Archived: Care Avenues Limited

Updated 16 August 2017

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.

The inspection took place on 5 May 2017 and was announced. We gave the agency 24 hours’ notice of the inspection because it is a domiciliary care service and we needed to be sure that someone would be in the office.

Before our inspection we reviewed information we held about the service. We looked at our own records to see if we had received any concerns or compliments about the service. We analysed information on statutory notifications we had received from the provider. A statutory notification is information about important events which the provider is required to send us by law.

The inspection team consisted of one inspector.

As part of the inspection we spoke with six people who used the service and three people’s relatives. We spoke with the registered manager, the provider (who also assumed management responsibilities), two senior staff and nine support staff.

We looked at extracts from three people’s care and support plans. We looked at two staff recruitment files and other records relating to the management of the service. These included minutes of meetings with people and staff, service improvement plans, audits and quality assurance surveys.

Updated 16 August 2017

Care Avenues Limited is registered to provide personal care to people living in their own homes. At the time of our inspection, the agency was supporting 16 people with varying levels of support.

Our inspection took place on 5 May 2017 and was announced. The service had a registered manager at the time of our inspection. 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 were supported by staff who were able to identify risks and where possible reduce or remove them. However, some risks had been identified but there was no guidance for staff to follow to enable them to manage the risks safely. This placed people at risk of potential harm.

Staff were confident that they could recognise and report poor practice or concerns about people's safety. Current management arrangements meant that allegations were reported and managed appropriately.

People were supported by sufficient staff to meet their needs safely and effectively and in a timely manner. However, additional staffing resources were required to ensure support remained consistent at weekends and when regular staff were away from work. Staff were currently recruited safely meaning that only people suitable to work in the role were appointed.

People received their medicines safely and there were safe systems for administering, storing, recording and auditing medicines.

People were supported by staff who had the skills and knowledge to meet their needs effectively. Staff had access to a variety of training but identified that more ‘specialist’ training opportunities would enable them to better understand the needs of the people they supported. Training opportunities were being improved and most staff felt well supported to do their jobs effectively.

People's rights may not be protected under the Mental Capacity Act 2005. Most people who used the service had capacity to make their own decisions and choices. However, when it was considered that a person did not have capacity the agency was not managing this process effectively. Assessments were inappropriate and unclear leading to staff confusion as to who could make decisions and who required support. Where people were able, they were involved and supported by staff to make decisions that affected them.

People's nutritional needs were met and people were satisfied with the support they received at meal times. People shared their individual needs and preferences with staff so they could meet them effectively.

Staff worked with families to ensure that the guidance of healthcare professionals was followed when required to ensure people's good health and wellbeing. Effective information sharing meant that people’s health care needs could be effectively managed.

People were supported by staff who were caring and kind. People got to know the staff who supported them and all said that staff supported them in ways that they preferred. People told us that staff treated them with dignity and respect at all times. Staff understood the importance of this to ensure people felt confident and reassured. People's independence was promoted and they felt listened to and involved.

People told us they were able to raise concerns and felt confident these would be acted on by senior staff. The provider had a complaints procedure that people had been confident to use. Feedback suggested that when concerns had been raised they had been responded to appropriately and to people’s satisfaction.

Processes to audit the service were now in place and proving effective although prior to the recent management changes processes were either not being followed or had not identified issues. Quality was monitored and information shared with staff who felt involved and consulted.