Archived: Aveland Court Care Home

Updated 5 November 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and

regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection

outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was conducted by one inspector, an assistant inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Aveland Court is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care

provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. This meant the provider was legally responsible for how the service was run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection this included information we had received from whistle-blowers and the local authority safeguarding team. We sought feedback from the local authority and professionals who work with the service.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and four relatives about their experience of the care provided. We spoke with seven members of staff including the manager, head of care, care staff, domestic staff and maintenance staff. We used the principles of the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included six people's care records and 11 medicines records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the

management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records.

Updated 5 November 2022

About the service

Aveland Court is a residential care home providing personal and nursing care to 11 people aged 65 and over, some of whom were living with dementia and mental health conditions, at the time of the inspection. The service can support up to 30 people.

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

The provider’s wider quality assurance and governance systems had not always ensured actions were taken to address any issues and risks in a timely manner.

The provider had failed to sustain improvements in the service. The provider had failed to act upon known areas of concern, non-compliance and risk to improve the quality of care for people at Aveland Court. This had exposed people to on-going poor care and risk of avoidable harm.

The provider had not properly maintained the premises to ensure people and staff were protected from risks associated with their environment. We found some aspects of the environment unsafe and parts of the building in need of extensive refurbishment. This put the health and safety and well-being of people using the service at risk. We asked the provider to take immediate action to address these concerns during the inspection.

We were not assured that safe infection prevention and control (IPC) measures were being followed. Whilst we observed cleaning taking place during the inspection, the premises did not look clean or hygienic because of the general disrepair and poor condition of the carpeting, paint work and wallpaper. We were not assured that the provider was preventing visitors from catching and spreading infections as staff were not following government guidelines in relation to visitors coming into the service.

People's monitoring charts were not being completed consistently to ensure staff had sufficient oversight of each person's needs and changing risks. For example, repositioning charts did not always show people had been repositioned as documented in their care plan to avoid the risk of skin damage.

Medicines had not always been administered as prescribed to support people's well-being. People did not always have access to their medicines when they needed them. Medicines were not being stored safely.

We received negative feedback from relatives about how the service was managed. Relatives told us they did not have confidence in the management at the service.

People and their relatives had limited opportunities to express their views about the service or influence changes. Relatives told us they had not been asked for feedback and reported a lack of communication and information from the provider.

People told us they were happy living at Aveland Court and relatives felt that people were safe. Staff spoke confidently about how they would protect people from harm and said they were confident any concerns raised about poor practice and/or people’s safety, would be addressed promptly by the manager.

There were enough staff on duty to meet people's needs. We observed staff were attentive and responsive and call bells were answered promptly. Robust recruitment practices ensured the right staff were available to support people safely.

Accidents and incidents were recorded and reviewed by the new manager. Where people had accidents, involvement from health care professionals was sought when required.

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 requires improvement (published 16 December 2020). The service remains rated requires improvement.

Why we inspected

The inspection was prompted due to concerns received about infection prevention and control practices within the service. As a result, we undertook a focused inspection to review the key questions of safe and well led.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the

service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this report.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Aveland Court on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to risk management, infection prevention and control, medicines and the governance and leadership of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.