Archived: Avocet Trust - 93 Ings Road

We undertook this unannounced inspection on the 11 March 2016. At the time of the inspection there was one person using the service.

The service had a registered manager in post. 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.

We found improvements were required with the quality assurance system in place as this did not show what actions had been taken, when areas for improvement were identified through audits and surveys. A revised quality assurance system had recently been introduced which consisted of seeking people’s views and carrying out audits and observations of staff practice. This had been introduced to identify shortfalls so actions could be taken to address them.

We found there were policies and procedures in place to guide staff in how to safeguard people who used the service from harm and abuse. Staff received safeguarding training and knew how to protect people from abuse. Risk assessments were completed to guide staff in how to minimise risks and potential harm. Staff took steps to minimise risks to people’s wellbeing without taking away people’s rights to make decisions. People lived in a safe environment and staff ensured equipment used within the service was regularly checked and maintained.

We found people’s health and nutritional needs were met and they accessed professional advice and treatment from community services when required. People who used the service received care in a person centred way, the care plans described their preferences for care and staff followed this guidance.

Positive interactions were observed between staff and the people they cared for. People’s privacy and dignity was respected and staff supported people to be independent and to make their own choices. Staff provided information to people and included them in decisions about their support and care. When people were assessed by staff as not having the capacity to make their own decisions, meetings were held with relevant others to discuss options and make decisions in the person’s best interest.

We found staff were recruited safely and were employed in sufficient numbers to meet people’s needs. Staff had access to induction, training, supervision and appraisal which supported them to feel skilled and confident when providing care to people.

Medicines were, stored, administered and disposed of safely. Training records showed staff had received training in the safe handling and administration of medicines.

People who used the service were seen to engage in a number of activities both within the service and the local community. They were encouraged to pursue hobbies, social interests and to go on outings. Staff also supported people to maintain relationships with their families and friends.

Menus were varied and staff confirmed choices and alternatives were available for each meal; we observed drinks and snacks were served between meals. People’s weight was monitored and referrals to dieticians made when required.

Staff had received training in legislation such as the Mental Capacity Act 2005, Deprivation of Liberty Safeguards and the Mental Health Act 1983. They were aware of the need to gain consent when delivering care and support and what to do if people lacked capacity to agree to it. When people were assessed by staff as not having the capacity to make their own decisions, meetings were held with relevant others to discuss options and make decisions in the person’s best interest.

People had assessments of their needs and plans of care were produced; these showed up people and their relatives had been involved in the process. We observed people received care that was person-centred. They were able to bring in items from home to make their bedrooms feel homely.

People knew how to make complaints and told us they had no concerns about raising issues with the staff team.

During the visit, the registered manager confirmed the service provided constant respite support for one person and also provided regular respite for three other people at weekends.

At the time of our visit, none of the people who used the service were present. We reviewed records and spoke with the registered manager and one care worker.

We looked at two people's care records which included their care plans, risk assessments and health plans. These were clear, person-centred, detailed and provided up to date information on how their diverse needs should be met.

We found people had a choice of meals and their individual preferences were taken into account. A person told us, 'The meals here are really good, I always have a choice.'

The premises were in a good state of repair, clean and fresh. People told us they were happy with their rooms and the general facilities provided. Comments included: 'I like my room, there's plenty of space' and 'I've got my own shower, it's good here.'

There were enough qualified, skilled and experienced staff to meet people's needs. People told us staff had time to spend time with them and take them out on regular activities. People who used the service told us the staff were nice and looked after them. One person told us, "I like staying here, the staff take me out a lot.'

We found people felt they could say if they had any comments and complaints. One person said, "I would tell my key worker or the manager if I wasn't happy about something.'

In this report the name of the registered manager appeared who was not in post and not managing regulatory activities at this location at the time of the inspection. Their name appeared because they were still on our register at the time. A new manager had been appointed.

We saw that when staff helped the person they spoke calmly and provided clear information about choices and alternatives available. They used the person's preferred method of communication which included the use of Makaton. This is a simple form of sign language similar to that used with people who are hearing impaired. They were sensitive to the person's needs and provided reassurance and guidance when needed.

We saw that people who used the service were safeguarded from abuse because staff had received training and there was guidance for staff to follow if they witnessed or became aware of anything.

We saw that staff had received adequate training which helped them to care for the people who used the service and to meet their needs.