Archived: Avenues South East - 1a Webb Road

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Staff were aware of the importance of consent and people were asked for their consent before care was provided. People's needs were assessed and risk assessments were carried out before care was provided. These were regularly reviewed so that staff were aware of the best way to provide support.

The manager and deputy manager were available on a daily basis to oversee the staff, and monitor that people were being safely supported, for example with personal care and when travelling out in the community. Health care professionals and social services were involved in people's care planning and in responding to people's concerns when needed. There were always a minimum of four staff available to support people throughout the day and night staff were available to respond to night support needs.

There were arrangements in place to deal with emergencies and to make sure people were safe. People's health needs were included in their care planning to ensure they were healthy. Fire safety equipment and procedures were in place to ensure people would be kept safe in the event of a fire. The staff and manager were trained in protecting people from neglect or abuse and people told us they felt safe in their home.

Is the service caring?

We spoke with two families of people who used the service and observed staff working with people. People told us that the staff and manager were very caring and supportive. We saw that staff always took the time to stop and speak with people and spoke with them in a manner they best understood, speaking slowly and using pictures to help people to understand. One person said, 'the staff are always helpful and respectful" and a relative said 'they are very welcoming and friendly always.'

Is the service effective?

We saw from four people's records that their needs were assessed and a care plan was drawn up to meet those needs. Relatives of two people we spoke with told us they were happy with the plan and care provided. We observed support provided and staff were responsive to people and engaged them in activities. There were times when too many staff gathered together to do paperwork in front of people while they had nothing to do. We spoke to the staff and manager about this and they agreed this should not happen.

Regular reviews were made of people's care plans and people and their families were involved in the reviews. However there was a need for more family or advocacy support for two people in planning their care and in important decision making. There were suitable policies in place for consent to care, for example in relation to the management of medication, however people were unable to advocate for their own care needs, and there was an absence of involvement from people representing some service users in decision making about the use of bedrails, covert medication and agreement to administer medication. We observed that staff were able to effectively communicate with people and that care plans addressed people's individual care needs.

People who used the service were consulted for their views on a regular basis, which involved the person, their family or advocate and social services. Any changes they requested were included in a revised care plan.

Staff were provided with adequate support, guidance and training to do their job. They were experienced in supporting people with learning disabilities and used effective systems to communicate with people, such as including pictures in choices of food and activities and to ensure people knew familiar staff were scheduled to support them.

The garden area in the home was not adequately maintained and was being used to store rubbish. It was also limited in space for people using wheelchairs to enjoy their surroundings. There were some areas in the home that needed repair or redecoration.

Is the service responsive?

Families of two people who used the service told us that the staff and manager always listened to their concerns and did something to help sort out any problems they were experiencing. People were provided with a range of activities and changes were made when necessary to try out new activities. The main community activities were day centre based and the manager said they would like to move towards more personalised activities in liaison with day centre staff and the staff at the home. People's support plans were reviewed and changed when necessary in response to changing needs, for example in helping people with specialist eating support needs.

Is the service well led?

The registered manager recently left and a new manager has started at the home and expressed a commitment to register with the Care Quality Commission. The manager and deputy manager were involved in direct care and worked with all the staff almost every day. They felt this meant they could identify any issues quickly and address them if they arose. Staff and families we spoke with told us there had been significant management changes and they wanted more stable management at the home now. The families said they felt the home was now well managed and they hoped this would remain stable. Staff received direction and training to allow them to support people at the home, but some staff expressed a concern that there was a need to do some team building to bring the staff team together. We saw that the management were aware of this issue and had started to address this problem. Supervisions between the manager and staff had lapsed under previous management and the new manager and deputy had started to address this issue.

There were a range of systems in place to monitor the quality of people's care, and to make sure any concerns about staff, management or the way in which care was delivered were addressed.

We found people and their relatives were involved in their care and support and they were able to make appropriate decisions with staff support. People had care and support plans in place which were mostly up to date, and risk assessments which ensured they remained safe. The provider had procedures in place to protect people in relation to their medication and we found staff followed these procedures. Staff were appropriately supported through induction, training and supervision and appropriate and accurate records were maintained.