Avenues London - 1a Webb Road

Updated 12 April 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection site visit was carried out by a single inspector. An Expert by Experience made calls to relatives during the inspection. 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

Avenues London - 1A Webb Road is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for one month and had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 12 January 2023 and ended on 17 January 2023.

What we did before the inspection

We reviewed the information we held about the service. We contacted local authority safeguarding and commissioning team who worked with the service to gain their feedback

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We visited the service and spoke with people living there. Most people were not able to express their views verbally about their care. 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.

We spoke with 3 care workers, the manager, the assistant services manager and a senior operations manager. The Expert by Experience made calls to four relatives to gain their views.

We looked at 3 people’s care plans, risk assessments and logbooks. We reviewed other recorded related to the management of the service, such as staff training records, audits and environmental checks.

Updated 12 April 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Avenues London - 1a Webb Road is a residential care home that provides accommodation and personal care support for up to six people with complex learning and physical disabilities. At the time of our inspection the home provided support to six people in a purpose built building.

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

Right Support:

The model of care and setting did not always maximise people's choice, control and independence. There were not always enough staff to meet people’s needs. People were not always supported to maximise their independence or participate in activities of their choice within their local community. Activities were often group based rather than a reflection of people’s personal choices preferences and hobbies.

Risks to people were not always identified and there were not always risk management plans in place.

Staff understood their roles under the Mental Capacity Act staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

People had personalised plans for their care but these were not always up to date. Records did not evidence if or how people were supported to identify or achieve their aspirations and goals.

Staff knew how to protect people from poor care or abuse. Medicines were safely managed. People were protected from the risk of infection. People’s nutritional needs were met. Staff received appropriate training to meet people’s needs. Staff enabled people to access health and social care support in the community. The service worked with people to plan for when they experienced periods of distress or anxiety. Staff had training on equality and diversity, and they considered people’s diverse needs.

Right Culture:

It was not evident that people were engaged or consulted about the running of the service. There were no residents’ meetings. Records of key worker meetings did not evidence how people’s views about the service were sought or acted on.

The service did not proactively consider aspects of people’s support needs with a view to increase their autonomy, their participation in activities of their preference, or empower them to lead fuller lives in the community.

The provider audited the quality of support provided to people. An action plan had been developed to address areas they had identified for improvement. However, this had not always identified issues we found, or actions had not always been addressed in a timely way.

Feedback about the new manager was positive. They and the provider were open and honest about the current shortfalls with the service. They had made some improvements to the service prior to the inspection. The provider and manager showed us how they had been working to address the culture and were aware it was a work in progress.

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 Good (published 28 August 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Avenues London, 1A Webb Road on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to staffing levels, identifying risk, person centred care and governance of the service at this inspection.

We have made a recommendation the provider seeks best practice guidance on supporting people to lead more independent, fulfilled lives.

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

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.