Avebury House

Updated 7 September 2023

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

The inspection was carried out by two inspectors, a senior specialist and an Expert 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.

Service and service type

Avebury House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. This means the provider is legally responsible for how the service is run and for the quality and safety of the care provided. As there was no registered manager in post, we spoke with the Regional Manager, who was the Nominated Individual at the time of the inspection. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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. We used all of this information to plan our inspection.

During the inspection

We spoke with 7 people who used the service and 9 relatives about their experience of the care provided. We spoke with 7 members of staff including the nominated individual, nurses, a senior care worker, care workers, domiciliary staff, maintenance staff and the activities coordinator. 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.

We reviewed a range of records. This included 4 people’s care records and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits, meetings, and health and safety, were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service.

Updated 7 September 2023

About the service

Avebury House is a residential care home providing personal and nursing care to up to 41 people. At the time of inspection there were 22 people living at the service, set across two floors. Each floor has a lounge and dining area, and there is a large garden. The service includes support for people with dementia, mental health, and physical disabilities.

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

People told us they felt safe, however, risks to people were not always clear and risk management plans were not always proactive in managing risks. We were not assured people were adequately protected from the risk of choking and fire at the time we inspected, however measures have now been put in place to mitigate these risks. There were enough staff to support the current number of people living at the service. Staff understood their roles and responsibilities in safeguarding people from the risk of abuse. People’s medicines were managed safely.

People were supported by staff who were kind and caring. People’s care and support plans were detailed but sometimes contained incorrect information, although these were under review at the time of inspection. People and their relatives were happy with the care provided by staff.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People had mental capacity assessments in place and the provider was making improvements to their assessment of people's capacity to ensure appropriate assessments were completed. Any conditions relating to Deprivation of Liberty Safeguards (DoLS) were being met.

People told us they had enough to eat and drink, but we received mixed feedback about the food provided. Staff received training including an induction when they started work, however this did not always meet individual needs such as training for specific health conditions. The provider had identified this and had plans to improve this.

The provider has recently recruited a Quality Assurance Manager, who completed a mock inspection in the home and produced a comprehensive service improvement plan. A consultancy service had been employed by the provider to support improvements. There had been many improvements since the last rated inspection, in terms of medicine management, pressure care management, and malnutrition. The provider demonstrated an open and transparent culture and was receptive to feedback. We saw changes had been made in response to feedback. Staff felt supported by the current management structure.

The service did not have a registered manager at the time of inspection but was recruiting someone for this position; there was an interim manager in post whilst recruitment took place. The service was being supported by the Regional Manager who at the time of the inspection was the Nominated Individual.

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

Rating at last inspection and update

The last rating for the service was inadequate (published 2 March 2023) where breaches were found in relation to Regulation 12 (Safe Care and Treatment) and Regulation 17 (Good Governance). The targeted inspection (published 18 April 2023) found the service was no longer in breach of the regulations.

At this inspection, we found a breach in relation to Regulation 12 (Safe Care and Treatment).

This service has been in Special Measures since 2 March 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect. We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.