Avenues London South West

Updated 24 December 2021

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 Care Act 2014.

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

This inspection was carried out by four inspectors and two Experts 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. Where people did not communicate verbally, we observed their interactions with support staff.

Service and service type

This service provides care and support to people living in 11 ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had two managers registered with the Care Quality Commission. 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.

Notice of inspection

We gave the service 24 hours' notice of the inspection. This was because we needed to be sure that the registered managers would be available to support the inspection when we visited the central office location.

What we did before the inspection

We reviewed information we had received about the service since it was registered with us. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We visited the central office location on 16 November 2021 and spoke with the registered managers. After that we visited three supported living homes and spoke to eight people living there, three service managers and 10 support workers. We made calls to 13 family members. We also received feedback from four healthcare professionals.

We reviewed a range of records. This included people’s support plans and medicines management records, staff files in relation to supervision, recruitment and training data. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found in relation to people's care records, fire safety and auditing systems.

Updated 24 December 2021

About the service

Avenues London South West is a supported living service for adults with an autistic spectrum disorder and learning disabilities. This service provides care and support to people living in 19 supported living homes but only 11 of these were providing a regulated activity to people. At the time of the inspection, out of a total number of 45 people, 32 people were receiving personal care.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. There was an open culture which helped people to achieve the outcomes they wanted to. Staff empowered people to make decisions about their care needs. People had support to build and maintain important relationships to them.

Issues we identified during the inspection in relation to records being completed for fire safety checks undertaken had been promptly addressed by the provider. People and their family members were happy with the care delivery and had no concerns about safety. Staff were aware of the safeguarding procedure should they have to apply it suspecting a person to be at risk of abuse. Personal protective equipment (PPE) was effectively used by the staff team. People had support to continue being active during the COVID-19 lockdowns and engage in activities of their choice at home. Risks to people’s safety were identified and a positive pro-active approach to risk taking was applied to encourage people’s independence. The provider followed robust recruitment procedures making sure they employed suitable staff to work with people using the service.

The provider had enrolled staff on learning disabilities training at the time we inspected the service. Staff received training before they started working with people and regularly attended refresher courses to ensure effective care delivery. The provider had an action plan in place to ensure staff were regularly supervised. Mental Capacity Act 2005 (MCA) principles were followed to support people in the decision-making process, making sure their involvement was encouraged. However, some MCA records required updating to ensure all relevant information was appropriately recorded. Where people required support to meet their complex nutritional needs, staff had provided the required care. Healthcare professionals told us how staff worked towards good practice to provide people with person- centred care.

Staff maintained good relationships with people they supported and were kind and understanding towards their care needs. People were involved in their care planning and made choices how they wanted to be supported to celebrate important events to them. Where people chose to have pets, staff helped to look after them. Staff respected people’s right to privacy and diversity.

People’s support plans were personalised to guide staff on how people wanted to be supported. Different aids related to people's communication needs were used to encourage people to take part in conversations. Systems were in place to gather feedback from people and their family members so that information collected could be used to inform the effectiveness of the care delivery.

The management team had worked to promote a positive culture at the service so that people could have a good quality life. Systems were in place to support the service delivery and where a short fall was identified, actions were taken quickly to improve the care provision. Regular audits were carried out to monitor day-to-day running of the service and the quality of service delivery.

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

Rating at last inspection

This was the first inspection of the service since it registered with the CQC on 1 May 2019.

Why we inspected

This was a planned inspection based on when the service registered with us.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.