us, I’ve seen the eye people here and I have the chiropodist visits.” Another person told us they had been visited by a dentist.

People were encouraged and supported to stay mobile and active as much as possible; referrals were made to the falls team when needed. A person told us, “I’m quite independent and move around as much as I can by myself, using my walker.”

The provider ensured that people had access to a balanced diet and understood the importance of a good diet in relation to health. For example, for a person who had healing pressure sores the provider was ensuring 3 portions of protein per day in their diet to aid healing. People who needed support with eating were supported well to ensure they ate enough.

People’s care and treatment was not consistently monitored effectively as staff recording of care needed further development. For example, for one person we identified gaps in recording of oral hygiene with no reason recorded of why there was a refusal and no evidence that oral care was re offered at a different time. This meant there was no way to identify a pattern for the person so that care could be adapted to achieve a better outcome. People who do not receive regular oral hygiene are at increased risk of oral health issues which can lead to pain, poor appetite, and increased risk of chest infection.

Another person had their catheter changed to a different size than that recorded in their care plan. No rationale for the change had been recorded to advise other staff if this had provided a better outcome for the person or not. A rationale was provided by a staff member post site visit which identified this as a stock issue. There was no evidence provided that GP guidance was sought prior to the decision for a change in catheter size. However, there was no evidence of harm to the person, and the GP was later consulted regarding the incident and a sufficient amount of catheter stock was prescribed.

There was evidence of good outcomes for people, Pressure sore healing was well monitored, with consideration for good level of fluids, a protein rich diet and regular repositioning all supporting good outcomes for people. Relatives told us of positive outcomes for people including improved trust and compliance to take medication since moving into the home and improved personal hygiene.

Consent to care was sought at the point of delivery, people’s right to refuse care and support was respected. Individualised and decision specific mental capacity assessments were in place for people where needed and deprivation of liberty safeguards [DoLS] had been applied for appropriately. Staff had received training in mental capacity and DoLS and demonstrated a good understanding. One staff member explained that if people refused personal care, they would go back and try again at different times of the day but never force them. One person told us, “They’re [staff] always polite and ask before helping me.” Another person said, “They do check first if it’s ok to wash me or get me ready for bed.”