Background to this inspection
Updated
12 June 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was conducted over two days and was completed by one inspector.
Service and service type:
Carter Avenue is registered to provide accommodation and personal care for up to six people. At the time of the inspection five people were living at the home. The service had a manager 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 did not give notice of our inspection.
What we did:
Before the inspection we reviewed the information we had received about the service, including previous inspection reports and notifications. Notifications are information about specific important events the service is legally required to send to us. We considered information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed the action plan the provider sent us following the previous inspection.
During the inspection we gathered information from:
¿ Observations of care staff and all people using the service.
¿ Speaking with two people who used the service.
¿ Four people's care records.
¿ The registered manager, the nominated individual and two members of the provider’s management team.
¿ Seven members of care staff.
¿ Records of accidents, incidents and complaints.
¿ Audits and quality assurance reports.
¿ Records of recruitment, training and supervision.
Following the inspection, we gathered information from:
¿ Two relatives of people using the service.
¿ Three external healthcare professionals.
¿ One social care professional.
Updated
12 June 2019
About the service: Carter Avenue 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. Carter Avenue is registered to provide accommodation and personal care for up to six people and supports people living with a learning disability. At the time of the inspection there were five people living at the service.
Best practice guidelines recommend supporting people living with a learning disability in settings that accommodate less than six people. The service model at Carter Avenue was therefore aligned to the principles set out in Registering the Right Support. The service goals for people using the service reflected the principles and values of Registering the Right Support including; choice, promotion of independence and inclusion. Overall people's support was focused on them having as many opportunities as possible, to have new experiences and to maintain their skills and independence.
People’s experience of using this service:
A person told us they enjoyed living at Carter Avenue. They said they felt safe and staff were nice. People's relatives were also positive about the service. People were supported to participate in a range of activities of their choice.
Although we found areas of improvements since the last inspection, we also found some areas of practice that had the potential to place people at risk. Where marks or bruising had occurred, these were not promptly investigated by the registered manager meaning that action to mitigate any risks or causes of injuries may be delayed. People received their medicines safely and as prescribed, although audits had not identified that these may not always be stored at safe temperatures. Governance systems used to assess the quality and safety of the service did not always identify concerns and drive improvement.
People received support which met their needs, staff knew what was important to people. People's dignity and privacy were respected.
People's rights to make their own decisions were respected. Staff supported people to make choices in line with legislation. However, people could not access the rear garden independently due to steps and uneven surfaces. This provided an unnecessary restriction for people.
The environment was generally clean, and plans were in place for a major redecoration and refurbishment of the kitchen and other areas of the home.
People and family members knew how to complain and were confident that if they raised concerns, the registered manager would act promptly to address these.
At this inspection the service met the overall characteristics of requires improvement; more information is in the full report.
Rating at last inspection: The service was last inspected in February 2018 where we undertook a full comprehensive inspection (report published May 2018). It was awarded a rating of Requires Improvement.
Why we inspected: This was a planned inspection based on the previous inspection rating.
Follow up: We found two breaches of regulations. The service remained rated as requires improvement. We will request an action plan from the registered provider about how they plan to improve the rating to good and meet the requirements of the regulations. In addition, we will meet with the provider to discuss their plans to make improvements. We will also continue to monitor all information received about the service, to review any risks that may arise and to ensure the next planned inspection is scheduled accordingly.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk