Avondale Care Home

Updated 6 February 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector, one specialist advisor, one pharmacy inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service

Service and service type

Avondale 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.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced.

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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with 12 people using the service and five relatives about their experience of the care provided. We also spoke with the registered manager, the director of nursing and quality, the deputy manager, the nominated individual, and six members of the care team. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records to the way the service was run this included seven people’s care records and medication administration records (MAR).

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at records of the medicine history for someone receiving time specific medicine.

Updated 6 February 2020

About the service

Avondale Care Home provides residential, nursing, dementia and respite care for older adults aged 65 and over. At the time of our inspection the service was supporting 76 people.

The service has six units across three floors each of which has separate adapted facilities and can accommodate up to 90 people in total.

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

People were not always protected from the risks associated with unsafe medicines administration. This was because some people on time specific medicines did not always receive them in line with best practice guidance. Detailed guidance was in place for people receiving their medicines covertly.

People reported and illustrated that they were safe living at Avondale and were unanimous in confirming that they felt that there were always a sufficient number of nurses and staff on duty.

One person told us, “There are no safety issues here, I can tell you staff numbers are never a problem here, I think the numbers are right. Some staff changes have happened recently, I miss the good ones of course when they go but they are always replaced so there is that compensation; but they do get busy sometimes and very occasionally they have a little time to come and chat.”

Staff we spoke with confirmed they had received training in safeguarding and knew what action to take if they felt people were being abused. Recruitment files confirmed staff had been safely recruited. Staff received an induction when they first joined the service and regular training was completed and refreshed when required. Staff received regular supervisions and they told us they felt supported.

People and relatives were positive about the caring nature of staff. They commented, “The staff are amazing, some are really caring, a home from home here, I know mum is happy here”, “I find that the staff here are like an extended family- I would go to [Name] if she was working if I had a problem” and “There is a new carer, I don’t know her name she is very good and lovely.”

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.

Risks associated with people’s care and support needs had been identified and actions taken to minimise risks. Care plans were on an electronic system and reflected people’s care needs, including specific dietary requirements.

People were able to take part in a wide range of social events. The service had use of transport which could be used three days each week. Animal therapy and outside entertainers were regular events at the service. One relative said, “Some outside entertainers come in, I know there have been brass bands and an Opera singer”.

The provider had a quality auditing system in place. Accidents and incidents were documented and reviewed as necessary. People told us they knew how to make a complaint. We saw complaints were responded to in a timely manner.

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 outstanding (published 13 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to safe care and treatment at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. If we receive any concerning information we may inspect sooner.