Archived: The Avenue Residential Home

Updated 17 November 2015

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 26 and 27 August 2015 and was unannounced. The visit was undertaken by one inspector.

Prior to the inspection we looked at the information we already had about this provider. We also spoke with service commissioners (people that purchase this service on behalf of people living at the home) to obtain their feedback.

Providers are required to notify the Care Quality Commission about specific events and incidents that occur including serious injuries to people receiving care and any safeguarding matters. Appropriate notifications had been sent by the registered provider.

All this information was used to plan what areas we were going to focus on during the inspection.

During the inspection we met and spoke with four of the people living at the home, spoke at length with six members of staff and three relatives of people living at the home. We spent time observing day to day life and the support people were offered. We looked at records about staff recruitment, training, care plans and the quality and audit systems at the home.

After our inspection we spoke with two health and social care professionals who supported people who used the service.

Updated 17 November 2015

We inspected this home on 26 and 27 August 2015. This was an unannounced Inspection. The home was registered to provide care and accommodation for up to ten people who may have a learning disability or mental health support needs. At the time of our inspection eight people were living at the home. The accommodation was provided in single bedrooms; the home had bedrooms and bathrooms on the ground and first floor. There were shared lounge, kitchen and dining facilities available on the ground floor.

The service was previously inspected in July 2014 and at that time we found the service was not compliant with three of the regulations we looked at. The issues identified were that the provider did not have suitable arrangements in place for managing care and support needs of some people who used the service which impacted on others who used the service, safeguarding arrangements to protect people who used the service from abuse needed to be improved and arrangements for assessing and monitoring the quality of service provision were not wholly effective. The provider took action and at this inspection we found improvements had been made.

The registered manager was present during our inspection. 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.

There was a CCTV system in use in areas of the home used by people who used the service. This was an established system but use of this had not been updated in light of new guidance and agreements about use of the system had not been reviewed. You can what action we have asked the provider to take at the back of the full report.

We found that not all people using this service felt safe. Although staff knew how to recognise when people might be at risk of harm and most were aware of the provider’s procedures for reporting any concerns, staff did not follow safeguarding procedures that they had been instructed in on the day of the inspection. The registered manager took prompt action when they were informed of the safeguarding concern.

The service provided enough staff on duty with the right mix of skills and abilities to make sure that people’s needs were met and that they could respond to emergencies. Robust recruitment checks were in place to ensure staff were suitable to work in the home. We found that there were sufficient numbers of staff available to meet people’s individual needs.

People had received their medicines safely. We observed staff practising good medicine administration.

People’s needs had been assessed and care plans developed to inform staff how to support people in the way they preferred. Measures had been put into place to ensure, in most instances, that risks were managed appropriately. These ensured that people were involved in making decisions which minimised restrictions on their freedom, choice and independence.

People were supported to eat and drink sufficient amounts to maintain good health. People were supported to stay healthy and were supported to have access to a wide range of health care professionals.

Most staff we spoke with were aware of their responsibilities under the Mental Capacity Act 2005 (MCA) and the Deprivations of Liberty Safeguards (DoLS) to protect people’s rights. Some necessary applications to apply for restrictions from the local supervisory body had not been progressed or submitted in a timely manner, failing to protect the rights of people.

Staff treated people with respect and communicated well with people who did not use verbal communication. People told us they continued to pursue individual interests and hobbies that they enjoyed and they were happy with the range of activities available to them.

There was a complaints procedure in place. People told us they had opportunity to raise concerns and that they were listened to. Relatives told us they knew how to raise any complaints and were confident that they would be addressed.

We found that whilst there were systems in place to monitor and improve the quality of the service provided, these were not always effective in assessing the quality of the service provided.