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Inspection Summary


Overall summary & rating

Good

Updated 7 November 2017

This inspection took place on 23 and 24 August 2017. The first day of the inspection was unannounced. This meant the staff and provider did not know we would be visiting.

Croft Avenue Care Home provides personal care and accommodation for up to 30 people some of whom were living with dementia On the day of our inspection there were 26 people using the service.

There was no registered manager in post. A new manager had been appointed and was in the process of registering with CQC. Croft Avenue had not previously been inspected by CQC under its current registration.

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.

There were suitable numbers of staff on duty during our inspection. We received feedback that staffing had improved of late although we received mixed reviews about this. We have therefore recommended that staffing remain under review in light of concerns raised.

Staff had received training in the safeguarding of vulnerable adults and were aware of the procedures to follow. Recruitment processes included the vetting of applicants to ensure they were suitable to work with vulnerable adults.

Procedures for the ordering, receipt storage and administration of medicines were satisfactory. The trolley was not secured to the wall when medicines were administered from the corridor. We received feedback from the provider following the inspection that this was now secured following our feedback.

Risks to people and general risks were assessed and plans were in place to mitigate these. The building was clean and tidy and well maintained. Regular safety checks on the premises and equipment were carried out. The environment did not fully meet best practice in relation to supportive design for people living with dementia. We have made a recommendation about this. We also found the laundry door did not have a lock and there was a risk people might access this area who lacked capacity. All hazardous substances were locked away. A key pad was immediately put in place to reduce this risk.

Staff received regular training, supervision and appraisal to ensure they had the skills and support necessary to do their job effectively. Specialist training was provided, for example in relation to mental health needs, when required.

People were supported with eating and drinking. Nutritional needs were assessed and plans were in place to support people to maintain a healthy body weight. Support from a GP or dietitian was sought when required.

The service was operating within the principles of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.

We observing caring interactions between staff and people. Staff supported people sensitively and discreetly and demonstrated they knew people well. They were cheerful and supported the privacy and dignity of people as they went about their work.

A new manager was in post who was in the process of registering with CQC. We received a number of reports regarding the positive impact the manager had on the service and staff morale was good. They were aware of their responsibilities and were proactive in addressing any issues we identified during the inspection.

Inspection areas

Safe

Good

Updated 7 November 2017

The service was safe.

Suitable procedures were in place for the management of medicines and feedback we provided was acted upon to make further improvements.

We received feedback that there had been an increase in staffing but there remained mixed views about the numbers of staff available. We have made a recommendation about keeping staffing under review.

Staff had received training in the safeguarding of vulnerable adults and were aware of the procedures to follow. Recruitment practices supported the provider to make safer recruitment decisions through the vetting procedures followed.

Effective

Good

Updated 7 November 2017

The service was effective.

Staff received regular training to provide them with the skills to do their job effectively. Supervision and appraisals were carried out to provide support and meet development needs of staff.

People were supported with eating and drinking and nutritional assessments and records of weight were kept under review. People were referred for dietary support where necessary.

The service was operating within the principles of the Mental Capacity Act 2005 [MCA]. Applications to provide people of their liberty were submitted to the local authority in line with legal requirements.

The environment was clean and homely. Not all areas met best practice with regards to supporting people living with dementia. We have made a recommendation about that.

Caring

Good

Updated 7 November 2017

The service was caring.

We observed kind courteous and caring staff interactions. People and their relatives were complimentary about the staff and the good relationships they had with them.

The privacy and dignity of people was respected. Care was offered sensitively and discreetly, people living in the home were seen to be caring towards each other and a culture of acceptance and support was fostered.

Staff took time to explain what they were doing and did not rush people.

Responsive

Good

Updated 7 November 2017

The service was responsive.

Person centred care plans were in place which were up to date and regularly reviewed.

People were involved in a range of spontaneous and planned activities and there were good links and involvement with the local community.

A complaints procedure was in place and people knew how to make a complaint and had other opportunities to share the views and ideas.

Well-led

Good

Updated 7 November 2017

The service was well led.

A new manager was in post and was in the process of registering with CQC. There had been gaps in record keeping at the beginning of the year but there were no gaps identified since the new manager came into post. Staff and visiting professionals credited the new manager with a number of positive changes.

Staff told us they enjoyed working in the service and that morale was good.

Regular checks on the quality and safety of the service were carried out and the views of people and their relatives were sought on a regular basis.

There were close links with the local community