Archived: Churchfield Avenue

We found the following examples of good practice.

Visitors could visit their family member/friend by appointment. They were asked to complete a rapid COVID-19 test, had their temperature checked and completed questions around COVID-19. Visitors wore personal protective equipment (PPE) that was provided and remained socially distanced. Staff helped people to use telephones to call family and friends. This helped people stay in contact.

External visitors to the home, including health or social care professionals entered via the back entrance were asked to wait before entering. They then signed in, sanitised their hands and had their temperature checked. There may be a request to take a rapid COVID-19 test. Or disclose the result of their last COVID-19 swab test. PPE would be made available if needed.

Letters were used to update people’s named relative /advocates re COVID-19 restrictions, testing and vaccinations. People and staff had individualised COVID-19 risk assessments in place.

Staff put on their PPE before starting work. Staff wore their PPE correctly. Staff were bare below the elbows and wore a minimum amount of jewellery, with long hair tied up. This promoted good infection control practice.

Staff had two rapid COVID-19 tests each week. They completed this test at home and staff waited for their results before starting work. Whole home testing was taking place and no staff or service users had refused to be tested. All service users had been vaccinated.

The home looked clean. Communal rooms had been decluttered to support effective cleaning. Windows were opened to promote good ventilation.

Churchfield Avenue is a residential care home providing personal care to seven people living with a learning disability aged 18 and over at the time of our inspection. The service can support up to nine people in one adapted building.

This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home.

People’s experience of using this service and what we found

People were happy with the service and the staff that provided their care.

People felt safe living at the home because staff knew what they were doing, they had been trained, and cared for people in the way people wanted. Staff assessed and reduced people’s risks as much as possible. There were enough staff to support people with their care and support needs. The provider obtained carried out key recruitment checks on potential new staff before new staff they started work.

People received their medicines and staff knew how these should be given. Staff supported people with meals and drinks. They used protective equipment, such as gloves and aprons to prevent the spread of infection. Staff followed advice from health care professionals and made sure they asked people’s consent before caring for them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People liked the staff that cared for them. Staff were kind and caring, they involved people in their care and made sure people’s privacy was respected.

Staff kept care records up to date and included national guidance if relevant.

The service was well managed by a registered manager. The senior staff team were passionate about giving people a high-quality service.

People and their relatives were asked their views of the service and action was taken to change any areas that they were not happy with. The provider had systems in place to effectively monitor and bring about improvements in the service. Concerns were followed up to make sure action was taken to rectify the issue.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last

The last rating for this service was good (published 27 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service had a registered manager in post. 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.

This inspection was carried out on 26 June 2017 and was an announced inspection. At the last inspection on 7 July 2015, the service was rated as ‘good.’ At this inspection we found the service remained ‘good.’

Staff demonstrated their knowledge of how to report incidents of poor care and harm. Staff helped people in a way that maintained their safety and people were looked after by staff in a kind and patient manner. Staff supported and encouraged people to make their own choices and live as independently as possible. People were treated with respect and people’s privacy and dignity were promoted by staff.

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.

People were looked after by enough, suitably qualified staff to support them safely with their individual needs. Staff enjoyed their work and were supported and managed to look after people. Staff understood their roles and responsibilities in meeting people’s needs and they were trained to provide effective and safe care. Staff were supported to maintain their skills by way of supervision, competency checks, and appraisals.

Staff were only employed to look after people once all pre-employment checks had been completed and were found to be satisfactory.

People’s care arrangements took account of people’s wishes and choices, including their likes and dislikes and future goals. People’s care plans recorded their individual assessed needs and any assistance they required from staff. Risks to people who lived at the service were identified, and plans were put into place by staff to monitor and minimise these risks, as far as possible, without limiting people’s independence.

People were supported to take their medicines as prescribed and medicines were safely managed by staff who were trained, and whose competency had been assessed. Where there had been any errors in the administration of people’s medicines, these had been identified and dealt with to reduce the risk of recurrence.

The service was flexible and responsive to people’s needs. People were encouraged to maintain contact with their relatives and friends when they wished to do so. Staff assisted people to maintain their links with the local community and encouraged them to continue with any hobbies or interests.

People were supported to eat and drink sufficient amounts of food and fluids. People’s choice about what they wished to eat and drink was promoted and supported. Staff monitored people’s health and well-being needs and acted upon issues identified by assisting people to access a range of external health care services.

There was a process in place to manage any concerns and complaints received.

Arrangements were in place to ensure the quality of the service provided for people was regularly monitored. People who lived at the service and staff were encouraged to share their views and feedback about the quality of the care and support provided. Actions were taken as a result to drive forward any improvements required.

Further information is in the detailed findings below.

As part of this inspection we met with six people who used the service, two family members of people who used the service, a healthcare professional who was in regular contact with the home, the registered manager and six members of staff. We reviewed records relating to the management of the service which included three care plans, daily records, the premises, staff recruitment records and quality assurance monitoring records.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at

Is the service safe?

Risk assessments regarding people's individual needs and activities were carried out and arrangements were in place to minimise potential hazards. Staff understood their roles and responsibilities in making sure people were protected from the risk of harm or abuse. The provider ensured that only staff who were suitable to work with vulnerable people were employed. The premises were well maintained and met the needs of people living in the home. Refurbishments and redecoration of some areas of the home were planned and would be completed in the next few weeks. We saw that arrangements regarding Mental Capacity Acts (2005) assessments were in place, where necessary, to ensure that people who could not make decisions for themselves were protectedIs the service effective?

We found that carers were knowledgeable about people's individual care and support needs. Observations we made during our inspection confirmed that the care staff provided friendly and consistent support when assisting people with personal care. Care and support was regularly reviewed with any changes recorded to ensure that people received up to date care. People were also able to make choices regarding how they wished to spend time during the day either at home, or when accessing facilities in the wider community.

Is the service caring?

Observations made during our inspection showed that people received warm, consistent and friendly support from care staff and they were enabled to make choices and changes when required. One person told us that, 'I am very happy living here.' Staff told us that they were very well supported and supervised by the manager and senior staff so that they could provide safe care and support to people.

Is the service responsive?

We saw that people's personal care and social support needs were assessed and met by staff. This also included people's individual choices and preferences as to how they liked to be supported. We observed that people could make changes to their support and had been involved in reviews of their support as much as possible. We saw that regular reviews were in place to update people's care and support needs.

Is the service well led?

The home was effectively managed and staff told us that they felt very well supported and were regularly trained so that they could safely provide care and support. Observations made during our inspection showed that staff were responsive and attentive so that people were supported consistently and safely. Health and safety checks were in place to monitor the safety of the services that were provided. The service gathered opinions from people who used the service, their relatives and staff to identify any improvements that could be made to the service.

Care and support was regularly reviewed to ensure that peoples' needs were being met. There was evidence of people's agreement and involvement in the planning of their care and support.

Staff were trained in safeguarding people from harm and had access to policies and information about how to contact the local authority safeguarding team.

There were regular staff supervision and ongoing training sessions in place to ensure that staff could safely deliver care and support to people.

The home had an effective system to regularly assess and monitor the quality of the service that was provided to people.

We saw that there were thorough processes in place for the administration, storage and stocktaking of medication prescribed for people using the service.

Improvements had been made to the premises and rear garden following the compliance action made during our inspection on 5 May 2012.

There were improved arrangements in place for the regular supervision of care staff so that their work performance and development needs were monitored.