1 January 2021
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.
As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.
This inspection took place on 9 December 2020 and was announced.
1 January 2021
The inspection took place on 14 November 2017 and was unannounced. At our last inspection we found a breach of Regulation 13 in relation to the process for applying for Deprivation of Liberty Safeguards authorisations. When we returned to the service we found that action had been taken to address this breach. At our last inspection we rated the service as Requires Improvement, at this inspection we rated the service as Good.
Avenue House provides residential care and accommodation for up to 30 people. 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. At the time of our inspection there were 28 people living at the home. The service is provided by a Quaker organisation; however people of all backgrounds and faiths can use the service. There was a registered manager in place.
A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. 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.
At our last inspection, we found that the procedures had not always been followed when a person needed Deprivation of Liberty Safeguards (DoLS) in place. This was a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following the inspection, the registered manager submitted an action plan to show how they would address the shortfall. At this inspection, we found that the action had been taken and the service was no longer in breach.
We found that people living in the home were positive and happy with the care they received. They told us that staff treated them well and with dignity and respect. This was reflected in our observations. People and their families were involved in decisions about care and about the running of the home. There were plans in place to involve people further in directly influencing developments in the service. The business plan contained an objective to have at least three service users on the board of trustees by 2018.
People received care that was safe. Medicines were stored securely and there were processes in place to record their administration. We did find some errors with stock levels of some medicines, however this was rectified promptly following our inspection and evidence sent to us to confirmed that this had been done. There were enough staff to ensure people’s needs were met safely and when new staff were recruited, checks were carried out to ensure their suitability. Improvements had been made in how the service managed safeguarding referrals. Concerns were shared with the local authority when necessary.
The service was effective at meeting people’s health needs. If there were concerns for example about a person’s nutritional intake, then this was monitored and plans put in place to support the person. People’s GP and other healthcare professionals were involved in people’s care. Staff were well trained and received regular supervision to ensure they were able to carry out their roles effectively.
People received personalised care that met their needs. A pre assessment took place prior to the person arriving at the home and this helped staff create suitable care plans for people. Care plans covered a range of needs, including nutrition, moving and handling, personal care and emotional needs. People were able to take part in a range of activities if they wished to do so. There was a procedure in place for managing complaints.
The home was working towards the Gold Standards Framework accreditation. This is a framework that supports a service to provide high quality care at the end of people’s lives. The registered manager spoke enthusiastically and positively about the accreditation and showed us evidence of the work completed to date.
The home was well led. The registered manager had close links with the board of trustees, and trustees made regular visits to the home. There was a business plan in place outlining the aims and objectives for the service and how it could be improved. We saw evidence that this was being worked towards. For example, it outlined that a dignity in care champion would be put in place in the staff team; the registered manager told us this member of staff had been identified and would be supported over the coming weeks to develop the role.