The Avenues Care Centre

Updated 4 March 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.

Inspection team

This inspection was completed by an inspector, a medicines 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

The Avenues Care Centre 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. The Avenues Care Centre is a care home without nursing care. 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 a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 23 January 2023 and ended on 30 January 2023. We visited the service on 23 January 2023.

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 (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 spoke with 3 people and 8 relatives about their experiences of the service. We also received information from another relative. We spoke with 7 staff including the nominated individual, registered manager and care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included 12 people’s care records, 9 medication records and three staff files in relation to recruitment. A variety of records relating to the management of the service, including checks and audits were reviewed.

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.

Updated 4 March 2023

About the service

The Avenues Care Centre is a residential care home providing personal care to up to 62 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 53 people using the service.

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

People and their relatives told us they felt safe at The Avenues Care Centre. However, we found the service was not always safe and people had been placed at risk of harm on occasions.

Some risks to people had not been identified and care had not been consistently planned to keep people as safe as possible. No care had been planned for 2 people. Medicines were not always managed safely and there was a risk people’s medicines would not be effective.

Staff had not been recruited safely and the leadership team could not be assured staff were of good character and had the skills and experience to meet people’s needs. Staff had not been supported to develop all the skills they needed to meet people’s needs. There were not always enough staff on duty and this had caused a delay in people receiving their medicines at times.

Leadership at the service was not consistently effective and people’s safety had reduced since our last inspection. The registered manager and provider did not have oversight of all areas of the service. Effective checks had not been completed to ensure shortfalls were identified and action was taken to address them. This left people at risk of harm. Action had not been taken to understand everyone’s experiences of the service and act on the feedback received. The management team had not created an open culture where all staff were confident to share information about accidents, so effective investigations could take place. People were not always referred to in respectful ways.

Following our inspection the provider put an action plan in place to address the shortfalls we found. This included the action to be taken, by when and by who.

Action had been taken to keep people safe following accidents and any safeguarding risks had been acted on. People were supported to remain independent. 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. The service was clean and people were able to receive visitors when they wished.

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 requires improvement (published 15 June 2022).

Why we inspected

We carried out an unannounced focused inspection of this service on 27 April 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service remains requires improvement. This is based on the findings at this inspection.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Avenues Care Centre on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to risk and medicines management, staff recruitment, staff deployment, checks and audits, gathering and acting on feedback and governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.