We carried out a review of the data available to us about 18 Acorn Avenue on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about 18 Acorn Avenue, you can give feedback on this service.
18 Acorn Avenue provides accommodation with personal care for up to 3 people with a learning disability or who are autistic. At the time of this inspection there were 2 people using the service.
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. Providers must have regard to the guidance. People's experience of using this service and what we found.
People’s experience of using this service and what we found
18 Acorn Avenue is situated in a residential area. There was nothing outside to show it was a care home. The building was a similar size to other properties with a garden, which people have access to. Internally the premises were spacious and well designed for the people living there.
Right support
The service had enough staff, including for 1-to-1 support for people to keep them safe and take part in activities, when they wanted. The numbers and skills of staff matched the needs of people using the service.
Staff showed a genuine interest in people's well-being and quality of life. They were kind, caring and nurturing and as a result we saw people were at ease, happy, engaged and stimulated. 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.
People were supported to access healthcare services to promote their wellbeing and help them to live healthy lives. Staff managed risks to minimise restrictions, focusing on what people could do for themselves. Systems were followed by staff to ensure medicines were managed safely. However, we have made a recommendation about the safe storage of medicines.
Right Care:
Staff delivered care in line with information in people's care plans and recognised models of care for people with a learning disability or autistic people. This ensured people were receiving care tailored to them which promoted a good quality of life.
Staff understood people's individual communication styles and we saw they had developed a good rapport with them. People were supported to develop and maintain relationships, follow interests and take part in activities that were socially and culturally relevant to them.
People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. The registered manager worked well with other agencies to safeguard people. Investigations into incidents had been used as an opportunity to learn lessons, change practice, and drive improvement.
Staff recruitment, induction and training processes promoted safety, including those for agency staff. People were supported by staff who had received a wide range of relevant and good quality training to meet their needs.
The service had effective infection, prevention and control measures to keep people safe, including good arrangements for keeping the premises clean and hygienic.
Right Culture:
The registered manager had worked hard to instil a culture of care where staff felt truly valued. There was a transparent, open and honest culture between people, those important to them, staff and managers. The attitudes and behaviours of the manager and staff ensured people using the service lead inclusive and empowered lives. Staff understood their role in making sure that people were always put first. They provided person centred care and sought to protect and promote people's rights.
The service had effective governance arrangements in place to assess the quality and safety of the service. These were used to identify and drive improvement. Systems were in place to apologise to people, and those important to them, when things went wrong.
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 requires improvement (published 04 February 2022). At this inspection we found improvements had been made and the overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection. This report only covers our findings in relation to the Key Questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
Why we inspected
This was a focused inspection to check the provider had made improvements in relation to the Key Questions Safe and Well-led and prompted by a review of the information we held about this service to assure ourselves people were receiving safe, good quality care.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 18 Acorn Avenue on our website at www.cqc.org.uk.
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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
18 Acorn Avenue provides accommodation with personal care for up to three people with a learning disability or who are autistic. At the time of this inspection there were three people using the service.
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. Providers must have regard to the guidance.
People’s experience of using this service and what we found
Right Support
• There was an ongoing programme to update and renovate the property. Improvements were needed to ensure the property was well maintained and easy to clean. A sensory room was planned which would enhance people’s quality of life.
• People were able to personalise their rooms.
• Staff focused on people’s strengths and promoted their independence. They supported people to take part in activities and pursue their interests in their local area.
• Staff enabled people to access health and social care support in the community.
• Staff supported people to make decisions following best practice in decision-making.
• People received support with their medicines in a way that promoted their independence and achieved the best possible health outcome.
• Managers and staff had worked hard to keep people safe from the risks of COVID-19 and to minimise the impact of the pandemic on people’s quality of life.
Right care
• The provider had raised safeguarding alerts with the local authority. However, they had not fully considered people’s individual needs when investigating and acting on safeguarding concerns. They assured us they were taking action to ensure people’s wellbeing and safety were prioritised when decisions were made about the service.
• The registered manager and care staff understood how to protect people from poor care and abuse.
• People received kind and compassionate care. Staff protected and respected people’s privacy and dignity.
• The service had enough appropriately skilled staff to meet people’s needs and keep them safe.
• People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.
• People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.
Right culture
• The wider organisation was going through an unsettled time, which impacted on the service being provided at 18 Acorn Avenue. High turnover at all levels of management meant change was not consistently implemented and improvements were not always sustained.
• The provider was committed to learning lessons and driving improvements. They acknowledged they were not always visible at the service and were taking action to improve oversight.
• Feedback about the registered manager was overwhelmingly positive. The registered manager advocated strongly for people and staff to ensure the quality of care was maintained.
• Staff knew and understood people well. They placed people’s wishes, needs and rights at the heart of everything they did.
• People and those important to them were involved in planning their care.
• Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating
This service was registered with us on 23 July 2020 and this is its first inspection. The service had been previously registered under a different registration.
Why we inspected
This was a planned inspection of a newly registered service. The timing of the inspection was prompted in part by concerns received about some of the providers other services. A decision was made for us to inspect 18 Acorn Avenue to assure ourselves people were receiving safe, good quality care.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.
We found the following examples of good practice.
The registered manager was following the government's guidance on whole home testing for people and staff. This included weekly testing and rapid testing for staff. Staff encouraged people to have their test by having a special chair and biscuits to follow which has helped them to agree to having them; they are now used to having them. All staff have received their first Covid-19 vaccination.
Staff had received training on the use of personal protective equipment (PPE) and infection control practices and processes were in place to minimise the spread of infection. There was an adequate supply of PPE.
Staff worked in teams with arranged shift patterns to reduce footfall. Increased cleaning regimes had been introduced including hard surface contact cleaning hourly.
The service had one vacancy but a decision had been made not to admit at this time. The vacant bedroom will be used as part of contingency plan if the need arose for staff to stay over.
People were used to a full activity agenda and going out. New strategies had been introduced to help reduce people’s anxieties and fill their days. For example on Wednesdays they baked scones and had a tea party with hot chocolate in branded cups from a well known coffee shop. Clock charts identified daily individual activities of choice including going out for regular short walks and as a behaviour strategy, a drive out in the car.
The provider was supporting staff well being including the offer of a free ten session counselling service if required.