Aveley Lodge

Updated 14 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 19 and 20 July 2018 and was unannounced. The inspection was carried out by two inspectors. A third member of staff, new to CQC was present to observe the inspection process.

Before the inspection we reviewed information available to us about this service. The registered provider had completed a Provider Information Return (PIR). This is a document that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the information provided in the PIR and used this to help inform our inspection.

We reviewed previous inspection reports and the details of any safeguarding events and statutory notifications sent by the provider. A notification is information about important events which the provider is required to tell us about by law, like a death or a serious injury. We used this information to plan what areas we were going to focus on during our inspection.

We spoke with five people who were able to express their views, but not everyone chose to or were able to communicate effectively or articulately with us. We used the Short Observational Framework for inspection [SOFI]. SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with four relatives of people living at the service and a person that volunteered to help with activities. We also spoke with one team leader, a senior carer, two care staff and the activities organiser. We spent time discussing the management and leadership of the service with the registered manager, finance manager and public relations manager. We reviewed two people’s care plans in detail and a third that was being redesigned. We looked at three staff files and reviewed records relating to the management of medicines, complaints, staff training and how the registered persons monitored the quality of the service.

Updated 14 September 2018

This inspection took place on the 19 and 20 July 2018 and was unannounced.

At our last inspection on 19 September 2016 we found improvements were needed to ensure the providers governance arrangements identified shortfalls and reflected the action taken to address these. This included, ensuring applications to deprive people of their liberty were made to the local authority for authorisation and ensuring people received their medicines as prescribed by their GP.

At this inspection we found the required improvements had been made, however we found the systems for monitoring risks to people needed improving. For example, where unexplained bruising or skin tears had occurred, no incident report was completed, just a body map. The charts did not show what action had been taken to investigate what had happened, or if the appropriate authorities were informed if after investigation they remained ‘unexplained’. However, the deputy manager could tell us, in detail about each incident and what follow up action had been taken to ensure people’s health, safety and welfare. The registered manager took immediate action during the inspection to revise the form, which incorporated a body map and process for reporting incidents.

Aveley Lodge 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 is a 25 bedded residential home providing care and support to older people, some of whom may be living with dementia. The premises was well maintained, bright, welcoming and clean. On the day of our inspection there were 24 people living in the home.

A registered manager was in post. 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.’

People told us Aveley Lodge was a safe and secure place to live. People had been informed of what they needed to do to keep safe, including fire safety and how to raise concerns. Staff knew the process to follow and whom to inform both within the organisation and to outside agencies if they witnessed or had an allegation of abuse reported to them.

People were provided with the support they needed to promote their independence and freedom, yet minimise the risks. People received their medicines when they needed them.

There was enough staff available to meet people's needs. Staffing numbers had been calculated based on the needs of the people using the service. Thorough recruitment and selection processes were in place which ensured staff recruited had the right skills and experience. The provider was committed to providing a continuous cycle of training that ensured staff had the right skills and knowledge to meet people's needs. A buddy system was used to ensure new staff were supported. Staff spoke consistently about the service being a good place to work. They felt supported, received regular supervision and had access to plenty of training opportunities.

People were supported to eat and drink and maintain a balanced diet. Staff were aware of people's dietary needs and the support they needed to eat their meal. Mealtimes were a positive, sociable experience for people with a good ratio of staff present to ensure they received the support they needed to eat their meal.

The provider had worked hard to create positive and lasting links with community health services. People were supported to maintain their health. Their records confirmed they had access to a range of healthcare services including the GP, optician, specialist nurses and dietician.

People were supported to express their views and make decisions about their care. People's ability to make decisions was assessed in line with the requirements of the Mental Capacity Act (MCA) 2005. Where appropriate Deprivation of Liberty Safeguard (DoLS) authorisations were in place to lawfully deprive people of their liberty for their own safety.

The management team and staff were fully committed to ensuring people received the best possible care. Staff understood people’s human right to be treated with respect and dignity and to be able to express their views. Technology and a ‘pen pal’ scheme helped people to stay in contact with family and friends.

Aveley Lodge provides good care and a wide range opportunities for people to engage in activities that enhance their well being. The arrangements for social activities were designed to meet people’s individual needs. Activities were arranged to make ‘People happy, mobile and to give purpose to their lives. The management team and staff were guided by people's wishes and aspirations when it came to arranging activities.

Staff understood the importance of supporting people to have a good end of life as well as living life to full whilst they were fit and able to do so. People had been provided with the opportunity to discuss their experiences of bereavement and express their own wishes for their end of life care.

The service was managed by a dedicated management team and staff that were approachable and easy to talk to. The management team and staff demonstrated a shared responsibility for promoting people's wellbeing, safety and security. Staff were aware of the provider's five key principles of care, dignity, respect, independence, information and choice and how these linked to the core vision and values of the service.

People and their relatives were encouraged to share their views and provide feedback about the service. The feedback obtained from surveys completed in 2017 and 2018 was overwhelmingly positive.

Aveley Lodge is an important part of the local community. The provider, people using the service, their relatives and staff have raised monies for other charities, including the local church. The provider had several schemes, including a staff bonus in place to drive improvement and reward staff that use their initiative. The service and staff had also won many care awards, including most recently the National Family Business Award 2018.