We carried out a review of the data available to us about Avon Valley Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Avon Valley Care Home, you can give feedback on this service.
People's experience of using this service and what we found
There had been significant improvements following the inspection of 15 September 2021. Positive changes had been made to infection control measures. Staff wore face masks appropriately in line with the latest guidance. The shortfalls identified with masks had been dealt with by the registered manager. The staff involved had been spoken with and all staff had been retrained in how to safely wear masks. The systems for monitoring the home and short falls in the staff practice had improved. Spot checks were carried out of staff to check person protective equipment was worn safely. We were assured by the infection, prevention and control measures.
People told us they felt safe living at the home. Staff were trained in safeguarding and understood their responsibility to protect people from avoidable harm and abuse. Risks to people's health and safety were assessed with guidance for staff to follow. Staff were recruited safely and there were enough staff to provide safe and effective care. Medicines were stored and administered safely in line with people's prescriptions. Accidents and incidents were reported and recorded with audits in place to help identify any trends or patterns.
Staff were enthusiastic and happy in their work. They felt supported within their roles. Staff described working together as a team, they provided person-centred care and helped people to achieve their potential. There was a programme of audits in place to assist the management team to identify and address shortfalls. As a result, the home continuously improved.
Rating at last inspection
The last rating for this service was Requires Improvement (published 22 October 2021). At our last inspection we found people were not protected from the risk of infection. Official guidance was not being followed in relation to staff wearing masks. Systems for monitoring the home and ensuring people and staff were kept safe were not always robust and had not identified obvious short falls in staff practice. At this inspection we found improvements had been made.
Why we inspected
We carried out an inspection of this service on 15 September 2021. We rated the service requires improvement in Safe and Well Led due to the shortfalls, which we identified. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.
We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Avon Valley Care Home on our website at www.cqc.org.uk.
Avon Valley Care Home is a residential care home providing accommodation and personal care for up to 78 people. At the time of the inspection there were 59 people living at the home. The home is purpose built and just over two years old. The home has three floors. There were communal lounges and dining areas. People also have access to a garden area.
People's experience of using this service and what we found
People were not always protected by the homes infection control policy and procedures. Improvements were required to help ensure people were protected from the risk of infection. Staff were not wearing face masks safely and the appropriate guidance had not been followed. Monitoring the quality of the home was therefore not always effective.
Systems were in place to protect people from the risk of abuse. Risk assessments had been carried out to identify risks. These included information about how to mitigate those risks. Steps had been taken to help ensure the physical environment was safe. There were enough staff working at the home to meet people's needs. The provider had robust staff recruitment practices in place. Medicines were managed safely. Accidents and incidents were reviewed to see if any lessons could be learnt from them.
Assessments were carried out to determine people's needs prior to admission to the home. Staff were supported through training and supervision to gain knowledge and skills to help them in their role. People were supported to eat a balanced diet and were able to choose what they ate. The premises were clean and well maintained. People had access to health care professionals.
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 interests; the policies and systems in the home supported this practice.
People were supported by staff who knew them well. People's dignity and privacy was respected, and staff understood the importance of maintaining people's independence. There were a range of activities available which were personalised to people's interests.
People, their relatives and staff told us the home was managed well. Staff enjoyed working at the home. The home worked in partnership with other organisations to provide safe, effective and consistent care. People were treated as individuals and their diversity was respected. People's care was tailored to their needs and preferences and staff knew people well. People's views and opinions of the home were sought and acted on. The registered manager promoted an open culture in relation to accidents and incidents.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The service was registered with us on 11 July 2019 and this is the first inspection.
Why we inspected
This was a planned inspection to check whether the provider was meeting legal requirements and regulations, and to provide a rating for the service as directed by the Care Act 2014
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to the services response to infection control measures, and good governance. This meant that improvements were required.
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 and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We found the following examples of good practice.
All staff used the appropriate Personal Protective Equipment (PPE) in line with current government guidance. Staff changed into and out of their uniform in the workplace to minimise the spread of infection.
Staff had received training on the signs, symptoms and management of COVID-19. Training to don and doff PPE had also been completed by all staff. PPE stations were located throughout the home.
There was an infection control policy and contingency plan in place that had been updated as guidance had changed. We found the home to be clean with regular cleaning taking place throughout the day.
There was a clear process for visitors, which included a temperature check and the wearing of PPE. The environment for visitors followed national guidance for visitors to care homes. A visiting pod had been ordered and was due to be installed. Protective screens were also used to facilitate some pre booked visits in the garden. For people who were receiving end of life care their loved ones were able to visit. They were required to take a lateral flow COVID-19 test with a negative result before entering. Full PPE was also worn. Video and phone calls were utilised to promote people’s communication with family and friends. People were able to access tablet devices from the home to partake in video calls.
Social distancing measures were in place to protect people. Lounge chairs were distanced from each other. Dining rooms tables were set with two chairs per table.
The registered manager and staff communicated regularly with family of people living in the home. Regular relative meetings were held virtually. The registered manager told us the virtual meetings worked well with many more family and friends attending than previously held face to face.
All staff had access to the internal employee wellbeing scheme. The management team supported staff with their well-being during the pandemic.