We carried out a review of the data available to us about Avon Cliff 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 Avon Cliff, you can give feedback on this service.
Avon Cliff is a residential care home providing nursing and personal care to up to 52 people. The service provides support to older adults. At the time of our inspection there were 46 people using the service.
People’s experience of using this service and what we found
People told us they felt safe and had confidence in the staff. People were supported by staff that had been trained to recognise signs of abuse and understood their role in reporting concerns. People’s risks were assessed, monitored and reviewed and staff knew people well and the actions needed to minimise risk. People had their medicines managed safely. Infection control and prevention measures met best practice guidance. People were supported by enough staff who had been recruited safely.
People and the staff team described the home as well led, friendly and open. They spoke positively about the service and the care provided. Staff felt appreciated and described teamwork and communication as good. Quality assurance processes were robust and effective at driving continual improvements. People, families and the staff team had opportunities to provide feedback, with their views respected and acted upon where appropriate. Links with local universities and colleges provided opportunities for students to learn and experience working in a social care setting. Access to professional nursing and social care organisations meant the service kept up to date with new developments and best practice guidance.
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 5 December 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Avon Cliff 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.
Avon Cliff is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Avon Cliff accommodates up to 52 older people in purpose-built premises. Nursing care is provided. There were 43 people living or staying there when we inspected.
The registered manager, who had been in post since April 2018, had recently resigned. 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 service had been through a period of change. The previous registered manager had worked at the home for several years and had moved to another home operated by the registered provider in February 2018. The registered provider had provided interim management for the service and everyone we spoke with during the inspection had confidence in these arrangements and staff told us they felt well supported.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
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All of the feedback we received about Avon Cliff from people, visitors was positive. People were happy living at the home and reported that they felt well cared for. The atmosphere in the home was warm and friendly.
People were supported by staff who understood how to recognise the risks and how to support them to reduce these. Staff understood how to identify and report abuse and how to whistle blow. Staff also supported people to take medicines safely.
People were supported by skilled and caring staff who were well trained and supported.
People were enabled to have maximum choice and control of their lives and staff did this in the least restrictive way possible; the policies and systems in the service supported this practice.
People, relatives and professionals told us they could confidently raise any concerns, and these were addressed appropriately.
Quality assurance systems involved people and led to a safer and better-quality service.
Further information is in the detailed findings below.
This was an unannounced inspection that took place on 29 June 2017. At the last inspection in March 2016, the service was rated good overall, but the question 'Is the service safe?', was rated requires improvement.
The purpose of this inspection was to follow up on the actions taken by the service to address the breach of regulation in relation to the provision of safe care and treatment. This was because at the last inspection we found that; people had not always been protected against the risks associated with the unsafe management and use of medicines and the risks to people's health and safety had not been properly assessed and action had not been taken to mitigate any such risks. We also found that appropriate checks to ensure that new staff were suitable to work with vulnerable people had not always been completed.
At this inspection there were significant improvements. The provider had given the registered manager clinical and management support. Systems had been reviewed, assessed and improved. All actions included in the registered manager and provider’s action plan had been met.
The people living at the home told us that they felt safe and well cared for. A visitor told us that they were very happy with the care provided for their relative. They said the staff were kind and caring as well as being supportive and respectful. They particularly commented that staff had taken time to find out about the person, what was important to them and about their past career. They had then used that to ensure that the person was engaged in meaningful activity. The visitor summed up the conversation telling us that they always feel they can go home knowing that their relative was happy in the home and well looked after. Staff in the home were also positive about the home and the service they provided. They were all aware of the shortfalls from the last inspection and had worked hard with the registered manager to rectify the issues.
At this inspection we changed the rating for the key question ‘Is the service safe?’ from Requires Improvement to Good. The overall rating for the service remained Good.
Further information about this inspection is in the detailed findings below. Our previous comprehensive inspection from March 2016 provides information about the other areas that have previously been inspected.
Avon Cliff is a purpose built home and is registered to accommodate a maximum of 52 people who require either nursing or personal care. There were 44 people living there at the time of our inspection. The home is well equipped and has good communal facilities which include a café and hairdressing salon.
The home was led by 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.
All of the people living at the home and visitors told us that they felt safe and well cared for. We received only positive comments about Avon Cliff throughout our inspection. Staff in the home were also positive about the home and the service they provided. They told us they felt well supported by the management team that was in place.
People were not always protected against the risks of unsafe management of medicines and risks to their health and safety were not always properly assessed and managed.
People received care and support that was person-centred and respectful. There were appropriate numbers of staff on duty to meet people’s needs. People’s needs were assessed and plans were in place to ensure that their needs were met. People’s choices and decisions were respected and staff enabled people to retain their independence.
Staff were not always recruited safely because full pre-employment checks had not always been carried out and satisfactory references had not always obtained. Staff received regular training and supervision and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience to help people with their care and support needs.
Observations and feedback from staff, relatives and professionals showed us that the home had an open and positive culture.
There were systems in place to monitor the safety and quality of the service. This included the use of audits and surveying the people who used the service and their representatives.
You can see what action we told the provider to take at the back of the full version of the report
We spoke with five people using the service and three of their relatives. We also reviewed five care plans and five staff personnel files.
One person told us that the care support provided by the staff was "fantastic" and another commented that the staff were "great". A general practitioner (GP) visiting the home told us that the nursing staff were "very competent" and were "good at identifying relevant medical problems at an early stage".
Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.
Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.
People were protected from unsafe or unsuitable equipment.
People were cared for, or supported by, suitably qualified, skilled and experienced staff.
There was an effective complaints system available.
The inspection team was led by a CQC inspector and joined by an Expert by Experience; people who have experience of using services and can provide that perspective.
We talked with nine of the people who lived in the home and observed the care and support provided to others who were unable to communicate verbally with us. We also spoke with a relative who was visiting. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.
People who used the service told us that they were happy with the way they were looked after. We spoke to nine people. They all told us that they were respected and involved in their care.
The people we spoke with said that the staff usually knocked on their doors before they entered their rooms and that they were called by their preferred names. People also told us that their personal care was delivered in a gentle and sensitive manner by staff who ensured doors and curtains were closed when appropriate.
Everyone we spoke with told us that they had enough to eat and drink and always had fluids available to them. People said that they had never felt the need to ask for snacks or drinks as there was plenty provided through the day. They all said that they only had to use their call bell if they wanted anything and were confident that this would include snacks if this was what they wanted.
Everyone that we spoke with said that they felt well cared for and safe at Avon Cliff. They said that their possessions were respected and looked after and they had no worries regarding this matter.
Two people told us that they felt that the meeting of some of their needs, for example bath times, were more determined by staffing levels and time constraints than by their personal preferences. One person said, 'sometimes people are different with you if they are very busy'. We found that this observation was echoed by some of the other people we spoke to.
The majority of the people we spoke with said that they had some communication difficulties with some of the staff where English was not their first language.
Another person said 'what's good about the matrons is they don't just hide away in the office they do come around and check if everyone is alright'.