Background to this inspection
Updated
6 October 2022
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 two inspectors 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
Avocet Trust – 20-22 Middlesex Road 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. Avocet Trust – 20-22 Middlesex Road 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
This inspection was unannounced.
Inspection activity started on 15 July 2022 and ended on 09 September 2022. We visited the location’s service on 14 July 2022, 21 July 2022 and the 09 September 2022.
What we did before the inspection
We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with the registered manager, the deputy manager, two senior carers and a carer. We reviewed a range of records in relation to the safety and quality of the service, this included people’s care plans and medicines records. We spoke with two people who use the service and four relatives about their experience of care. 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.
After the inspection
Following our visit, we spoke by telephone to two relatives about their experience of the care provided. We also spoke with two health professionals. We continued to seek clarification from the provider and the registered manager to validate evidence found.
Updated
6 October 2022
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 and providers must have regard to it.
About the service
Avocet Trust – 20-22 Middlesex Road is a care home providing personal care for up to 9 people across 3 adapted buildings. At the time of our inspection there were 7 people living at the service. The service supports people living with a learning disability and/or autism.
People’s experience of using this service and what we found
The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.
Right Support
We have made a recommendation about the provider seeking and acting on feedback provided by people and their relatives.
We have made a recommendation about the management of some medicines.
People were able to access their community and nearby shops and the home was integrated well within the community. The home was spacious and bedrooms were personalised, however some minor decorating works were required in one of the homes on site, the registered manager assured us this was underway.
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. Staff communicated effectively with people and individual communication passports supported discussions and helped improve communication.
Right Care
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. Staff understood how to protect people from abuse and there was a culture of learning from accidents and incidents. Care plans and risk assessments were person centred and contained enough information to guide staff in their practice.
Right Culture
The service had a positive culture and staff felt respected, valued and supported. The provider had an effective governance system in place that identified and managed risks to the quality of the service through audits and action plans. The service worked in a transparent and collaborative way with relevant stakeholders and agencies to support service development and joined up care.
Rating at last inspection and update
The last rating for this service was requires improvement (published 23 November 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
We carried out an unannounced inspection of the service on 13 October 2021 and 20 October 2021. 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 as breaches were found in safe care and treatment and governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. 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 Avocet Trust – 20-22 Middlesex Road on our website at www.cqc.org.uk.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.