Avila House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Incidents were recorded and reported to the provider. Staff meetings provided opportunities for information to be shared with staff and lessons were learned. Monthly forums were held across the organisations of the provider and team leaders represented locations. The registered manager explained their understanding of duty of candour and said, “Being transparent when something goes wrong and being open with relatives. We apologise and report to CQC, making sure the staff understand what has happened too.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between services.

When a person moved into the service, their care was assessed by the funding authority who commissioned the care hours needed to support them. A staff member said, “People have different hours of care during the day. We give a new person time to settle in because it can be overwhelming sometimes. We ask people how they would like to have their care and at what time suits them.” Handover meetings took place daily and a whiteboard in the administration office provided staff with up-to-date information about people, without breaching confidentiality. One person had moved in from 1 of the provider’s other services, and their care needs were reviewed. As a result, occupational health had updated their moving and handling assessment, providing staff with information on how to safely transfer the person.

The provider worked with people to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live safely, free from bullying, harassment, abuse, discrimination, avoidable harm, and neglect. The provider shared concerns quickly and appropriately.

Staff completed safeguarding training and knew what to do if they suspected people were at risk of harm. A staff member explained, “Safeguarding is looking out for people and if people don’t have a voice, standing up for them. We all have the contact of our manager and regional director. We can send an email or report it direct. Staff meetings always include safeguarding protocols, how to report and who to report any concerns to.”

The provider worked with people to understand and mitigate risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive, and enabled people to do the things that mattered to them.

One person was at risk of falls so they had a pendant which they wore; this could be pressed if they had a fall. Another person told us about the equipment required to enable staff to move them safely. They added that overhead tracking was being considered which would only require 1 member of staff, rather than 2, when carrying out transfers.

Care plans included information for staff to follow about people’s identified risks, and any action needed. For example, 1 person was at risk of choking, so detailed advice was provided to staff on what to do in this event.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People had tenancy agreements and accommodation was the responsibility of a housing provider. Access to the building was through a coded keypad. People told us they were concerned when the lift broke down as they were unable to leave their flats easily, although this situation had improved following a replacement motor for the lift. People had personalised their flats with their own furniture and the accommodation was spacious and accessible. One person said their kitchen was, “Fabulous, because the worktops moved up and down, so I have enough space to move around.”

Personal emergency evacuation plans (PEEPs) had been drawn up for people, and staff were trained so they knew what to do in an emergency.

The provider did not always make sure there were enough qualified, skilled, and experienced staff. They did not always work together to provide safe care that met people’s individual needs.

The number of hours’ support people received depended on how much funding was provided by the local authority. People gave us mixed feedback about the amount of support they received. One person told us they had to wait for staff to respond to their call bell. They said that on one occasion they had to wait for 30 minutes when they were desperate to use the bathroom. Another person felt there was a lack of flexibility in the timings of calls and explained the time taken to prepare a meal was such that staff did not always have time to sit with them to make sure they ate safely. If this happened, then their meal would be removed, whether they had finished it or not. A third person told us they could not always have personal care when they requested it. We raised this issue with the registered manager who was unaware of these concerns and disputed this was the case. They also told us, “Staff levels are sufficient. We are asked to flex up and down. Staffing hours outweigh the care hours. We’ve just recruited to 1 20-hour contract and another full-time staff member.”

Recruitment systems were effective, and appropriate checks were made to ensure new staff were safe and suitably qualified to work in a care setting.

Staff completed a range of training to enable them to undertake their role and responsibilities effectively. Training included supporting the needs of autistic people and people with a learning disability which was organised by the provider. Staff received regular supervision from their line managers.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People were supported by staff to be as independent as possible, for example, in cleaning and tidying their flats. The risk of infection was mitigated as people were encouraged to stay in their own homes if they had a contagious illness. Staff used personal protective equipment (PPE) when undertaking personal care which they discarded when they left people’s homes. The registered manager told us, “If there was an outbreak, say Covid-19, we’d ask people to stay in their flats to minimise the risk of spread, increase the use of PPE, regularly sanitise hands, etc. We’d inform the local authority if there was an outbreak.” Staff completed infection prevention and control training.

The provider made sure that medicines were safe and met people’s needs, capacities, and preferences. Staff involved people in planning, including when changes happened.

People’s medicines were kept in special locked cabinets in their bedrooms. People had access to these medicines. One person showed us 2 locked cabinets. One contained the boiler and the other their medicines. They told us they were independent in taking their medicines and held the key to the medicines cabinet. Where people self-administered their medicines, this had been risk assessed appropriately. People were issued with medication administration records so they could log when they had taken their medicines, and staff could check for this. Some people required the support of staff to take their medicines. The provider had a medicines policy, including for medicines to be taken ‘as required’. Staff completed training in the administration of medicines and their competency to do so was checked.