Archived: Avalon Wirral Services

Updated 7 December 2016

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 20 and 21 October 2016 and was unannounced. The inspection was carried out by an Adult Social Care (ASC) Inspector.

Prior to our visit we looked at any information we had received about the service. This included the Provider Information Return (PIR). A PIR is a pre-inspection survey that seeks key data and information about the service prior to the inspection. The PIR is then used by inspectors to effectively plan their inspection visit.

During the inspection we spoke with four people who used the service, three shared lives carers, the registered manager and three service managers.

We looked at three care files, the personnel files of two shared lives carers, training records for all shared lives carers and other records relating to the management of the service.

Updated 7 December 2016

This was an unannounced inspection carried out on 20 and 21 October 2016. Avalon Wirral Services provides personal care and support to enable people to live independently in the community who would otherwise be unable to do so. The service operates a ‘Shared Lives’ scheme which supports people to live in a family setting with a main carer, as part of the carer’s family.

At the time of our inspection, 49 people were being supported in a shared lives arrangement. Shared lives carers are only permitted under the scheme to care for a maximum of three people in their own home at any one time.

At the time of our inspection there was a registered manager 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.’

People who used the service said they were happy with the support they received. They were all very positive about their shared lives carer and family. One person told us that they felt part of the family, another said living with the family was “Where they wanted to be”. All of the people we spoke with said they received the support they needed when they needed it.

The shared lives carers we spoke with told us that Avalon’s staff were supportive and that they felt trained to support they people they cared for. They said that they were able to contact Avalon staff at any time and that they had assisted and supported them at all times without hesitation.

We reviewed three care records. People’s needs and risks were assessed and well managed with the exception of one person’s whose care file we looked at. This person’s records showed that they at times, displayed risky and challenging behaviour that posed a serious risk to other people. These risks had not been formally risk assessed prior to the shared lives arrangement being set up and there was no appropriate risk management plan in place to advise the shared lives carer on how to prevent and manage these behaviours should they occur. We spoke to the manager about this, as we could see that behaviours of a concerning nature had occurred during the shared lives arrangement.

Records showed that people received support from a range of other health and social professionals in relation to their needs which was supported by the service. For example, doctors, dentists, mental health services, specialist medical teams and chiropody. People were supported to participate in social activities that interested them and to access opportunities within the community such as volunteering, work placements and day centres. Arrangements were in place to regularly review people’s activities and social needs to ensure that people had a good quality of life.

People’s care plans were person centred and showed that people or their representatives had participated in discussions about their care. Records showed gaining people’s consent to their care, was important to the manager and the staff team and we found evidence of good practice in relation to the implementation of the Mental Capacity Act 2005. For example, where a person’s capacity to consent was in question for a particular decision, best interest meetings were held to ensure that any decision made on the person’s behalf was made in their best interests. We saw that the manager had liaised with the local authority in relation to people’s capacity to consent where they had concerns and in some instances the manager had completed a capacity assessment on the person’s behalf. This aspect of service delivery required further development to ensure the MCA was consistently applied.

Regular meetings took place with the person, their shared lives carer and Avalon staff to discuss people’s needs and to ensure they were being met. Care plans were updated when any changes occurred and from our discussions it clear that both the shared lives carers and Avalon staff knew people well and genuinely cared for the people they looked after.

Some people were supported to administer their medication by their shared lives carer and were supported to be as independent as possible in this process. For example, one person was able to administer their medication but not able to order it appropriately, so support was tailored to meet their needs. Their ability to self- administer was risk assessed to ensure they were able to do this safely and their shared lives carer took responsibility for ensuring the medication was re-ordered when required. Shared lives carers had received training to administer and manage people’s medication and people’s medication was regularly checked by Avalon staff to ensure it was managed appropriately.

Shared lives carers were recruited safely through an assessment process with the appropriate pre-employment checks undertaken to ensure they were safe and suitable to work with vulnerable people before they were accepted onto the scheme.

A survey of people’s views had been completed in 2016 and showed that people were very happy with the service provided and the support they received from both their shared lives carer and the Avalon staff team. None of the people or shared lives carers we spoke with had any complaints about the service or the way it was provided. Information about complaints was available and through our conversations, everyone we spoke with knew how to make a complaint or raise a concern.

The service was well led and the culture of management was open and transparent. There were a range of quality assurance systems in place to assess and monitor the quality and safety of the service and to obtain people’s views. These systems were robust and enabled the manager to come to an informed view of how well the service was performing. The provider maintained keen oversight of the service and ensured standards were maintained through monthly management reports and regular senior management meetings.