The Care Quality Commission
  • Care Home
  • Care home

Archived: Consensa Care Limited - Third Avenue

Overall: Good read more about inspection ratings

21-25 Third Avenue, Manor Park, London, E12 6DX (020) 8514 5169

Provided and run by:
Consensa Care Ltd

All Inspections

10 July 2014

During a routine inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014. 

At the previous inspection of this service in December 2013 we found a breach with regulations because the service did not have effective systems in place to monitor and assess the quality of care provided. We found this breach to be met during the course of this inspection. This inspection was unannounced.

The service is divided into two separate houses next to each other. One home is for up to four adults with mental health needs and associated brain injuries. People in that home require minimal staff support and are able to access the community independently. The other home is for up to seven adults with learning disabilities, and specialises in providing support to people with challenging behaviours and/or autism. At the time of our visit this home had three vacancies.

People told us they were happy with the care and support provided. We found that systems were in place to help keep people safe. For example, staff had a good understanding of issues related to safeguarding vulnerable adults. Where people had behaviour that challenges clear guidelines were in place and we saw staff following these guidelines. However, we did have concerns that the shift patterns that staff worked potentially put people at risk as staff reported they felt very tired sometimes at work. If staff are too tired to carry out their required duties then this could potentially affect the quality and safety of care provided to people.

We found that the home was responsive to people’s needs and people were able to make choices over their daily lives. Where there was a need for a Deprivation of Liberty Safeguard (DoLS) authorisation it had been implemented appropriately. People who were subject to a DoLS authorisation were supported by staff to access the community in line with their assessed needs and stated wishes. DoLS is law protecting people where the state has decided their liberty needs to be deprived in their own best interests.

Staff had a good understanding of their roles and responsibilities and we observed staff interacting with people in a respectful and caring manner. Staff told us they had undertaken various training courses such as first aid and the safe administration of medication. However, the service had highlighted the need for more specialist training for example about working with people with autism.

Although the service had a registered manager in place that individual had no responsibility for the day to day running of the home. They were in day to day control of the service in the past, but for more than a year they have worked as the manager of another location that is operated by the same provider. The service does have a manager in place that is in day to day charge of the home, but they are not registered with the Care Quality Commission. This is the person we are referring to throughout this report when we refer to the ‘manager’. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

Staff and people that used the service told us they found the manager to be approachable and accessible and we observed an open and relaxed atmosphere in the home. Quality assurance systems were in place which included seeking the views of people that used the service. It was however noted that not all health and safety checks had been carried out thoroughly.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014. 

At the previous inspection of this service in December 2013 we found a breach with regulations because the service did not have effective systems in place to monitor and assess the quality of care provided. We found this breach to be met during the course of this inspection. This inspection was unannounced.

The service is divided into two separate houses next to each other. One home is for up to four adults with mental health needs and associated brain injuries. People in that home require minimal staff support and are able to access the community independently. The other home is for up to seven adults with learning disabilities, and specialises in providing support to people with challenging behaviours and/or autism. At the time of our visit this home had three vacancies.

People told us they were happy with the care and support provided. We found that systems were in place to help keep people safe. For example, staff had a good understanding of issues related to safeguarding vulnerable adults. Where people had behaviour that challenges clear guidelines were in place and we saw staff following these guidelines. However, we did have concerns that the shift patterns that staff worked potentially put people at risk as staff reported they felt very tired sometimes at work. If staff are too tired to carry out their required duties then this could potentially affect the quality and safety of care provided to people.

We found that the home was responsive to people’s needs and people were able to make choices over their daily lives. Where there was a need for a Deprivation of Liberty Safeguard (DoLS) authorisation it had been implemented appropriately. People who were subject to a DoLS authorisation were supported by staff to access the community in line with their assessed needs and stated wishes. DoLS is law protecting people where the state has decided their liberty needs to be deprived in their own best interests.

Staff had a good understanding of their roles and responsibilities and we observed staff interacting with people in a respectful and caring manner. Staff told us they had undertaken various training courses such as first aid and the safe administration of medication. However, the service had highlighted the need for more specialist training for example about working with people with autism.

Although the service had a registered manager in place that individual had no responsibility for the day to day running of the home. They were in day to day control of the service in the past, but for more than a year they have worked as the manager of another location that is operated by the same provider. The service does have a manager in place that is in day to day charge of the home, but they are not registered with the Care Quality Commission. This is the person we are referring to throughout this report when we refer to the ‘manager’. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

Staff and people that used the service told us they found the manager to be approachable and accessible and we observed an open and relaxed atmosphere in the home. Quality assurance systems were in place which included seeking the views of people that used the service. It was however noted that not all health and safety checks had been carried out thoroughly.

6, 13 December 2013

During an inspection looking at part of the service

Care plans showed a person centred approach and included guidance to staff on how minimise and work with identified risks. Staff we spoke with were knowledgeable about people's support needs.

Following a significant incident we found the provider had not raised a safeguarding alert until prompted to do so. The provider failed to ensure that the staff providing care and support for the person were advised of special conditions which had been set as part of their placement in the service. The provider had also failed to ensure that staff were sufficiently competent to recognise a possible unlawful control of people who use the service.

There was an improvement in the communal areas of the larger of the two buildings. Sofas and carpets had been replaced, walls had been painted and people's bedrooms showed some signs of personalisation.

The provider was able to demonstrate that they had undertaken various monthly audits as part of their quality assurance system and had implemented a staff survey. Policies and procedures were in place but these were in need of review to ensure they fully reflected the changing practices within the service and the organisation.

Not all records were comprehensive enough to demonstrate that the health and wellbeing of people that used the service were protected in line with the regulations.

30 May 2013

During a routine inspection

Third Avenue is a service registered as one location but operates as two separate homes. One building has 10 bedrooms and is designed for people with very high support needs and the other has four bedrooms and is designed for people with a greater level of independence.

Care and treatment was not always planned and delivered in a way that ensured people's safety and welfare. Care plans and risk assessments offered varying levels of information and guidance to staff. Not all care seen was delivered in line with the individual plans and not all plans contained sufficient detail to ensure everyone's safety and wellbeing.

There were appropriate arrangements in place in relation to obtaining, recording, handling, safe keeping, disposal and administration of medicines.

Although there was an appropriate 'Safe Handling of Medicines' policy and procedure in place, we found not some discrepancies in the records.

We found that the majority of staff had received some supervision, however no staff had received the organisation's expected level of one supervision every six to eight weeks.

There was no effective quality assurance system in place which identified, assessed and managed risks to the health, safety and welfare of the people who used the service and others. However, the provider was aware of the need to develop a robust quality assurance system and actions had been taken at an organisational level to address this shortfall.

14 March 2013

During an inspection looking at part of the service

The manager told us that all staff had completed safeguarding training. Staff records confirmed all staff had completed the e-learning training in February and March this year.

We saw that staff had attended Mental Capacity Assessment (MCA) training in January. Staff we spoke with were able to tell us when an assessment should be carried out and the process that was involved.

We were told by the manager that all staff had received training in breakaway techniques and de-escalation.

Staff we spoke with were clear about what intervention techniques they would use when faced with challenging situations. They said the training had made them more confident in dealing with the people who presented very challenging behaviour.

7 November 2012

During a routine inspection

People that used the service told us they were happy living at Third Avenue and the staff were all very helpful. One person said 'the carers are very nice people, they are always polite.' Staff were seen treating people with respect and took care not to discuss personal issues in the presence of other people.

Care plans were detailed and risk assessments gave clear guidance to staff. Although we saw this paperwork in place, staff had not been given the training they needed to work safely with people with challenging behaviour and to ensure their practice was appropriate. For example we saw one staff member incorrectly handle a challenging situation. We discussed this with the registered manager who agreed the practices we witnessed were not agreed strategies. They told us they would address this with staff as a training and support issue.

13 October 2011

During a routine inspection

Overall, service users gave positive feedback about the home, and the support provided. Comments included, 'It's nice, very good here.' and another service user said 'They said treat it as your home.' when referring to what staff said to her when she first moved in to the home.