Avalon Care Home

Updated 14 June 2023

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 Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was conducted by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Avalon Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Avalon Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 24 April 2023 and ended on 2 May 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 8 people that used the service and 1 relative. We spoke to 5 staff including the registered manager, senior staff and care staff.

We looked at a range of records including 4 care plans and medicine records. We looked at health and safety records, audits and 3 staff recruitment records.

Updated 14 June 2023

Avalon Care Home is a residential care home providing personal care for up to 26 people. The service is registered to provide support to people living with dementia, people with a learning disability or autistic spectrum disorder, people with mental health needs, people with a physical disability and or sensory impairment, and younger adults. There were 20 people living at the care home at the time of the inspection.

The care home has two floors. The ground floor has become a communal area for younger people and people with a learning disability.

People’s experience of using this service and what we found

Governance and quality assurance systems had improved since our last inspection. People said they felt safe, and risk assessments were clearly written and reviewed. Medication was administered safely by staff who were trained to do so. Some people were supported and encouraged to administer their own medication where able. Accident and Incident logs had improved since the last inspection, therefore opportunities to mitigate risk were identified.

Infection control prevention was improved, and the home looked and smelled cleaner. There were enough suitably qualified staff to support people, however some people told us they could not always go out and about due to lack of staff.

Safeguarding systems and policies were in place and staff could describe the action they would take if they felt people were at risk of abuse.

People were supported to follow modified diets and had choice and control over what food was served. Staff were undertaking training courses, most staff had been trained, however there were some gaps in staff training records. This was due to new staff starting. Staff had been supervised and appraised.

Staff and people living at the home liked the registered manager and felt they had made good progress since the last inspection. The registered manager understood their duty to share information in an open and honest manner.

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 service supported this practice.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care: Although we found gaps in the support and culture, staff were very caring in nature and upheld people’s dignity and privacy. Care plans were written respectfully and put the person at the centre of their care.

Right Culture: Although staff and managers had values to support people to lead confident and inclusive lives, the environment of the home made this difficult. Younger people who had a learning disability lived within a care home environment, meaning opportunities for choice and control were limited. It was difficult for staff to meet the needs of everyone, due to a wide range of service user groups, with different sets of guidance for staff to follow.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 16 November 2022).

Why we inspected

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider was no longer in breach of regulation.

This service has been in Special Measures since 16 November 2022. During this inspection the provider demonstrated that some improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We undertook this focused inspection to check they 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, Effective and Well-led which contain those requirements. We also checked whether the Warning Notice we previously served in relation to Regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.

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.

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 Inadequate to Requires Improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Avalon Care Home on our website at www.cqc.org.uk.

Follow – up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.