Archived: 26a Sussex Avenue

Updated 26 May 2018

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 8 February 2018 and was unannounced. We carried out this inspection sooner than expected due to concerns being raised about how people’s health conditions were being supported. The inspection was carried out by one inspector.

Before the inspection, we did not ask the provider to complete 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. This was because we inspected the service sooner than we had planned. We looked at previous inspection reports and notifications we had received. Notifications are information we receive from the service when significant events happen, like a serious injury.

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.

During the inspection we spent time with people who live at the service. We spoke with the registered manager, assistant team leader, the cook and two staff. After the inspection we received feedback from four relatives. We looked at two people’s care plans and the associated risk assessments and guidance. We looked at a range of other records including three staff recruitment files, the staff induction records, training and supervision schedules, staff rotas, medicines records and quality assurance surveys and audits.

Updated 26 May 2018

26a Sussex Ave is a service for up to ten people with learning disabilities and complex needs including physical disabilities. The service is a single storey property in a residential area of Canterbury. There were seven people living at the service when we inspected.

26a Sussex Ave is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a manager at the service who had submitted an application to CQC to register prior to the inspection. The manager was supported by a team leader and assistant team leader. 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.

At our last inspection in November 2016, we found concerns about works which needed to be completed at the service and a lack of consistent staff resulting in a reliance on agency staffing. At this inspection some improvements had been made. However, some larger pieces of work remained ongoing. The housing provider was in the process of becoming the provider for care services. Once this was completed, a plan for a complete refurbishment of the service would be actioned. People, families and commissioners had all been kept up to date with the plans and what would be happening. As a result some work at the service remained outstanding.

Agency staff were still used to cover shortfalls, but the number of permanent staff had increased. The manager had worked with the agency to build a core team of agency staff who worked at the service. There were enough staff and they had the training and support required to meet people’s needs. Improvements had been made to how staff were allocated, which they told us helped them understand their responsibilities. Staff were recruited using safe procedures to ensure they were suitable to support people.

People’s care was given in a person centred way; however people’s care plans would benefit from more detail and information being displayed in a consistent way. There was a risk that staff may not know where to find some information as it was recorded in a variety of places in each care plan. One care plan had been updated as a pilot, this was much improved and there was a plan to replicate this for each person. We have made a recommendation about this.

Relatives told us they were asked for their views via surveys and felt able to complain. However, some relatives did not feel that concerns raised had been addressed fully and to their satisfaction. They told us that although improvements had been made there was ‘still a way to go’ in resolving issues and communicating effectively. We made a recommendation about this

Staff understood their responsibilities in relation to keeping people safe and who they could report any concerns to. Risks to people and the environment were assessed and plans were in place which gave staff the guidance they required to minimise risks. Lessons were learned from accidents and incidents. For example, documents to record when people’s health deteriorated had been updated as the result of a recent safeguarding. People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible; the policies and systems in the service supported this. When people had limited communication staff used communication tools to support them to express themselves and where appropriate involved loved ones in making choices.

People had complex health needs; staff worked closely with local health care professionals to ensure people had the support they needed to remain healthy. When people had long term health conditions staff were proactive in seeking support. Relatives told us that communication about people’s health had vastly improved. People’s medicines were managed safely by trained staff, in the way people preferred. People had access to a range of food and drinks which they liked and which were presented in a way that met their health needs. People were encouraged to remain hydrated throughout the day.

People took part in a range of activities which they enjoyed including accessing local day services. Staff were working with people to expand their knowledge of things people enjoyed and to increase the range of activities they accessed. The service had been designed to meet the needs of people who required support such as wheelchairs, walking aids and hoists. Staff understood the need for infection control measures and were seen to use gloves and aprons when required.

There was a shared vision for the service and staff told us the management team were approachable and supportive. Systems had been implemented to support staff to improve communication with each other, relatives and other professionals. However, these were not yet embedded and staff were still adjusting to new ways of working. Audits were completed to monitor the quality of care provided to people and the environment. Any shortfalls formed the basis of an action plan which the management team completed. CQC had been informed about incidents as required and the service had displayed their rating in the entrance hallway.

This is the first time the service has been rated Requires Improvement.