We carried out a review of the data available to us about The Avenue Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Avenue Care Home, you can give feedback on this service.
The registered manager checked our LFD test results and asked to see our COVID pass on arrival.
The registered manager had completed outcome forms for all people which covered their risk of contracting COVID-19.
The registered manager and staff communicated regularly with family of people living in the home. They also had effective relationships with other professionals such as GP surgeries for the benefit of people living in the home.
The home was clean and tidy, staff followed cleaning rotas. Care staff were documenting cleaning being carried out within the home and these were checked by the management team to ensure cleaning was carried out effectively. All staff ensured regular disinfection of frequently touched surfaces of the home for example, light switches and door handles.
There were enough stocks of PPE in the home. Staff had received training from the local authority on donning and doffing and infection, prevention and control.
The registered manager had a good understanding of zoning and cohorting which was followed in the event of a COVID-19 outbreak.
The provider had an up to date infection control policy which had been updated to include COVID-19.
The Avenue Care Home is a residential care home providing personal care to 23 people aged 65 and over at the time of the inspection. One person was in hospital at the time of the inspection. The service can support up to 24 people.
The Avenue Care Home accommodates people in one adapted building over two floors.
People’s experience of using this service and what we found
Staff were not always recruited safely; employment history was only recorded for the previous 10 years.
Some people’s care and support plans did not always contain all the detail required to support them in the best way. The provider was aware of this and was in the process of reviewing and updating all care plans.
Some medicines were not always recorded as being given. The registered manager took immediate steps to rectify this.
People told us there were enough staff to meet their needs and documents demonstrated this. There was good planning and provision of meaningful activities for people.
Staff had good access to supervision, training and team meetings and told us they worked together as a team.
There was a redecoration programme in place and ongoing improvements were being made to the environment.
People were supported by staff who were kind, compassionate and caring and who understood their likes, dislikes and preferences. People were happy living at The Avenue Care Home and told us they felt safe. They were positive about the food and were supported to access health care professionals to maintain their health and wellbeing.
The provider had effective governance systems in place to identify concerns in the service and drive improvement.
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.
The provider was responsive to our feedback and took immediate action to make improvements in the service.
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 21 August 2018) and there were two breaches of regulation. 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 enough improvements had been made and the provider was no longer in breach of regulations.
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.
The Avenue had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.
We inspected The Avenue on 14 January 2016 and found the previous registered manager had not provided staff with regular ongoing supervision to make sure their competence was maintained. This was a breach of Regulation 18 of the Health and Social Care Act 2008 Regulated Activities Regulations (HSCA RA) 2014. Staffing.
At this inspection we found the provider had made progress and was no longer in breach of Regulation 18.
Improvement was required to enable people living with dementia to navigate throughout the home safely and effectively.
Staff complied with the requirements of the Mental Capacity Act 2005.
Infection control procedures were consistently effective in maintaining a clean and risk free environment.
People were supported to engage in meaningful activities.
Staff were aware of people’s individual risks and were able to tell of the strategies in place to keep people safe.
Staff knew each person well and had a good knowledge of the needs of people.
Staff received supervision, providing them with appropriate support to carry out their roles.
Food menus offered variety and choice. The chef prepared meals to meet people’s specialist dietary needs.
Where possible, people and relatives were involved in care planning.
Staff supported people with health care appointments and visits from health care professionals.
Care plans were amended to show any changes and they were routinely reviewed every month to check they were up to date.
People and relatives knew who to talk to if they had a complaint. Complaints were passed on to the registered manager and recorded to make sure prompt action was taken and lessons were learned which led to improvement in the service.
People’s needs were fully assessed with them before they moved to the home to make sure that the home could meet their needs. Assessments were reviewed with the person, their relatives and where appropriate other health and social care professionals.
The provider had appropriate arrangements in place should people require end of life care.
At this inspection we issued one breach of the Health and Social Care Act 2008. You can see what action we took at the back of this report.
The Avenue Care Home provides accommodation for persons who require personal care for up to 24 older people and people who may be living with dementia.
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.
The provider had arrangements in place to protect people from risks to their safety and welfare.
Staffing levels were sufficient to support people safely. Recruitment processes were in place to make sure only workers who were suitable to work in a care setting were employed.
Arrangements were in place to store medicines safely and to administer them according to people’s needs and preferences.
Staff received appropriate training to make sure they had the skills and knowledge to support people to the required standard. The staff induction did not fully require staff to demonstrate they had the appropriate skills and knowledge and we have made a recommendation about this.
Staff did not receive regular supervision to make sure their competence was maintained and to ensure they were formally supported. However, informal support was available to them.
People were supported to access healthcare services, such as GPs, dentists and opticians and their health was monitored.
People found staff to be kind and caring. They were encouraged to take part in decisions about their care and support and their views were listened to. Staff respected people’s individuality, privacy, dignity and independence.
The service involved people in the care assessment and planning processes. Care and support was based on people's assessed needs that took into account their needs, conditions, and preferences. Staff were aware of people’s support needs and preferences. However, some of the information recorded in care plans did not support this and we have made a recommendation about this.
Care plans were adapted as people’s needs changed, and were reviewed regularly.
People were able to take part in leisure activities which reflected their interests. Group activities and entertainments were available if people wished to take part.
The home had an open, friendly atmosphere in which people were encouraged to make their views and opinions known.
Systems were in place to make sure the service was managed efficiently and to monitor and assess the quality of service provided.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time of this inspection. We have advised the provider of what they need to do to remove the individual's name from our register.
We spoke to three people who live at the service and to a relative of a person living at the service.
People said they liked living at the home. They reported they were satisfied with the care and support they received. One person said, 'The staff are very good. They look after me well.' Another person said, 'I am well looked after. The care is good.'
People said they were able to exercise choice in how they spent their time. For example, this included times for getting up, where they preferred to have their meals, and whether they wished to take part in activities.
A relative of someone living at the service told us they visited the home before making a decision with their relative about whether or not to move in. Written information was said by the relative to have been provided, which included the service's aims and objectives as well, as the complaints procedure. The relative told us the people at the home were well cared for and that there was flexibility so that people could express themselves. Staff were said by the relative to be skilled in working with people with dementia.
People said there were activities they could choose to take part in if they wished. This was also confirmed by a relative who added that they considered this was something the home could improve on.
People said they liked the food and that there was a choice. A relative said the food looked good and wholesome. The relative also told us the home monitored people's weight as well as food and fluid intake where this was needed.
People and a relative of someone said they considered the home to be a safe place for people to live.
A relative told us the home provided a satisfaction survey questionnaire so that they could give their views on the service. The relative also said the home's staff and management were approachable.
People, and a relative of someone living at the home, said the premises were kept clean.
During this visit we also spent time observing the care of people who may not have been able to give us their views because of dementia. We also read care plans and other documents to gain evidence of their experience of using this service.
The people we spoke to were happy with the care provided. They said staff were 'very nice' and 'very good'. One relative, speaking about how staff treated their mother said 'they are very good', and she had 'no grumbles'. People said they received the care and support they needed. One person said 'they have looked after me beautifully' and were 'very patient'. We observed that staff responded to requests and checked out with people that they had what they needed. We noted a good rapport between staff and people using the service.