Elliot Avenue

Elliot Avenue is a two storey residential care home and is able to provide accommodation and personal care for up to six people living with autism and learning difficulties. At the time of our inspection there were four people living there in one adapted building.

We found the following examples of good practice.

Staff had regular and effective infection prevention and control (IPC) training. This helped support good practises including putting on, taking off and disposing of PPE correctly. There were processes and checks in place to help reduce risks of infections for people and staff and visitors not subject to regular COVID-19 testing, including health questionnaires and temperature checks.

There were enough staff who could work in separate groups known as a cohort. Only these staff would care for people who needed to isolate to avoid the risk of cross contamination. Frequently touched items such as handrails, light switches and furniture were cleaned using appropriate disinfectants.

The registered manager adhered to IPC guidance by ensuring people who had a need to attend healthcare appointments were safely readmitted to the service. This included isolating away from other people. Items such as bedding and clothing was laundered separately and people were supported to avoid contact with other people until it was safe to do so.

The provider’s policies and audits promoted a safety culture where all staff and people using the service had been vaccinated. Audits of IPC practice ensured the cleaning and disinfection programme was effective with attention to detail in ensuring the home and vehicles used by people were kept clean and tidy.

Staff helped support visits to people in a safe way. Other means of staying in touch with relatives and friends included, visiting relatives at home, frequent telephone calls, social media and e-mails. Risks to people or staff at increased risk were managed well to help ensure they stayed safer.

Elliot Avenue provides accommodation and personal care for up to five people with a learning disability, mental health support needs and/or autism. At the time of our inspection there were four people receiving support.

The service was a domestic style property that was similar to the surrounding properties. There were deliberately no identifying signs, to indicate it was a care home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

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. However, best interest decisions were not always recorded appropriately.

People were safe at the service and there were enough staff to meet their support needs. Staff had a good understanding of people’s needs. However, we identified instances were documented guidance was not sufficiently developed to ensure people were supported in a consistent manner.

The provider had quality assurance systems in place. However, these had not identified gaps in documentation identified at this inspection.

Staff told us they received training and support to carry out their role. They felt supported by the registered manager.

People were supported to manage their medicines safely.

People lived in a clean environment which was appropriate for their needs.

People were supported to eat and drink enough throughout the day. The service worked well with other professionals to ensure people received the right support.

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. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Professionals and relatives said they felt that staff were always kind and caring. Observations showed that staff were attentive to people’s needs.

People and relatives were encouraged to provide feedback regarding the quality of care provided.

People were supported to communicate their wishes and make decisions. Staff were knowledgeable about the most effective methods to support people to communicate.

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

Rating at Last Inspection

At our last inspection, the service was rated good (published on 31st March 2017).

Why we Inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor the service to ensure people receive safe, compassionate, high quality care. We will return to visit as per out re-inspection programme. If we receive any concerning information we may inspect sooner.

A registered manager was in post at the time of the inspection. 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 3 March 2017 and was an announced inspection. At the last inspection on 26 May 2015, the service was rated as ‘good.’ At this inspection we found the service remained ‘good.’

People were safe living at the service and staff were knowledgeable of how to report incidents of harm and poor care. Information was provided to people in different formats to enable them to report any concerns that they may have had. Accidents and incidents were identified and recorded. and actions were taken to, as far as possible, reduce the risk of recurrence.

People had health, support, and care plans in place which took account of their individual needs. These plans recorded people’s choices, their likes and dislikes, any assistance they required and their future goals to be achieved. Risks to people who lived at the service were identified, and plans were put into place by staff to minimise these risks and enable people to live as safe and independent a life as possible.

People were looked after by enough, suitably qualified staff to support them safely with their individual needs. Pre-employment checks were completed on staff before they were deemed to be suitable to look after people at the service. People were supported to take their medicines as prescribed and medicines were safely managed by staff whose competency had been assessed.

Staff assisted people in a way that supported their safety and they were treated with respect. Staff assisted people in a kind manner and with compassion. Staff promoted and encouraged people to make their own choices. People’s dignity was respected at all times and staff assisted people in the way they wished to be supported.

The service was flexible and responsive to people’s individual complexities and needs. People maintained contact with their relatives, the local community and where appropriate attend educational classes which they benefitted from. This engagement with the local community was seen as a natural part of people’s lives. People were supported and encouraged by staff to take part in a range of hobbies and personal interests. Staff endeavoured to develop people’s abilities and progress people’s independent living skills.

People were supported to eat and drink sufficient amounts of food and drink. They were also assisted to access a range of health care services when needed and their individual health needs were met.

Staff enjoyed their work and were supported and managed to look after people. Staff understood their roles and responsibilities. They were assisted by the registered manager to maintain and develop their skills and knowledge by way of supervision, observations, and appraisals. Staff were trained to provide safe and effective care which met people’s individual needs and knew people’s care requirements well.

There was a process in place so that people’s concerns and complaints were listened to and acted upon promptly. Staff worked alongside people offering additional suggestions and ideas that the person may not have considered themselves. As such, people felt empowered and listened to.

The CQC monitors the operation of the Mental Capacity Act 2005 (MCA 2005) and the Deprivation of Liberty Safeguards (DoLS) which applies to care services. DoLS applications had been made to the appropriate authorities to ensure that people’s rights were protected. People’s rights in making decisions and suggestions in relation to their support and care were valued and acted on.

Relatives were able to raise any suggestions or concerns they might have with the registered manager and team of staff. People and their relatives/ advocates were involved in the agreement of people’s care and support plans. Communication between relatives of people living at the service and the registered manager and staff team was good.

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

The person we spoke with during our inspection was positive about the care and support they received. They told us that they were, "Happy here. Staff are nice.' A relative of a person using the service told us that they, 'Think (Elliot Avenue) is great.'

We looked at two people's care records and found that they contained detailed information to enable staff to deliver safe care and support. We saw that care was planned in a way that supported people to live as independent a life as possible.

People were protected from the risk of dehydration and poor nutrition because nutritional needs were assessed ensuring that any such risks were identified and eliminated. We also saw evidence of where a person's religious and cultural food and drink requirements were put in place by the provider.

When reviewing medication administration records (MAR) charts, we saw documented evidence of accurate medication administration by staff.

There were effective staffing levels in place to ensure the safety and well-being of people who lived at the home.

There was an effective system in place for people using the service, their relatives and visitors to the home to raise a concern or complaint if they wished to do so.

Since our previous inspection of 7 January 2013 we saw that the provider had made improvements to people's plans of care and also people's risk assessments. Evidence we saw demonstrated to us that people were supported as much or as little as the person wanted but only when this was safe to do so. People's assessed risks, such as transport or access to the community, demonstrated to us that risks to people were effectively managed.

People's ability to provide consent was assisted through the use of health care professionals, families, representatives and care staff to ensure, through best interest meetings, that people only received care and treatment that they had consented to.

We reviewed three people's care plans who currently live at Elliot Avenue and found that these contained plenty of detailed information that would allow any carer to care for that person. However, only one of the care plans had been reviewed within the last 12 months.

All of the staff we spoke with were able to accurately describe to us the different types of abuse and the reporting process associated with the safeguarding of vulnerable adults (SOVA).

We reviewed staff recruitment records and found that all staff had an enhanced criminal records bureau check completed before they commenced work at the home. We also saw that previous employment checks had been completed and any gaps in employment history had been explained.

The provider used various means to establish people's views on the quality of the service. They showed us that they aimed to make changes and improvements to the quality of the home people lived in and the care that they received.