The Avenue Nursing Home

Updated 19 September 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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 3 inspectors, 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 Avenue 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. [Care home name] is a care home [with/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 22 November 2022 and ended on 1 December 2022. We visited the location on 22 October 2022.

What we did before the inspection

We sought feedback from the local authority and professionals who work with the service.

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 4 people who use the service and 6 relatives about the experience of care provided. We looked around the building and observed people being supported in communal areas. We spoke with 10 staff members including the registered manager, manager, deputy manager, nurse and senior and care staff members.

We reviewed a range of records. This included 4 people’s care records and daily notes and multiple medication records. We looked at 3 staff files in relation to recruitment and a variety of records relating to the management of the service, including audits and policies.

Updated 19 September 2023

About the service

The Avenue is a care home providing personal and nursing care for up to 64 people. At the time of our inspection there were 47 people using the service. The Avenue is a purpose-built home and accommodates people over two floors. People living on the ground floor require support with personal care needs, some are living with early onset of dementia. The first floor supports people with more complex needs including people living with dementia.

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

People were not always safe as medicines were not always managed safely. The systems and processes in place were not robust enough and had not identified the issues found on inspection.

People had person centred care records and received person centred care which reflected their needs. Environmental safety checks were completed and certification in date. The service was clean and hygienic and had robust cleaning schedules and dedicated housekeeping teams. Staff followed correct infection prevention and control practices. The service was adequately staffed and had received appropriate checks prior to employment to maintain the safety of people in the service.

People’s nutritional needs were met. The service had been adapted to meet the needs of people living with dementia which included a vast range of dementia friendly technological aids and equipment. Staff received a thorough induction and continued training programme during employment, and there was enough staff to meet the assessed needs of people. There was an abundance of activities planned for both in and out of the service.

People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible and in their best interests; the policies and systems in the service support this practice.

People were treated with dignity and respect by a consistent care staff team. People were encouraged to be as independent as possible by care staff who were kind, caring and compassionate.

People were supported to keep in touch with their family and friends through video and phone calls and indoor or outdoor visits. People had access to healthcare services. People and relatives were overwhelming positive about the service provided.

There was consistent and effective leadership from the registered manager and an effective governance structure which meant the service was appropriately monitored at manager and provider level.

The registered manager and provider were responsive to the inspection findings and feedback and took immediate action during and after the inspection to improve some systems and remedy some concerns raised.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 25 October 2109 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service. Please see the safe section of the report.

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 see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified a breach in relation to the safe management of medicines at this inspection.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.