Avon House Rest Home - Balcombe

Updated 11 October 2017

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.

The service was last inspected on 21 April 2015 where we found there were no formal systems of quality assurance in place that provided evidence of the monitoring of the service and actions for improvement. At this inspection we found improvements had been made however there were still some areas to improve on and to become embedded.

This inspection took place on 12 September 2017 and was unannounced. The inspection team consisted of three 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. The expert-by-experience for this inspection was an expert in care for older people.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what they do well and improvements they plan to make. We looked at this and other information we held about the service. This included previous inspection reports and notifications. Notifications are changes, events or incidents that the service must inform us about. We contacted health and social care professionals involved in the service for their feedback, three health and social care professionals gave feedback regarding the service.

During the inspection we observed the support that people received in the communal lounges and dining room. We were also invited in to people’s individual rooms. We spoke to eight people, three relatives, two care staff, a chef, the deputy manager, registered manager and the provider. We spent time observing how people were cared for and their interactions with staff and visitors in order to understand their experience. We also took time to observe how people and staff interacted at lunch time.

We reviewed four staff files, medication records, staff rotas, policies and procedures, health and safety files, compliments and complaints recording, incident and accident records, meeting minutes, training records and surveys undertaken by the service. We looked at seven people’s individual records, these included care plans, risk assessments and daily notes. We pathway tracked some of these individual records to check that care planned was consistent with care delivered.

Updated 11 October 2017

We inspected Avon House Rest Home on 12 September 2017. Avon House is a residential care home that provides accommodation and support for up to nineteen people. The people living there are older people with a range of physical, mental health needs and some people living with dementia. On the day of our inspection there were fifteen people living at Avon House. Avon House is a large detached Victorian House spread over three floors. People’s bedrooms were situated on the ground and first floor. The house is set within a large landscaped garden.

The service had a registered manager 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.

An auditing and quality review system was in place, however further improvements were planned and required to ensure oversight was maintained and embedded. We have identified this as an area of practice that needs improvement.

People told us they felt safe living at the home, staff were kind and caring and the care they received was good. One person told us “The care here is superb and makes me feel really safe”.

People were protected from the risk of abuse because staff understood how to identify and report it. One member of staff told us “If I thought that someone was not happy or showed any concern, I would alert the manager straight away”. Staff had access to guidance to help them identify abuse and respond in line with the providers policy and procedures if it occurred.

The provider had arrangements in place for the safe ordering, administration, storage and disposal of medicines. People were supported to get their medicine when they needed it. People were supported to maintain good health and had access to health care services.

Staff considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles of the MCA in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded. The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found the registered manager understood when a DoLS application should be made and the process of submitting one.

People’s individual needs were assessed and care plans were developed to identify what care and support they required. People were consulted about their care to ensure wishes and preferences were met. Staff worked with other healthcare professionals to obtain specialist advice about people’s care and treatment.

People were encouraged to express their views and had completed surveys. Feedback received showed people were satisfied overall, and felt staff were friendly and helpful. People also said they felt listened to and any concerns or issues they raised were addressed. A relative told us “Any concerns I have , I go to the manager. She is very approachable and will listen”.

Staff supported people to eat and drink and they were given time to eat at their own pace. People’s nutritional needs were met and people reported that they had a good choice of food and drink. People had access to and could choose suitable leisure and social activities. One relative told us “I think the food is superb, mum is a faddy eater but she really enjoys the food here”.

Staff felt fully supported by the registered manager to undertake their roles. Staff were given training updates and supervision. For example staff were offered the opportunity to undertake additional training and development courses to increase their understanding of the needs of people. One member of staff told us “We get regular training and are told when we need to update our training. We use online training for some subjects”.

The atmosphere at the home was a happy one with a homely feel. People, staff and relatives found the registered manager approachable and professional. One person told us “The manager is very good, always around and make sure we are all ok”.