Avery Lodge Residential Home

Updated 28 August 2019

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 two 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

Avery Lodge Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (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 CQC who was also one of the partners for the provider. This means that they 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.

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. 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. The action plan the service submitted following their last inspection in May 2018 was also considered. We used all of this information to plan our inspection.

During the inspection

We spoke with six people who used the service and one relative about their experience of the care provided. We spoke with eight members of staff which included both of the partners for the provider, one of which was registered as the manager, the deputy manager, two senior care assistants, a kitchen staff member and two care assistants.

We reviewed a range of records. This included the care and medication records for three people. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including quality monitoring audits, maintenance and training records, were also reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found and we spoke with one professional who has had recent involvement with the service.

Updated 28 August 2019

About the service

Avery Lodge Residential Home is a residential care home. At the time of the inspection is was providing personal care to 14 older people with mental health issues. The service had no vacancies. It is an adapted period building with accommodation over two floors.

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

The service had made improvements since our last inspection and need to continue to do so. At the time of the inspection, several stakeholders had been working with the service and both they, the people we spoke with who used the service and staff confirmed improvements had been made. However, some concerns were still evident although the service is no longer in breach of the Health and Social Care Regulations 2008 (regulated Activities) 2014. The provider needs to continue to develop its quality monitoring system and its approach to governance. This needs to include an understanding of why actions are taken in relation to the impact it has on the quality and safety of the service, rather than just be a paper exercise. If you decide to go down a recommendation route, you could put that here?

The service had failed to rectify identified hot water temperatures that were above safe levels. This was actioned shortly after our inspection. Incidents and accidents had been investigated and appropriate actions taken but the service had no formal mechanism in place to analyse these for trends to mitigate against reoccurrence. The other risks to people, both on an individual basis and as a group, had been identified, assessed and mitigated. People received their medicines as prescribed and there were enough staff to meet people’s needs. Processes were in place to help protect people against the risk of abuse.

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. However, documentation regarding these practices needed to be improved. Although the service had made some improvements to the environment, further refurbishment was required, and a plan was in place to achieve this. We have made a recommendation regarding this. People benefitted from receiving support from staff who had been trained and supported and demonstrated the skills required. They worked in partnership with others to ensure people received effective and appropriate care including to meet nutritional and healthcare needs.

People told us they were supported by staff who were caring, patient and listened to them. They felt respected and involved in the care they received. Staff knew people well and used their knowledge of people’s histories to form meaningful relationships. People told us staff knew them, and their individual needs, and met those needs to their preference. People’s dignity was maintained, and people were encouraged to remain as independent as possible including accessing the community.

People’s past lives, and experiences, had been considered when planning care and delivering it. Care plans were person-centred and contained detailed information on people’s histories and relationships which helped staff deliver care individual to each person. People’s needs had been regularly reviewed and people important to them had been included in that. Where people had communication needs, these had been met. Although we saw no formal activities going on during our inspection, we saw that staff had time to fully engage with people and that individuals accessed the community or garden and spent time engaged with others. People told us they had no complaints about the service they received however, the service had processes in place should people need to raise concerns. These processes considered the need for a quick resolution and the need for openness, discussion and transparency.

People told us they were happy living in the home and with the care they received. Staff worked well as a team and felt valued, supported and able to contribute ideas. People’s views had been sought and they were involved in the running of the service. Relationships had been built with other professionals and this had improved the service people received.

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 requires improvement (published 12 July 2018) and there were two breaches of regulations. 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 improvements had been made and the provider was no longer in breach of regulations.

The last rating for this service was requires improvement. The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Avery Lodge Residential Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.