Archived: Avenue House - Dorchester

Is the service safe?

At the last inspection of March 2014, we found the premises were not safe and suitable for the provision of care. Due to circumstances involving an on-going change of ownership, the home was under the management of the receiver at the time of inspection. They had appointed a management company to work alongside the registered manager, oversee a program of essential improvements and manage the quality of service. At this inspection we found there had been considerable improvement to the premises internally and externally. A full review of the works required had been made in April 2014 and a plan devised for building and refurbishment works. We found that urgent matters relating to health and safety had been addressed. The overall environment had been improved.

At the last inspection in March 2014 we found areas of concern in medicines administration. At this inspection we found that practice in this area had improved which meant that people were protected from the risks associated with medicines management.

Is the service effective?

We found that servicing of equipment had taken place and there was an effective system to monitor and maintain this as necessary. The home had worked with other agencies to make improvements to care and to the environment.

Care plans contained enough information to guide care.

Staff worked with people's consent and understood the need to seek appropriate safeguards if people lacked mental capacity.

Is the service responsive?

A new call bell system was in operation and we saw that staff responded quickly to calls from people, most of whom needed help with mobility. We saw that people received their choices at meal times and received care in line with their individual care plan.

Is the service caring?

People and their relatives told us that they found staff caring and approachable. We found a welcoming atmosphere for visitors and saw that staff worked to create a positive environment. One person told us 'the care here is very good, I definitely feel safe here." Another person told us, 'the staff treat you with respect, they know my routine." A relative told us, 'the care here is good and the staff are fantastic at communication."

Is the service well led?

The service benefitted from a registered manager who was supported by a management company who assisted them to manage improvements and oversaw quality. The registered manager demonstrated they knew about the needs of the people who lived there and they supported staff to deliver the service effectively and safely. The home was in the middle of a survey of people, staff and relatives to ask them what they thought of the service, using questionnaires. Although checks were made on quality, some aspects of this were under development and to ensure there was an effective and robust monitoring system.

The home was clean and there was system in place to ensure people were protected from the risk of infection.

The home was not being adequately maintained. There was no plan in place to ensure the premises were brought back to an acceptable standard. There was no risk assessment in place relating to the building which meant that people were at risk of having their health and safety needs not being met.

We found that where people could not consent to care or treatment, due to enduring mental health illness, action had been taken to ensure the care and accommodation was provided in 'their best interest'

People told us that their care needs were met. However, we found that people were not being supported consistently, and this put them at risk of not having their needs met.

People told us they felt safe living at the home. The provider had made arrangements to ensure that staff knew how to protect vulnerable people.

The infection control procedures in place at the home were not being followed, putting people at risk of cross infection.

The premises had been redecorated in some areas and new flooring had been provided. However, the hot water supply in some communal areas put people at risk of scalding.

The care records used by the home did not provide sufficient guidance for staff to ensure that people's needs were consistently met.

We found that the provider had taken steps to address the infection control concerns noted at the last inspection. Staff had clear guidance on how to prevent infection at the home.

We spoke with staff who told us about the plans that were in place to update the environment. Whilst there had been improvements in the environment the home was still not fully compliant in relation to the essential standards relating to the environment. We spoke with the provider who made a firm commitment to ensuring that the home would be safe for people to be cared in and fit for purpose.

We looked at the care records and found that people's consent to care were not always considered.

We spoke to staff who had an understanding of how to meet people's care needs but were less clear about providing for their welfare needs.

The provider had not made adequate arrangements to ensure the home was clean and that infection control practices were known by staff and effectively implemented.

The provider had not made adequate arrangements to ensure the home was adequately maintained.