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Averlea Residential Home Good

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Inspection report

Date of Inspection: 27, 31 January and 27, 28 February 2012
Date of Publication: 24 April 2012
Inspection Report published 24 April 2012 PDF

Overview

Inspection carried out on 27, 31 January and 27, 28 February 2012

During a routine inspection

We carried out a scheduled inspection of the domiciliary care agency and the care home at the same time as they operated from the same office located in Averlea Residential Home. We made unannounced visits to Averlea on 31 January, 27 February and 28 February 2012 when we talked to seven people who lived in the home, one relative who was visiting at the time, and three staff members who worked in the home. On 3 February 2012 we visited four people in their own homes, who received personal care services from the domiciliary care agency, and spoke with four of their relatives during the visits. During this inspection we also spoke with three staff members, in person or on the telephone, who provided personal care to people in their own homes.

During our first visit to Averlea we spoke with the registered manager of the domiciliary care agency but she was not available for the rest of the inspection. We spoke with the registered manager of the care home and one of the owners during all of the visits to Averlea.

At the time of this review the domiciliary care agency provided services to approximately 75 people, most of whom received personal care, and employed approximately 30 staff. There were 13 people living in the care home and 10 care staff were employed as well as domestic and catering staff.

During our visits to the office we looked at records pertaining to both the domiciliary care agency and the care home. These included records relating to the care and support people received, staff files, the operation of the care home, and policies and procedures. We asked for the staff training records, and some other documentation, to be sent to us which we received on 19 March 2012. We also asked for the quality assurance records but were told by the registered manager of the care home that there was no system in place to assess and monitor the quality of care provided or to identify, assess and manage risks relating to the health, welfare and safety of people who use the service and others who may be at risk.

People who received care and support from the domiciliary care agency were very positive about the way they were treated by the staff who supported them. Comments from people receiving the service and their relatives included "them's lovely", "we think the world of them", "we can't praise them enough" and "they respect me as a person". People also said that the agency was reliable, flexible around people's changing needs, and time keeping was "very good". However the agency did not have robust arrangements in place to safeguard people against the risk of abuse as few of the staff had received training in this area and the agency's policies and procedures were not clear about the action staff should take.

People who lived in Averlea Residential Home said they were happy living in the home, felt safe and were well cared for. Comments included "we are so well looked after", the staff were "lovely" and "they treat me like one of the family". We observed interactions between the staff and people who lived in the home and saw that staff were friendly and respectful to the people they supported. People talked to us about their personal routines, the activities they enjoyed, and the meals provided in the home. People said they were involved and supported to make decisions about their personal and healthcare needs and that these were being well met by the staff team and visiting healthcare professionals. People received their medicines when they needed them and these were administered in a safe way. However we found that there was no protocol for the administration of 'as required' medicines and medicines were not always being stored or disposed of properly.

People also told us they had not been provided with any information about the home, they did not know how to make a complaint, they did not know who the registered manager was or her name, they were unaware of their care plans and had not been involved in writing them, no activities took place apart from bingo and they were never told what the next meal would be. They said there were no meetings held between the people who lived in the home and the management, they had never been consulted about the quality of care in the home, and had no involvement in how the home was run. We also found that the arrangements in the home to safeguard people from abuse, such as written policies and procedures, were not suitable which may place people at risk of abuse.

During our visit to the office we examined the care files belonging to five people who received a domiciliary care service and four people who lived in the care home. We found that the care and support plans for both people receiving domiciliary care and living in the care home contained detailed information about some aspects of people's care and gave clear directions to staff about how people wanted each task to be carried out. However, from discussion with the people who used the services, we found that the care plans did not contain all of their care and support needs; the people receiving a domiciliary care service said the staff did not always read them; and the people living in Averlea Residential Home were not aware of the existence of the care plans. We also looked at the financial records of three people who lived in the home whose spending money was administered by staff in the home. We found that these records were not audited on a regular basis to ensure accuracy and protect people from possible financial abuse.

During our visits to the care home we looked around the communal parts of the care home and eight bedrooms. We found that all the bedrooms were warm and most of them contained many personal possessions, although this varied from one person to another. The bedroom doors had locks fitted but, if locked from the inside, the staff were not able to enter in an emergency. None of the bathroom and toilet doors available to the people who lived in the home had locks fitted which meant that people's right to privacy was compromised.

During our first visit we found that none of the bedroom doors had 'hold open' devices fitted that would automatically close if the fire alarm went off but these had been fitted by the time of our second visit. After discussions with staff about what to do in the event of a fire, and the registered manager saying that the fire risk assessment needed updating and that she had not yet written the personal evacuation plans for each person living in the home, we made a referral to the fire service due to our concerns regarding fire safety awareness in the home.

We looked at staff training records and spoke with staff from the domiciliary care agency and the care home about the training they had received to enable them to do their jobs. We found that almost all of the staff had qualifications in care and had received some training related to essential areas of their work. However we also found that staff had not received training related specifically to the needs of the people they supported to enable them to deliver care and treatment to people safely and to an appropriate standard.