Archived: Avenues South East - 56 Oakwood Road

There was 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 and associated Regulations about how the service is run. The registered manager assisted us during our inspection.

At our last inspection in August 2016 we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to take action in relation to consent and good governance. Following that inspection the provider submitted an action plan to us to tell us how they planned to address these concerns. We carried out this inspection to check if the provider had made the changes required. We found that improvements had been made in all areas and the regulations were now being met.

Staff were following the legal requirements to make sure that any decisions made or restrictions to people were done in the person’s best interests. Staff understood the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS).

Quality assurance audits were carried out to help ensure the care provided was of a standard people should expect. Any areas identified as needing improvement were made by staff. If an emergency occurred, such as a fire, people would be evacuated following guidance in place for staff.

People lived in an environment that was hygienic, free from infection and suitable for their needs. People were cared for by staff who knew them well and had developed relationships with them. People were spoken to in a respectful way and encouraged to do things for themselves or spend their time as they wished. Staff supported people to eat a good range of foods and staff ensured that those with a specific dietary requirement received their food in an appropriate way.

People had access to external health services and professional involvement was sought by staff when appropriate to help maintain good health. Medicines were stored appropriately and recording of medicines was completed to show people had received the medicines they required.

People were encouraged to take part in activities and staff were consistently thinking of new ways to keep people stimulated. We found support plans were person-centred and staff reviewed these regularly. There were a sufficient number of staff on duty to enable people to either stay indoors or go out to their individual activities. Staff recognised people’s individuality and as such provided new ways of ensuring people’s needs were met.

Staff met with their line manager on a one to one basis and staff said they felt supported. Staff received a good range of training. Staff met together regularly as a team to discuss all aspects of the home. People had support from an individual keyworker whose role was to help someone work towards their goals and to ensure the person received the most appropriate care for their needs.

Risks to people’s safety were identified and control measures were in place to minimise the risk of harm. Staff recorded all accidents and incidents and took relevant action to minimise the risk of them happening again. Staff were knowledgeable about their responsibilities to keep people safe and were aware of reporting procedures should they suspect potential abuse. Appropriate checks were carried out to help ensure only suitable staff worked in the home.

A complaints procedure was available for any concerns. This was given to people in a format that was easy for people to understand. People, their relatives and external stakeholders were encouraged to feed back their views and ideas into the running of the home.

Although the registered manager also managed another of provider’s services, we found they had good management oversight of the home. Staff said the registered manager was supportive and there was a good culture within the team. We saw the registered manager was very hands on. The registered manager was aware of their statutory duties in relation to their registration with CQC.

This was an unannounced inspection that took place on 9 August 2016.

The home had a registered manager. 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 and associated Regulations about how the service is run. We were assisted by the registered manager during our inspection.

Staff understood the main principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DOLS). However we found that not all decisions made had been reached through a best interest process.

Some care records did not contain the most up to date information about a person, although staff did provide appropriate and relevant care due to their knowledge of people.

People were made to feel as though they mattered and staff had taken time to get to know people in order to develop close relationships with them. People were treated with care and dignity and their individual characteristics recognised and respected by staff. People were encouraged to be independent and do things for themselves wherever possible. People’s rooms were homely and personalised.

Care plans were comprehensive and written in a person-centred way. Accidents and incidents were monitored and action taken to help ensure that further accidents did not happen.

There was a range of activities for people to participate in both within and outside of the home. Staff supported people to have a balanced diet and people who had a specific dietary requirement received their food in an appropriate way.

There were procedures and risk assessments in place that staff implemented to reduce the risk of harm to people. Staff understood the signs of abuse and knew what action to take should they suspect it.

People received the medicines that were prescribed to them. There were a sufficient number of staff on duty which meant people did not have to wait to be supported. In the event of an emergency there were arrangements in place to help ensure people’s care continued with the least impact possible.

People were cared for by staff who were recruited through a thorough recruitment process. Appropriate checks were carried out on applicants before they began to work with people. The majority of staff were experienced care workers who had the skills, knowledge and experience to care for people appropriately and safely. Staff felt supported by the management through relevant training and supervision.

People’s healthcare needs were met by suitably qualified staff as people had access to healthcare professionals when required. Regular health checks were carried out to monitor people’s well-being.

People, their relatives and other stakeholders were encouraged to give their feedback. A complaints policy was available in an easy-read format should anyone wish to make a complaint.

Staff were encouraged to participate in the running of the home. They said the registered manager had made positive changes to the home since they had been there. Quality assurance procedures were carried out to monitor the quality of the service.

During the inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

judgements. We asked the provider to send us a report of the changes they would make to

comply with the standard they were not meeting.

We have followed up to make sure that the necessary changes have been made and

found the provider is now meeting the standard(s) included within this report. This report

should be read in conjunction with the full inspection report.

We have not revisited 56 Oakwood Road as part of this review because the provider was able

to demonstrate that they were meeting the standards without the need for a visit.

We saw that people who used the service were free to move around the building. For example, we saw people choosing where to be around the home, one person showed us in and out of the building and another joined us for part of the inspection in the office.

We observed staff had a good knowledge of people's needs, communication methods and behaviour management plans, demonstrating this through their positive interactions with the people who used the service.

We saw that staff offered choices and sought consent before offering care, and information was included in formats and languages people would understand better therefore the person's consent would be better informed. However, where people did not have capacity the provider did not always act in accordance with legal requirements.

We found that people who used the service, staff and visitors, were not protected against the risks of unsafe or unsuitable premises. This was because bathrooms were not suitably designed to be kept hygienic and clean; window restrictors were not all robust and fit for purpose; hot water was not managed effectively to protect people from legionella and other bacterium; bedroom and toilet doors did not all lock properly; and closing devises had become so worn that fire doors to the bedrooms no longer closed fully when released in the event of a fire, making the door's fire and smoke protection measures obsolete.

We found that people were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

We observed that staff spoke to people using the service in a friendly but respectful way and in a fashion that supported their independence.

We conducted a random telephone survey of four family members of the people who lived at the service. They confirmed that the service placed a great emphasis towards promoting people independence and individuality. Family members told us that their relatives were cared for and supported by staff who were dedicated and trained to work with people with autism and learning disabilities and that their relative was being cared "for in a friendly and caring environment".

We spoke to three relatives of people who lived at the service they told us that they were happy with the care and treatment that was provided to their family members. One told us that they had 'nothing but praise' for the care that is given.

We reviewed the staff training matrix which indicated that all staff safeguarding training was complete. Staff indicated that they fully understood their role in safeguarding the people who live at the service.

The service receives monthly visits carried out by the provider to ensure the standard of care meets the needs of the people who live at Oakwood Road. Systems were also in place to monitor accidents and incidents.