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Inspection carried out on 23 August 2017

During a routine inspection

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.