Archived: Ava House

Updated 25 November 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.

This inspection took place on 18 October 2017 and was unannounced. The inspection was carried out by an adult social care inspector.

Ava House provides care and support to four people with a learning disability. It is situated in a residential area of Maryport. The provider also owns a domiciliary care service in the Allerdale area which is also managed by this registered manager.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed the information we held about the service, such as notifications we had received from the registered provider. A notification is information about important events which the service is required to send us by law. We also spoke with social workers, health care practitioners and commissioners of care. We planned the inspection using this information.

We met all the people living in the home, spoke with them or observed their interactions with staff. We read all four care files in depth. We checked on medicines managed on behalf of people who lived in the home. We also looked at individual menu plans, daily and weekly planners and daily notes.

We met four members of staff and the registered manager on the day of the visit. We read five staff files including recruitment, induction and development information. We saw the rosters for the four weeks prior to the inspection.

We also looked at quality monitoring records, records related to fire and food safety and records of individual financial transactions.

Updated 25 November 2017

Ava House provides personal care and accommodation for up to four people who may have a learning disability. The accommodation is provided in two semi-detached houses which have been adapted and turned into four separate self-contained flats. There is a communal dining kitchen and a staff office on the ground floor. People have their own flats that have a kitchen, bathroom, bedroom and a lounge. The ground floor units are wheelchair accessible.

The home was designed to provide a transitional service with a view towards moving people on to more independent living. This is sometimes termed a ‘Reablement Model’ as people were generally expected to stay up to two years, or less depending on their needs. This intent has changed somewhat as only one person is currently undertaking reablement. The registered manager was working with the local authority on future planning needs.

This was an unannounced inspection that took place on 18 October 2017. At the last inspection in June 2015, the service was rated as Good. At this inspection we found the service remained Good. We judged that the domain 'Responsive' was no longer outstanding because the previous outstanding elements of reablement work were no longer being carried out to the same extent in the home.

The service had a registered manager who also managed a domiciliary care service, Living for Life, which provides support to people living with learning disability in the community. 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. The registered manager was suitably qualified and experienced to manage the service.

Staff had received training on ensuring people were kept free from harm and abuse. They were confident in management dealing with any issues appropriately. Staff knew how to contact outside agencies if necessary.

Good risk assessments and emergency planning were in place. Accidents and incidents monitoring was in place but there had been no recent issues in the home.

We saw that staffing levels were usually suitable to meet the assessed needs of people in the service. An extra member of staff was in place in the house because there was a problem with assistive technology. The registered manager had also increased staffing levels so that people could be taken out to activities more often.

Staff recruitment was thorough with all checks completed before new staff had access to vulnerable people. The organisation had robust disciplinary procedures in place.

Medicines were managed appropriately. People had their medicines reviewed by their GP and specialist health care providers.

Staff were trained in infection control and supported people in their own environment. The home was clean and orderly on the day of the inspection.

Staff were supported to develop appropriately. Staff told us they were keen to learn and we saw that induction, training, appraisal and supervision helped them to give good levels of care and support.

Staff received good levels of training around principles of care in relation to people living with a learning disability and/or autism. Restraint had not been used in this service. Consent was sought, where possible. The manager and the local authority worked together to ensure the service operated within the Mental Capacity Act 2005

People were supported to get good health care support from their own GP, specialist nurses and consultants. Staff worked with people to support and encourage them to visit dentists and other health care providers.

Staff we spoke to displayed a caring attitude. They understood how to support people and help them maintain their dignity and privacy. Staff showed both empathy and respect for people living a learning disability or with autism. People in the service had access to advocates. Staff understood the values and culture of the organisation.

Everyone supported by the service had been appropriately assessed. Each person had a person centred plan that staff followed closely. New plans had been put in place that were comprehensive yet were easy to follow.

People were encouraged to go out and to engage, where possible, with age and ability appropriate activities and social events. Staff were aware of how difficult this was for some people and planning for activities was done with care and consideration.

Complaint procedures were in place. There had been no complaints received about the service.

The service had a suitably experienced and qualified registered manager and she delegated the day-to-day running of the service to a senior support worker. Some changes were underway to introduce another senior support worker to the home. Staff understood the scheme of delegation.

There was a suitable quality monitoring system in place and regular audits and analysis undertaken. The registered manager was developing a plan for the future of the service. Suitable record keeping was in place.