Avon 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 remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 83 (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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

Assessments were comprehensive, clear and holistic and included people’s physical and mental health needs, communication and social needs.

One person had mental health needs and could become agitated and distressed at times. Their care plan included a positive behaviour support plan to guide staff in how to support the person when they showed signs of becoming distressed or agitated. Staff knew the person well and understood the specific triggers that could cause their mental health to deteriorate. Staff told us the guidance within the care plan provided a clear strategy that supported a consistent approach and provided the person with reassurance in a calm and gentle manner.

Information in assessments and care plans was consistent and linked information to support effective, personalised care. For example, details from a Speech and Language Therapy (SaLT) assessment identified a person was prescribed a thickener for fluids. This guidance was included throughout their care records, including within the section on skin integrity where the need for regular fluids was noted, as well as within the care plan for oral care, to ensure staff did not use mouthwash which could pose a risk. This ensured staff were aware and managed risks of choking for this person in all aspects of their care.

People and their relatives had been involved in developing care plans and their views and preferences were included to inform staff about personalised details. One relative said they were, “Fully involved with care planning. They went through everything.” We saw examples in care plans including how many pillows one person preferred, and the type of squash drink another person liked. We observed staff were aware of these preferences. People’s communication needs were assessed and included details to support consistent support. For example, a person needed their spectacles to be able to watch television, and we noted how a staff member made sure they were wearing their glasses and their chair was positioned so they could watch the television.

The provider planned and delivered people’s care 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.

People and their relatives were included as much as possible in planning care and support. One relative described being involved with regular reviews of care plans and records showed their involvement. They told us how “small details made a difference”; they said, “It was like having their own family look after them.”

Staff used evidence-based tools and followed nationally recognised good practice guidance to support assessments. For example, a Malnutrition Universal Screening Tool (MUST) was used to measure the level of risk for people from malnutrition. People were receiving enough food and drink and their nutritional needs were being met. People told us they enjoyed the food on offer. One person said, “The meals are always lovely and there’s plenty of it.” A relative told us the quality of the food was good. They said their family member, “Always clears the plate, they used to be a fussy eater, but not now.”

Some people had been prescribed a modified diet due to risks associated with choking. Care plans included clear guidance for staff regarding modified textures and the use of thickener for fluids. We observed a staff member supporting a person with their meal, they were gentle and attentive in their approach, maintaining a slow pace and giving the person plenty of time to enjoy their meal. Staff were knowledgeable about people’s dietary needs and preferences and were supporting people in line with the guidance in their care plans.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff described positive working relationships with health care professionals. One staff member said, “We have developed a very good rapport with the nurses who come in regularly, they have helped us a lot, including with our understanding around diabetes and skin care.” Another staff member spoke about working collaboratively with staff from a palliative care team to support people with end-of-life care.

Staff described effective systems of communication and explained how this supported them to provide person centred care. One staff member said, “We have regular handovers, and staff are confident with people’s needs. Everything centres around people’s needs and what they want. If they want a cup of tea in the middle of the night or something to eat, they can have it.” Another staff member described how having “flash meetings” on a daily basis had improved communication. They told us, “We hear about changes, concerns and identify who is going to deal with certain responsibilities so everyone knows what is expected of them.” Another staff member explained how senior staff supported care staff in handover meetings by providing guidance and following up on any concerns they had raised. They told us, “We get clarity about what is needed and any issues we have mentioned are dealt with.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control.

People were supported to access the health care services they needed. One person told us, “They are on the ball with appointments, they make sure we get all the help we need. I am seeing the foot lady (chiropodist) soon.” Another person said, “They (staff) would call the doctor if I was not well.” Records showed that people were having regular health checks including with the GP, dentist and other health care professionals. Appropriate referrals were made to investigate health concerns and advice or guidance from health care professionals was included within care plans. For example, guidance from a Speech and Language Therapist (SaLT) was included for a person who was assessed as needing a modified diet.

Staff told us they had enough time to spend with people to support them to remain as active and independent as possible. One staff member said, “Our priorities are all about people’s needs, we don’t have to rush them.” We observed staff encouraging people to walk to retain their mobility with support from a staff member.

The provider monitored all people’s care 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.

People were consistently positive in their view of the care they received. One person told us, “All the staff are wonderful, the care here is marvellous.” Another person said, “It is 100% good care, no complaints at all. I can’t fault it.” A third person said, “I’m very happy here, the care is very good.”

Systems for monitoring people’s needs were robust and records were accurate and consistent. This supported the regular review of assessments and care plans to keep them updated and to accurately reflect the care people were receiving. Staff demonstrated a firm understanding of the importance of monitoring people’s care. One staff member said, “We record carefully, especially when something changes.” They gave an example about a person who sometimes had low moods. They said, “The seniors and the manager look at everything in detail and then they can decide what needs to change to help improve their mood. For example, if we need more training or if we could do things differently.”

We noted how staff had identified a change in one person’s skin integrity. A risk assessment had been undertaken, and appropriate equipment was put in place to support pressure care. The care plan had been updated with increased monitoring to assist the person to move and this had prevented a deterioration in their skin integrity.

The registered manager described how a person had needed all care in bed when they first came to live at Avon House and did not want to leave their room. They explained how staff had worked consistently over time with the person and now supported them to get up and dressed and to come downstairs as much as possible. They told us the person was, “So much happier now they are less isolated.”

A relative told us how impressed they were by the support provided with people’s mental well-being. They told us how staff had supported their family member to visit a close relative who lived in another care home and described the positive difference this had made.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff had received training and were able to describe the principles of the Mental Capacity Act 2005. They understood the importance of gaining consent for care and described how they supported people to make decisions. One staff member told us, “People have the right to refuse, and we respect that.” We heard staff checking with people before providing care. Some people lacked capacity to make specific decisions. Records included details of decisions that had been made in people’s best interests and appropriate actions had been taken to involve relevant people in line with the legislation. Some people were subject to restrictions, for example bed rails were in place to prevent a person from falling out of bed. Where people were not able to consent to these restrictions, the provider had made appropriate applications for Deprivation of Liberty Safeguards (DoLS). Some DoLS had been authorised and there were conditions imposed, for example, to have medicines reviewed regularly. Records showed the provider had ensured they complied with these conditions.