Avon Manor

We found the following examples of good practice.

• The provider had constructed a COVID-19-secure visiting pod with floor to ceiling screens and windows where the visitor and resident access through different entrances. This was constructed in the grounds of the home so that visitors did not need to enter or pass through the care home. The pod had full Infection Prevention and Control (IPC) and Personal Protective Equipment (PPE) materials for visitors to use. The provider had installed a loop system which is an assistive listening device that allows people with sensory needs to communicate effectively.

• The home was limiting visitors to two per day to ensure that staff could manage this safely and effectively.

• Staff were supported to use PPE safely and creatively. For example, one staff member needed a specific type of disposable gloves, and these were sourced for them. A routine was agreed to ensure they could safely and effectively carry out their role.

• The registered manager has carefully considered the layout of the home in preparation for any potential outbreak. The contingency plan would effectively zone the home and staff could access and leave each zone without the need to enter areas that were affected by COVID-19 and areas that were not.

Avon Manor is a residential care home providing personal and nursing care for up to 28 people in one adapted building. At the time of our inspection, the home was fully occupied.

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

People and their relatives felt the home provided a safe environment. People’s risks were identified and assessed with guidance for staff on mitigating risks. Staff followed this guidance. Staff levels were assessed based on people’s care and support needs and there were enough staff.

Medicines were managed safely. The home was clean and smelled fresh. When things went wrong, lessons were learned and staff reflected on improvements that could be implemented.

Staff completed a range of training to meet people’s needs. They received regular supervision and had annual appraisals. One person said, “The staff are very helpful, they are good staff”.

People were supported to have a healthy diet and with their nutrition and hydration needs. The lunchtime meal was a sociable occasion and people chose whether they wanted to eat in the dining room or in the sitting room. Some people preferred to have their meals in their rooms. Special diets were catered for. People had access to a range of healthcare professionals and support. Premises had been adapted to meet the needs of people living with dementia.

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 were looked after by kind and caring staff who reassured them when they became anxious, confused or distressed. As much as they were able, people were involved in decisions relating to their care and were treated with dignity and respect.

People received personalised care that was responsive to their needs. Activities were organised as far as possible according to people’s preferences and interests. Outings into the community were encouraged. If their needs could be met and it was their wish, people could spend the rest of their lives at the home.

People and their relatives spoke highly of the home, of the care provided and the warm, friendly staff. Visitors were made to feel welcome. Feedback was obtained from relatives and residents’ meetings took place.

Staff felt valued by the management team and staff meetings provided opportunities for staff to meet together. The home operated an ‘open door’ culture and the registered manager worked on the floor and was accessible to people, their relatives and staff.

A system of audits monitored and measured all aspects of the home and were used to drive improvement. There were strong links with the community. Nursery school children visited the home and sessions were enjoyed by people who participated in singing nursery rhymes and talking about toys. Local high school students attended the home for periods of work experience.

The registered manager liaised with other care home managers and attended managers’ forums. The home worked proactively with various healthcare professionals.

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 23 November 2016)..

Why we inspected

This was a planned inspection based on the previous rating.

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.

Avon Manor is registered to provide accommodation and care for up to 28 people living with dementia and/or other health needs. At the time of our inspection 27 people were in residence. Avon Manor is a large, older style property which is situated close to the town centre of Worthing and to the seafront. Communal areas include two large sitting/dining areas, a further quiet lounge with access to the gardens and a sun lounge which is used as a dining room. All bedrooms are of single occupancy.

A registered manager was 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.

People were protected from the risk of harm by trained staff, who recognised the signs of potential abuse and knew what action to take. People’s risks had been identified and assessed appropriately and guidance and advice provided for staff on how to mitigate risks. Staff had been trained in safe moving and handling techniques. Staffing levels were sufficient to meet people’s needs and keep them safe. Generally, medicines were managed safely, although we observed that some topical creams did not have the date of opening recorded on the tube or packaging. This issue was discussed with the registered manager so that appropriate action could be taken to address this.

Staff received a range of effective training and new staff complete the Care Certificate, a universally recognised qualification. Staff received regular supervision with the registered manager and attended staff meetings. Staff had been trained on the Mental Capacity Act 2005 and in Deprivation of Liberty Safeguards and understood their responsibilities under this legislation. People had sufficient to eat and drink and were encouraged with a healthy diet. People and their relatives expressed satisfaction with the meals on offer and people were supported by staff to ensure that mealtimes were an enjoyable experience. People were supported to maintain good health and had access to a range of healthcare professionals and services.

Staff knew people well and kind, caring relationships had been developed. The atmosphere at Avon Manor was warm and inviting and the resident pets: two dogs, a cat and three tortoises, were engaging and enjoyed by people living at the home. Relatives spoke highly of the caring attitude of staff. People were encouraged to be involved in all aspects of their care and relatives were also consulted and involved. People were treated with dignity and respect. At the end of their lives, people were supported to have a private, comfortable, dignified and pain-free death.

Personalised care plans were in place for people which included information about their lives before they came to Avon Manor. Detailed, comprehensive information enabled staff to provide people with the care they needed, in line with their personal preferences and choices. A range of activities had been organised and people were enjoying the activities on offer at the time of the inspection. There were limited opportunities for people to access the community on minibus outings. Relatives knew how to make a complaint, but no complaints had been received within the last year.

People, their relatives and staff were all asked for their views about the service and overall feedback was extremely positive and complimentary. Staff felt well supported by the registered manager and relatives expressed satisfaction with the quality of care delivered at Avon Manor. Audits were in place to measure and monitor the quality of care delivered. Some notifications that needed to be sent to the Commission had not been completed by the registered manager. This was discussed and considered to be an oversight by the registered manager, based on a misunderstanding of advice received. Other notifications had been completed as required.

We spoke with the manager, the cook, the care manager, one of the senior care staff, one day and one night care staff. One said 'It's a friendly atmosphere here'. Another said 'It's a home from home'.

We reviewed care records for three people who used the service. We found that people who lived at the home experienced safe and effective care because their needs were assessed and reviewed, and care plans kept current.

People could choose from a varied menu and had the support they needed to help them eat and drink.

There were sufficient staff with the right knowledge, experience and skills to meet people's health and welfare needs.

People using the service benefited from a staff team who were well trained and supported to do their job.

People were assessed prior to receiving care. Risk assessments and care plans were detailed and person centred. People said that they were treated with respect and were asked for their preferred form of address.

There was a robust recruitment procedure that the staff followed. We found that all necessary staff's checks were completed prior to them starting work. There was a complaint procedure that the manager and staff followed. People told us that they would approach the manager with any concerns and they were confident that this would be addressed.