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Avondale Lodge Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 11 January 2019

Avondale Lodge is a 'care home.' People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Avondale Lodge is an adapted building in Redcar and Cleveland. It is an established service for up to 12 people who live with a learning disability. Each person had their own bedroom on the ground and first floor with access to several communal areas on the ground floor. At the time of inspection, there were 10 people using the service.

This inspection took place at 6:30am on 10 December 2018. We attended the service early because we needed to review staffing levels at night, review the number of people up early in the morning and speak with night staff

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The manager started working at the service in June 2018 and became a registered manager on 7 September 2018. 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.'

We carried out an inspection on 15 and 18 August 2017, where we rated the service as inadequate. There were concerns relating to all areas of the service. We imposed conditions that required the provider to ensure the registered manager was competent to work at the service, staff had the necessary skills to effectively use positive behavioural support interventions and that there were sufficient staff on duty. The provider complied with these conditions.

We carried out a further inspection of the service on 19 December 2017 following concerns received in relation to the safety of people using the service and the overall quality of the service. Although we found improvements, concerns around many areas of the service remained. The service continued to be rated inadequate.

At inspection on 20 March 2018, we found the service had made significant improvements. We removed the conditions which we imposed. We contacted the provider following the inspection and told them they needed to continue with the improvements to be rated Good. We also told them that they needed to have a registered manager in post.

Concerns were raised again on 13 June 2018 and we inspected the service once more. We rated the service to be inadequate. There were insufficient staff on duty and people had not received their one-to-one hours. Staff were not following the correct procedures to keep people safe, were not actively managing risks to people and staff were not supported to deliver safe care. Financial records were not transparent and a safeguarding alert was upheld for financial abuse. People did not have maximum choice, did not engage in meaningful activities and care records did not support staff to deliver good care. There was a divided staff team and staff had not raised their concerns. There were delays in addressing action plans which impacted upon the decline of the service.

At this inspection, we found the service had significantly improved, however the service needed time to show that the improvements in place could be sustained.

Lessons had been learned since the last inspection. The service was now safe for people and staff to use. Staff knowledge of safeguarding and managing incidents had improved. Staff were responsive to people’s behaviours and dealt with before they escalated. The building had been maintained and the cleanliness had improved. There were enough

Inspection areas

Safe

Requires improvement

Updated 11 January 2019

The service was safe.

Staff were proactive in delivering safe care to people.

There was evidence to show lessons had been learned since the last inspection.

There were enough staff on duty and people received their planned one-to-one hours.

Effective

Good

Updated 11 January 2019

The service was effective.

People had maximum choice about their day to day lives. Best interest decisions had been made, but not consistently recorded.

Staff were supported to deliver safe care to people.

An improvement plan was in place to continue with the updates to the environment.

Caring

Good

Updated 11 January 2019

This service remained good.

People knew people’s needs well and were dignified in their approach.

People were involved in all aspects of their care.

Good relationships were observed between people and staff.

Responsive

Good

Updated 11 January 2019

The service remained good.

Significant improvements had been carried out with care records.

People were involved in activities which matched their interests.

Complaints had been resolved appropriately.

Well-led

Requires improvement

Updated 11 January 2019

The service was well-led.

The registered manager had demonstrated critical thinking and analysis which had significantly improved the overall quality of the service.

Action plans were in place to sustain improvements.

The staff team were supportive of each other and worked alongside health and social care professionals.