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St Matthews Limited - The Avenue Requires improvement

Inspection Summary

Overall summary & rating

Requires improvement

Updated 14 December 2018

St Matthews – The Avenue is a ‘care home’. 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.

St Matthews – The Avenue is in a residential area of Northampton and is registered to provide accommodation and personal care to people who may or may not have nursing care needs. They provide care for people with mental health needs and can accommodate up to 33 people at the home. When we visited there were 33 people staying there.

At our last inspection in September 2017 we rated the home as ‘requires improvement’ and found that there had been a breach of Regulation 12 (1) (2) (g) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – Safe care and treatment. This was because we identified unsafe practices around medicine administration.

At this inspection we found that improvements had been made to the management of medicines, and the home was no longer in breach of this regulation. However further improvements were required to how the service recorded the administration of medicines and we have made a recommendation for the provider to address this.

Improvements were required to staffing arrangements. In the morning there were not enough staff to support people to have their medicines at the time they preferred and a student nurse who was supernumerary had been left to support one person who required one to one care, and observe and support other people in the lounge area.

Risk assessments were in place which covered people’s known risks. Improvements were required to ensure all staff, including student nurses were aware of each person’s potential risks. Improvements were required to infection control practices to ensure the home was free from unpleasant odours and to ensure staff followed hygienic practices.

The service did not have a registered manager in post however there was an appointed manager who was in the process of registering with the CQC. The culture within the home was very task focussed and further improvements were required to ensure each person’s individual needs and preferences were acted on.

Improvements were also required to the auditing procedures in place. The audits did not always identify where improvements were required, for example, with infection control practices. And, the audits did not always ensure that any actions that had been identified, were carried out in a timely way. In addition, improvements were required to review and action the records that were maintained, for example, the bathing records to ensure that everyone at the home had their personal care needs met sufficiently.

Staff had a good understanding of abuse and the safeguarding procedures that should be followed to report abuse and incidents of concern. Staff induction training and on-going training was provided to ensure staff had the skills, knowledge and support they needed to perform their roles.

People's consent was gained before their care was provided. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. Care plans reflected people’s likes and dislikes, and staff spoke with people in a friendly manner.

A process was in place which ensured people could raise any complaints or concerns and there were opportunities to provide feedback about the home. Concerns or suggestions were reviewed and acted on where possible.

At this inspection we found the provider to be in breach of one of the regulations relating to improvements needed in the Well Led domain and having good governance systems. This is the second time this home has been rated as Require

Inspection areas


Requires improvement

Updated 14 December 2018

The service was not always safe.

Improvements were required to the procedures of recording people’s medicines, and to ensure there were always adequate numbers of staff on duty. Further improvements were also required to infection control practices.



Updated 14 December 2018

The service was effective.

The home was in the process of improving the environment for people to good effect. Staff had appropriate training and skills to support people and people were supported to consent to the car they received.



Updated 14 December 2018

The service was caring.

People were treated well and people were happy with how staff approached them. People were treated with dignity and respect and staff had a good knowledge of people’s needs.



Updated 14 December 2018

The service was responsive.

People had care plans in place which reflected their needs. Care plans were updated as people’s needs changed and there were systems in place to record people’s complaints.


Requires improvement

Updated 14 December 2018

The service was not always well led.

Improvements were required to the culture within the home which was task focussed and did not always identify people’s individual preferences. Improvements were required to auditing procedures to ensure they adequately identified improvements and actioned them in a timely way.