Archived: Avis House

We spent time with people who lived at the home and spoke with one person about their life at the home. The examples we have given are therefore brief because we respect people’s right to confidentiality.

There had not been a registered manager in post since April 2015. A manager had been in post since June 2015 and was in the process of becoming registered with CQC at the time of our 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.

Risks to people's safety were understood by staff and people benefited from receiving care which took into account their safety needs. There were enough staff to care for people and staff understood what actions to take if they had any concerns for people's wellbeing or safety. People were supported to take their medicines so they would remain well.

People were supported by staff who used their skills and knowledge so people’s health and well-being would be promoted. People were encouraged to make their own choices about what they would like to eat and drink, and often enjoyed going out for meals. Where people required support from staff so they had enough nutrition this was provided so people would enjoy good health. People were supported to access health services and staff followed the advice given by health professionals so they would receive the care they needed as their health needs changed. Staff worked with other organisations so people's rights to make decisions and their freedoms were protected

Caring relationships had been built between people and staff. People were encouraged by staff to make their own choices about their day to day care. People enjoyed spending time with staff and the manager and were given encouragement and reassurance when they needed it. People's right to dignity and privacy was understood and acted upon by staff.

The manager and staff knew people’s preferences and well. Staff planned people’s care in ways which took into account the ways they liked their care to be given. Staff took action when people's needs changed. People and their relatives had not needed to raise any complaints about the service, but were confident action would be taken if complaints were raised.

Staff understood what was expected of them and were supported by the manager and senior staff to care for people. There was open communication between people, the manager, relatives and staff. Regular checks were undertaken on the quality of the care by the manager and provider. Actions were taken to further develop people’s experience of living at the home.

We met four people who lived at the home. We spoke with one person, one visiting relative, four staff and the area manager. As some people were not able to clearly express their views we observed how people were cared for by staff.

We saw staff engaged positively with people. We saw that staff were readily available and responsive to people's requests for assistance. We saw that people's consent was sought by staff though asking them their views and pausing to check their non verbal responses and reactions. A visiting relative told us the staff were, 'Absolutely brilliant', and the staff were, 'All part of (their relative's) family'.

We looked at two people's care records and we saw that there had been a marked improvement in how care plans were set out which meant these reflected people's needs and how staff met them.

Staff were subject to checks prior to their employment so as to ensure they were safe to work with vulnerable adults. Staff told us that they felt well supported by the provider even though supervision was more of an informal arrangement since the registered manager had left.

The views of people and their representatives were sought and the service responded where there were identified risks to people.

We spoke with one person who said they liked living at the home. We spoke with two relatives who told us that they were happy with the care and support people received at the home. They said, 'Absolutely thrilled (person) has come on in leaps and bounds' and, 'My (relative) had excellent treatment and care there'.

We saw people's needs were assessed but care and treatment was not always planned and delivered in a way that was intended to ensure people's safety and welfare. We saw that staff did not always follow risk assessments and some care records were unclear as to what staff needed to do to support one person's health care needs.

Appropriate arrangements were in place in relation to the management of or the support provided to people to allow safe administration of their medication.

The provider had taken steps to provide care in an environment that was suitably designed for the needs of people that lived there.

We saw that there was enough qualified and experienced staff to meet people's needs.

People's representatives were assured that any comments and complaints they made on people's behalf would be responded to appropriately.