Avenues South East - 288 Shipbourne Road

288 Shipbourne Road is a residential care home that supported older people with a learning disability. The service was providing personal care to six older people, some who were living with dementia, at the time of the inspection.

People’s experience of using this service:

• The provider continued to provide a good service.

• The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensured the person who lives at the home can live as full a life as possible and achieve the best possible outcomes that include control, choice, inclusion and independence.

• People continued to be protected from avoidable harm by a staff team trained and confident to recognise and report any concerns. Staff assessed and minimised any potential risks to people.

• Staff followed the provider's procedures to prevent the spread of infection and reduce the risk of cross contamination.

• The provider had systems in place to enable staff to safely manage people's medicines.

• The provider had a system in place to make sure they only employed staff once they were satisfied of their suitability to work with people who used the service.

• Staff knew the people they cared for well and understood, and met, their needs. People received care from staff who were trained and well supported to meet people's assessed needs.

• Staff supported people to have enough to eat and drink and to access external healthcare services. Staff worked well along with external professionals to maintain people's physical and emotional wellbeing.

• 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. People were involved in making decisions about their care and support. Where people needed addition support to make decisions, staff had referred people to external advocates.

• Staff supported people in a kind and compassionate way and displayed empathy for people's fears. Staff were respectful when they spoke with and about people. Staff supported people to develop their independence. People were supported in a individualised way.

• The service was effectively managed by a registered manager. They led by example and had a passion for continually driving improvements and placing people at the centre of the service. They promoted a culture that focused on people as individuals. The registered manager developed positive links with outside agencies and used feedback to learn from mistakes.

• There provider and manager had put robust systems in place to effectively monitor the service and bring about improvement.

• People and their families felt able to raise concerns. The provider had systems in place, including a complaints procedure, to deal with any concerns or complaints.

Rating at last inspection:

The rating at the last inspection was Good (report published 31 August 2016).

Why we inspected:

This was a comprehensive planned inspection.

Follow up:

We will continue to monitor this home and plan to inspect in line with our re-inspection schedule for those services rated Good.

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

We carried out a comprehensive inspection of Avenues South East – 288 Shipbourne Road on 27 May 2016 at which we found a breach of regulation. At this inspection, we found people lived in an environment that was not always clean and well maintained. This included equipment, bathrooms, a toilet and commodes that were not clean. The garden fence had a fallen panel that needed to be repaired. A retaining wall was not secure whilst the upper patio was inaccessible due to an uneven surface.

We undertook a focused inspection on 8 March 2017 to check that the service now met the legal requirements. This report only covers our findings in relation to this. You can read the full report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Avenues South East – 288 Shipbourne Road’ on our website at www.cqc.org.uk.

At this inspection, we found the registered manager and provider had taken sufficient action to address the concerns raised at our last inspection. The provider had ensured repairs were carried out on the fence panel. The landlord who was responsible for the maintenance of the premises, flooring and the general décor of the service. They had redecorated the building to a good standard. The provider maintained the decoration of people’s rooms.

The work on the retaining wall and the uneven surface on the upper patio of the garden was scheduled for July 2017. The registered manager and provider continued to work with the landlord to ensure repairs at the service were addressed in a timely manner to improve the experiences of people living at the service.

People lived in a clean environment. Staff understood and applied infection control procedures to minimise the risk of spread of infection. The cleanliness and maintenance of the service was subject to regular checks and monitoring.

The Inspection took place on 27th May and was unannounced.

288 Shipbourne Road provides accommodation, care and support for up to 6 people with a learning disability. At the time of our visit there were 6 people living in the home. At the time of our inspection there was a registered manager at the home. 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.

The home had a friendly and warm atmosphere and staff spoke of how much they enjoyed working there. People were treated with kindness and compassion and there was a lot of positive interaction and laughter. Staff regularly checked to see if people needed anything and there was clear evidence of caring relationships between staff and the people they supported.

People lived in an environment that was not always clean and well maintained. During the inspection we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Support plans ensured people received the support they needed in the way they wanted. People’s health needs were well managed by staff so that they received the treatment and medicines they needed and were consulted about consent. People received a very person centred service and staff were responsive to people’s needs. People were treated with respect. Staff interacted with people very positively and people responded well to the staff. People received adequate food and drink and were supported to maintain a balanced diet.

Staff were provided with training specific to the needs of people which allowed them to carry out their role in an effective way. Staff met together regularly and felt supported by the manager. Staff were able to meet their line manager on a one to one basis regularly. Staff were aware of their responsibilities to safeguard people from abuse and were able to tell us what they would do in such an event. However, notifications and safeguarding referrals were not always sent in a timely manner. We recommend that the registered provider reviews its safeguarding reporting procedures.

There were sufficient numbers of staff employed to meet people’s needs at the home. We found appropriate checks were carried out to help ensure only suitable staff worked in the home. People who lived at the home are supported to take risks safely and their freedom is protected.

Complaints are responded to appropriately but not all complaints were recorded. One complaint had been dealt with but was not recorded in the complaints log. We recommended that all complaints, including verbal complaints be recorded following the registered providers complaints procedure.

The culture of the service is open and person focused. Quality monitoring systems were effective and action plans have led to change. The manager provided clear leadership to the staff team. Some statutory notifications were submitted late. We recommend that the registered provider reviews its statutory notification reporting procedures.

People were supported to take their prescribed medication when they needed it and to store and manage this in a safe way.

People were supported by staff who received training, guidance and support in their roles. People told us they liked the staff that worked with them.

Everyone had a support plan that ensured their needs were met. They were supported to stay in good health and to develop their skills. The plans helped people to do the things they were interested in and they included the things that were important to people, for example maintaining their appearance and going to lunch club. Staff understood the plans and followed them consistently.

Any risks to people's safety and welfare had been assessed and minimised. The home they lived in was well maintained and safe. Everyone had access to comfortable private and shared space. There were systems in place to ensure that people's views were listened to and that they could tell someone if they had a complaint. The manager made sure that action was taken to address any concerns they had quickly.