This inspection was unannounced and took place on 16 June 2016.
Avon Reach is registered to provide accommodation, personal and nursing care for up to 60 people. At the time of the inspection there were 57 people using the service.
The last inspection of the home was carried out in June 2013. No concerns were identified with the care being provided to people at that inspection.
There was 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.
Quality assurance systems were in place to monitor care, and plans for on-going improvements. Audits and checks were in place to monitor safety and quality of care. However these audits failed to identify concerns being raised by people who were using the service regarding dignity and respect. The provider took immediate action when these issues were raised.
People were supported by staff who had undergone an induction programme which gave them the basic skills to care for people safely. In addition to completing induction training new staff had opportunities to shadow more experienced staff. This enabled them to get to know people and how they liked to be cared for.
People were supported by sufficient numbers of staff who had a clear knowledge and understanding of their personal needs, likes and dislikes. Care plans were personalised to each individual and contained information to assist staff to provide care in a manner that respected their needs and individual wishes. Risk assessments which outlined measures to minimise risks and keep people safe were held in people’s care plans.
Each person had their care needs reviewed on a regular basis. The care coordinator discussed the ‘resident of the day’ scheme. They said this meant staff would concentrate on reviewing any changes with the person. They said “We need to evidence how we make sure people’s care is person centred and this helps us to look at people’s needs on an individual basis”.
Most people who lived at the home were able to make decisions about what care or treatment they received. Where people lacked capacity to make some decisions, the staff were clear about their responsibilities to follow the principles of the MCA when making decisions for people in their best interests.
People living at Avon Reach told us they were happy with the care and support provided. They said the registered manager and staff were open and approachable and cared about their personal preferences. A visitor informed us they used to work in care homes so were therefore aware of what “good care” was, they said “it’s perfect, staff are all really caring, the food is excellent”.
Staff made sure that people received any specialist diets received a varied choice of meals they required including soft textured food and were clear about who required support to eat and when. However the deployment of staff on the day of the inspection, meant that not all people were able to receive their meal whilst still hot. We addressed our concerns with the registered manager, who felt this was an isolated incident, and would review the mealtime arrangements with immediate effect. We observed the midday meal being served in the main dining area. The atmosphere in the main dining room was relaxed and cheerful with people talking about their day. Some people had invited friends and family to join them for lunch, others choose to eat in smaller more intimate dining areas with family or friends.
People were able to take part in a variety of activities, The provider also ensured where people were less active, enjoyed quality time with staff employed to offer one to one time in their rooms. Rooms, this prevented people from becoming isolated. A minibus available to take people out on trips within the local community and beyond. Activity coordinators were seen to be engaging with people, family and friends were also seen to join in and enjoy the activity of the day.
Safe systems were in place to protect people from the risks associated with medicines. Medicines were managed in accordance with best practice. Medicines were stored, administered and recorded safely. One person told us “Never had any concerns about not receiving my medicines or pain relief if I need it”. People were supported to access external health professionals, when required, to maintain their health and wellbeing.
The service had a complaints policy and procedure which was available for people and visitors to view. People said they were aware of the procedure and knew who they could talk with. People and staff said they felt confident they could raise concerns with the registered manager and they would be dealt with appropriately.