We inspected Avon House Rest Home on 21 April 2015. 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. Avon House does not provide nursing care. On the day of our inspection there were sixteen 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.
We previously inspected the service in November 2013 where concerns were noted in regard to gaps in the recruitment process and poor standard of record keeping. At this inspection, we found that improvements had been made and that compliance actions had been met.
The registered manager and deputy registered manager had a good oversight of the running of the home and a thorough knowledge of the people that lived there. However there was no clear system of quality assurance in place that audited practice within the home in order to help ensure continuous improvement.
We recommend that the provider seek guidance around best practices in implementing quality assurance processes.
Consent was sought from people with regard to the care that was delivered. Staff understood about people’s capacity to consent to care and had received training in this area. The registered manager was booked to carry out training regarding the Deprivation of liberty safeguards (DoLs).
People who lived at Avon House were safe as they were cared for by staff that knew them well and were aware of the risks associated with their care needs. There were sufficient numbers of staff in place to keep people safe and staff were recruited in line with safe recruitment practices. Medicines were ordered, administered, recorded and disposed of safely. Staff had received training in safeguarding adults and were in the process of updating their training.
People could choose what they wanted to eat from a daily menu or request an alternative if wanted. People were asked for their views about the food and were involved in planning the menu. They were encouraged and supported to eat and drink enough to maintain a balanced diet.
Staff were appropriately trained holding a National Vocational Qualification (NVQ) in Health and Social Care and had received all essential training. Staff had started a new recommended training called The Care Certificate which provides a benchmark for training in adult social care.
People could choose when they wanted to get up and go to bed and were cared for by kind and compassionate staff. One person told us ‘The staff are very friendly and cheerful, helpful. They are all very kind’. People’s individuality was respected and choices were given regarding how their care was delivered. People were involved in the running of the service and consulted regularly. Where someone was receiving end of life care this was provided in a holistic and sensitive way.
Prior to moving to Avon House, people were assessed by the registered manager so that care could be planned that was responsive to their needs. Care plans were reviewed on a monthly basis and care plans reflected people’s needs. They gave an accurate reflection of the support required by people who lived at the service. People were encouraged to stay in touch with people that mattered to them. There was a range of social activities on offer at the service, which people could participate in if they chose. These included group activities and one to one activities. There had been no formal complaints responded to but minor concerns had been documented and actions to resolve these recorded. The formal complaints process was displayed on the notice board.
The registered manager had created a culture that placed the person at the centre of the care that they received. Staff values reflected this and there was a cohesive approach to providing care and support. The organisation had links with the local community. Children from a local school visited the service every Wednesday and played scrabble with people. Professionals we spoke with told us that the staff at Avon House contacted them in a timely way and worked in partnership to deliver care and support.