Avondale House

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 changed to Outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 88 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. There was a comprehensive assessment of people’s needs to ensure the service would be able to safely support them, and robust care plans and risk assessments remained in place which continued to reflect people’s physical, mental and social needs. People were actively involved in reviews of their own care to ensure it continued to meet their wishes and expectations.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. There were clear and detailed care plans and risk assessments in place reflecting a comprehensive overview of people’s needs, which were regularly reviewed and coproduced with people and specialist health services. For instance there was clear information for staff recorded on the side effects of high-risk medications, on how to identify deterioration in a person’s physical or mental health, and why they should seek advice from other agencies. Stakeholders complimented how the service worked proactively alongside them. One professional told us “The manager has worked closely with myself in thinking about strategies and looking at alternative and innovative ways of approaching day to day tasks with my client”.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once. We observed strong and positive working relationships between staff in the service, who worked collaboratively to support people’s needs. People feedback positively about the impact the staff group had on them. One person told us “These guys have not only been a support system to me, but also my family. Massively”. Visiting professionals universally described strong and collaborative relationships with the service which helped them support people in a joined up way. One stakeholder told us “The people I have met from Avondale have always been first class and make joint working very easy”.

People received exceptional support from staff, who were knowledgeable and had been allowed the time, and space to understand people and how best to support them. There were regular team meetings which shared relevant and timely updates with staff, and allowed them to discuss each person’s needs to with each member of staff given a chance to share their observations. One staff member said “These are really good. We discuss each person including their current risk status. Everybody staff member is given a chance to share their opinions and observations”. All staff we spoke to were extremely knowledgeable about people’s needs, and were supporting people in a consistent way in line with their care plans to support them enjoy the best possible quality of life. This ensured people were supported in a way in which people’s preferences were known and met. People regularly shared compliments around individual staff members which were collated to recognise the impact staff made to people’s quality of life on a daily basis. One compliment we viewed stated “I feel safe at Avondale. I’m making progress with staff support and I now have trust in the people supporting me, which I never had in any previous placement”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. There were detailed and personalised plans for each person about how the service would support people to improve their health and wellbeing. Staff liaised closely with other services to enable people to access the care and treatment they needed. For example they supported people to access support groups around alcohol and substance misuse or to access support for their mental health services during a crisis. Key workers undertook focused work with people to explore safe relationships, including working alongside local sexual health services. They promoted healthier choices at every opportunity, using accessible communications to empower people to have the information they needed to manage their own health and wellbeing. One person told us “I am eating more fruit because it’s healthier and helps me lose weight”. Another person told us the service were supporting their mental wellbeing by helping them staying in contact with friends and family. They explained “I have a phone and speak to my relatives back home. My family and friends visit, it’s nice. I’ve had friends visit and we’ve had a picnic in the garden”

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves. The service closely monitored people’s care to ensure it was delivering the outcomes agreed set by each person to help them stay healthy and well. There were monthly focus sessions for each person which focused on the previous month, reflected on things that were working well or not working and to agree a plan for the coming month. The focus sessions had a positive impact on people including a reduction in self harm, and people were more equipped to pursue healthy relationships which had previously not been possible.

Staff had a strong understanding of people’s physical and mental health needs and signs that a person may be at risk of harm. Relatives told us the impact staff had on their relatives was significant. Relatives shared that they no longer worried constantly about their loved ones due to the care and support provided by staff. One relative told us “When my relative is feeling down they watch out for them. I get nervous they are going downhill, they know the first sign when things might happen, I’ve called and they kept an extra eye”. People were supported to have regular discussions about their own mental health which allowed staff to closely monitor their wellbeing. One staff member told us “We have resources which are really helpful in guiding us in having open conversations about people’s mental health. The manager will also guide you on how to support these conversations, and sometimes they will lead these conversations so we can observe and learn”. We found staff were exceptionally well equipped to support people with their mental health.

The provider always carefully explained to people what their rights around consent were, made sure they fully understood them and always fully respected these when delivering person-centred care and treatment. There was a strong culture focusing on individuals’ rights and ability of people at the service to make unwise choices or take positive risks. Everybody living at the service had capacity to make decisions for themselves, which was well understood by staff who empowered them to make choices and ensured consent was always sought. For example during our visits we saw people being supported to attend a Halloween party or to socialise with friends in the community.

The service recognised the importance and meaning that strong social relationships had to people, and worked to support people in maintaining these relationships whilst empowering people to manage associated risks safely. This allowed people to actively participate in society on their own terms, and to make their own decisions on risk taking whilst developing their own confidence and self esteem in engaging outside their own community. People were able to develop meaningful relationships that gave them purpose and supported their mental wellbeing, in the way that others in society would take for granted. One staff member told us ”People have the ability to make choices for themselves, even if we think they are unsafe. We will talk through this in depth with them to ensure they have all the information about the risks”. For example where people regularly stated they did not wish to take their medications, staff respected their ability to make this decision. However they worked alongside people to discuss the reasons for their choices, and explored other solutions creatively such as offering medications at different times or around how staff communicated with people.