Avon Court Care Home

Updated 26 August 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by four inspectors.

Service and service type

Avon Court Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Avon Court Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post, but they were on long term leave. The home was being managed by an interim manager; we will refer to them as a manager in the report.

Notice of inspection

This inspection was unannounced. The first day of our inspection started at 7.30pm.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 11 people and three relatives about their experiences of care and support received. We spoke with 12 members of staff, the manager and the area quality director and we contacted five healthcare professionals for their views about the service.

We reviewed nine people’s care and support records, multiple medication records, staff meeting minutes, agency staff profiles, three staff files in relation to recruitment, health and safety records, accidents and incidents and various quality monitoring and management records. We also reviewed the service improvement plan and policies and procedures.

Updated 26 August 2022

About the service

Avon Court Care Home is a nursing home providing accommodation and personal care for up to 60 people. At the time of our inspection there were 41 people living at the service. Accommodation was provided on two floors accessed by stairs and a lift. People had their own rooms and use of communal areas such as lounges, dining rooms and a conservatory. The home also provided rooms for people on a short stay arrangement in partnership with the local authority. These rooms were for people being discharged from hospital and in need of rehabilitation before moving back to their own homes.

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

Risks to people’s safety had been identified and assessed. Plans were in place for staff to use to support and provide care safely. Plans were reviewed regularly or when people’s needs changed. Two plans we reviewed needed more details, we informed staff during our inspection so action could be taken to update them. The provider had identified improvement was needed for care planning and taking action to improve quality of records.

People had their medicines as prescribed. The service had an electronic medicines management system which helped to identify shortfalls. We did note one person had not had their time sensitive medicines in a timely way. This was shared with the manager who took action to address this. Staff had medicines training and were assessed for competence.

People were supported by sufficient numbers of staff. There had been staffing challenges and agency staff were used to fill gaps in staffing rotas. The provider and the manager were working to recruit new staff using various methods. People told us staff were busy, but staff responded to them in a timely way. Staff had been recruited safely.

The home was clean and had been decorated shortly before our inspection. Cleaning schedules were in place to make sure all areas of the home were cleaned. Staff were observed to be wearing personal protective equipment (PPE) safely. Staff told us they had training on infection prevention and control good practice and received regular updates when needed. The home was following government guidance on testing for COVID-19.

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.

Prior to our inspection we received information of concern about staff interaction with people particularly at night. We visited in the evening and spent time observing staff interactions. We did not find evidence to substantiate any concerns. People told us staff were caring and kind and they felt comfortable with staff. People and relatives told us people were safe at the service. Staff had been given training on safeguarding and understood their responsibilities.

People could share their feedback using quality surveys and reviews of care. The service used a ‘Person of the day’ process to review people’s care and make sure they were satisfied. Staff were able to attend staff meetings to share views and have updates on events and people’s needs.

There was a registered manager in post who was on long term leave at the time of this inspection. The provider had placed an experienced interim manager at the service who had worked for the provider for many years. Feedback from people, relatives and staff about the manager and deputy manager was positive. We were told they were visible, approachable and very supportive. Staff told us there was good teamwork and despite staffing challenges morale was high amongst staff.

Staff worked in partnership with various healthcare professionals to make sure people had their health needs met. Due to the service having a number of ‘short stay’ rooms there were professionals regularly visiting the home to provide rehabilitation. Some professionals told us communication could be improved with the management. We shared this feedback with the manager and area director who told us they would review current systems.

Quality monitoring systems were in place to make regular checks on quality and safety. The provider had systems that gave senior management access to key data such as weight loss, pressure ulcers and medicines incidents. This enabled the provider to make sure the right action had been taken to support people safely.

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 4 February 2021). At our last inspection we recommended that the provider review their policy about making sure end of life medicines were included in the care planning process. At this inspection we found this action had been taken.

Why we inspected

The inspection was prompted in part due to concerns received about personal care, staff approach and some risk management. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Avon Court Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.