Archived: Avalon Residential Home

Updated 19 June 2015

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.

This inspection took place on 31 March and 1 and 8 April 2015 and was unannounced. The inspection team consisted of one adult social care inspector.

Prior to the inspection we looked at the information we had about the service. This information included the statutory notifications that the provider had sent to CQC. A notification is information about important events which the service is required to send us by law. We had information of concern from three ‘whistle blowers’. Whistle blowers are staff members that alert us about concerns. We used this information to assess how the service was performing and to ensure we addressed any potential areas of concern. We contacted the local commissioners before the visit.

We spoke with the registered manager, four care staff, one care worker/domestic, the cook, the registered providers, ten people living in the home and four relatives. We also spoke with two healthcare professionals visiting people. We observed staff talking to people and providing support. We looked at eight care records, four recruitment records, quality assurance information, duty rosters, maintenance records, peoples personal money records, some policies and procedures and a record of all staff training.

Updated 19 June 2015

This unannounced inspection took place on 31 March and 1 and 8 April 2015.

Avalon provides residential care for up to 19 older people. The home is a detached house with accommodation on three floors. People have access to a communal lounge and separate dining room. All bedrooms have ensuite toilet facilities, five bedrooms also have an ensuite shower and there is a bathroom on each floor. The gardens at the front were accessible for people. There were 16 people accommodated on the first day of our inspection visit and 17 people on the final day.

There was a registered manager. 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.

Three ‘whistle blowers’ contacted us before the inspection. A whistle blower is a member of staff who raises concerns that affect people and may put them at risk from poor care or abuse. We looked at all the concerns raised during our visit.

People were not supported by sufficient staff with the appropriate skills, experience and knowledge to meet their needs. People sometimes had to wait for assistance and staff were rushed. The provider responded to our concerns quickly and additional staff were rostered for the mornings.

We identified several maintenance issues that may have put people at risk from injury and some were rectified during the inspection visit. The home was under refurbishment and there were improvements and additional bedrooms. More improvements were planned for the year to increase communal space and continue with refurbishment of all rooms.

Medicines were stored safely and administration records were complete but there was a need for improvements to the procedure for giving people their medicines. Staff had been trained to give medicines and the provider told us they would monitor their practice.

Staff knew people well and how they liked to be cared for. Care plans were personalised and people were involved with planning their care. People were safeguarded from harm because staff were aware of their responsibilities to report any concerns. Risk assessments were completed which reduced risks for people, helping to keep them safe and independent. People described the service as safe and said they felt safe. They told us it was homely and they were looked after by kind staff. Staff were trained to keep people safe and knew who to contact if they had concerns.

People had access to healthcare professionals to promote their health and wellbeing but there was a need to improve the information recorded for healthcare professionals to review progress. People told us that healthcare professionals supported them well.

People had a choice of meals and they told us the food was good. The risk of malnutrition was monitored and people had professional support where required. Special diets were catered for and people’s personal food preferences were taken into account when planning menus.

People took part in activities. They were able to make suggestions for new activities but there was no clear organisation of activities as the person that organised them had left. Care staff provided some activities but had little time to plan them. Trips out were occasionally organised.

The arrangements for managing the home had been through some changes due to staff sickness and staff did not feel well supported. Monthly quality assurance checks were completed by the registered manager and senior staff had meetings to discuss any health and safety issues. There was a programme of audits completed to include medicines, care plans and people’s personal monies. People had residents meetings and were able to choose what activities they would like to do. People had not completed any surveys to check the quality of the service since 2013.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We completed this inspection at a time when the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the Care Quality Commission (Registration) Regulations 2009 were in force. However, the regulations changed on 1 April 2015; therefore this is what we have reported on. You can see what action we told the provider to take at the back of the full version of this report.