Background to this inspection
Updated
17 April 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Creative Support – Avonlea 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
Before the inspection visit, we reviewed information we had received about the service since the last inspection. This included information about incidents the provider must notify us of, such as any allegations of abuse. We sought feedback on the service from the local authority.
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
During the inspection
We spoke with one person who used the service about their experience of the care provided. We spoke with nine members of staff including support staff, a team leader, the registered manager and two directors.
We reviewed a range of records. This included several people’s medicines and health records and three people’s care records. A variety of records relating to the management of the service, including quality assurance records and policies and procedures were reviewed.
After the inspection
We spoke with three relatives about their experience of care provided. We continued to seek clarification from the provider to validate evidence found. We looked at recruitment, supervision, training and health and safety information.
Updated
17 April 2020
About the service
Creative Support – Avonlea is a residential care home, providing accommodation and personal care for up to seven people in one adapted building. It specialises in supporting people who have learning disabilities and or autism. At the time of our inspection, there were six people living at the 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
The provider's quality assurance systems and processes were not always effective at identifying concerns and driving improvement in the service. Systems that were in place were not implemented effectively and audits had not identified concerns with the service.
Staff were not consistently deployed to provide people with appropriate support. This meant people did not always receive care that met their needs and staff felt under pressure.
Medicines management required more comprehensive oversight. Environmental risk management and infection control procedures required strengthening.
Training had not always been refreshed at the timescales identified by the provider.
People and their relatives understood how to raise any concerns or complaints with the provider but did not feel their concerns were always responded to effectively.
Safe recruitment procedures were followed.
People were supported to eat a balanced diet that met their needs and any associated risks were managed with appropriate specialist input. Staff worked effectively with community health and social care professionals to achieve positive outcomes for people and ensured their health needs were met.
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 interest. Policies and systems were in place; however, staff practice did not always follow policy in relation to the administration of Deprivation of Liberty safeguards (DoLS).
Staff knew the people they supported well and adopted a caring approach towards their work. People were treated with dignity and respect.
People's care plans were individual to them and covered key aspects of their care needs. People had support to participate in a range of social and recreational activities.
People were encouraged to express their views about their care and support needs.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 21 September 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified a breach of regulation in relation to the governance of the service at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.