Avenues South East - 492 Maidstone Road

Updated 19 May 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Avenues South East - 492 Maidstone Road 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 had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced and carried out on 24 February 2020.

What we did before the inspection

Before the inspection, we reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We observed people as they engaged with staff and the support provided in communal areas. We spoke with one person using the service, four members of staff including an operations manager, an assistant manager and two care workers. We reviewed three people’s care plans, risk assessments and medicines records. We also reviewed a range of records including safeguarding and complaints logs, menus, audits, health and safety checks and minutes of staff meetings.

After the inspection

We spoke with two relatives by telephone to gather their views about the service. We interviewed the registered manager and a care worker on the telephone. We reviewed staff recruitment records, training and supervision and other records used in managing the service.

Updated 19 May 2020

About the service

Avenues South East - 492 Maidstone Road is a residential home providing care and support for four adults living with multiple learning disabilities. People who lived in the home had autism, cerebral palsy, communication difficulties, visual impairment, challenging behaviour and PICA, which is the persistent eating of substances with no nutritional value such as fabric and foliage. The service is part of a group of homes managed by the Avenues Trust. At the time of our visit, there were four people living in the home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service

Appropriate staffing levels were not always maintained to ensure people’s needs were met. Staff were not always supported through training and supervision in line with the provider's policy. The systems used to assess and monitor the quality of the service were not always effective to drive improvement. Records were not always consistent and updated when required to prevent the risk of unsafe care and support.

The home environment appeared clean and without any odours; however, hygiene levels required to be improved to prevent the risk of infection. The home environment was designed to meet people’s needs; however, this required to be refurbished.

Relatives were complimentary about the service and told us their loved ones were safe and their needs were being met. People were protected from the risk of abuse, and risks to people had been identified, assessed and had appropriate risk management plans in place. Accidents and incidents were reported and recorded, and any lessons learnt were used to improve the quality of the service. People were supported with their medicines safely.

People were supported by staff who treated them with kindness, compassion and respect. People's privacy and dignity was respected, and their independence promoted. People's communication needs had been assessed and information was presented in formats that met their needs. People were supported to participate in activities that were of interest to them and build relationships with those important to them to prevent social isolation. Relatives knew how to make a complaint if they were dissatisfied with the service but told us they had nothing to complain about.

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. People's needs were assessed, and care and support planed and delivered to meet individual needs. People were supported to eat healthy amounts for wellbeing and supported to access healthcare services where required. The service worked in partnership with key agencies and health and social care professionals to plan to and deliver care and support that met individual needs.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

Rating at last inspection:

The last rating for this service was good (published 16 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to staffing levels, supporting staff and systems used for assessing and monitoring the quality of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for 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.