Archived: Eastbourne Avenue

Eastbourne Avenue is a residential care home providing personal care to six people, some of whom were living with a learning disability and autism. The service can support up to seven people.

We found the following examples of good practice.

The service had implemented infection prevention and control checks on entry to the service. This helped reduce the risk of infection.

Staff supported people to maintain social distancing as much as possible. They utilised the available space in the house to promote social distancing.

Staff had access to IPC associated policies and procedures, which had been routinely updated and followed national guidance.

Staff promoted people’s health and emotional wellbeing through reassurance and engaging people in activities of interest to them. People were supported to use technology to maintain contact with relatives and friends.

The provider and registered manager regularly checked that staff followed guidance and used appropriate personal protective equipment (PPE). Staff had recently completed IPC training. External IPC professionals had recently visited the service to offer support and advice.

Further information is in the detailed findings below.

Eastbourne Avenue is a residential care home providing personal care and support to seven younger adults, some of who may be living with learning disabilities and autism. The service can support up to seven people.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The service was provided from two adjoining houses in a residential street and was registered to support seven people. It therefore conformed with current best practice guidance.

The principles and values of Registering the Right Support and other best practice guidance ensure people with a learning disability and or autism who use a service can live as full a life as possible and achieve the best outcomes that include control, choice and independence. At this inspection the provider had ensured they were applied.

The vision of the service reflected these principles ensuring people with learning disabilities have opportunities and choice and are supported to achieve their aspirations. Staff adopted the ethos to provide person-centred care that enable individuals to develop skills and behaviours to live independent lives.

There was an emphasis by the provider on continuous learning and improvement. The provider and work force were involved in range of initiatives to progress service delivery. People benefited and achieved a much improved quality of life due to staff understanding of positive behaviour strategies when people may become distressed.

The service was very well-led. Staff went the extra mile to ensure people received care that helped them develop.

Strong, committed leadership put people at the centre of service provision. People, relatives and staff were extremely positive about the management of the service and all felt valued and respected.

There was a strong and effective governance system in place. There were opportunities for people, relatives and staff to give their views about the service. Processes were in place to manage and respond to complaints and concerns.

There were sufficient staff employed. All people told us they felt safe with staff support and staff were approachable. One person said, “The staff are kind, they listen to you”. Another person commented, “This is my home, I’m safe here.”

Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks.

Staff received a range of training to ensure they could support people safely and carry out their roles effectively. We have made a recommendation about mandatory training and adhering to current guidance for the frequency of refresher training.

Staff knew the people they were supporting well. Records detailed how people wished to be supported and people were fully involved in making decisions about their care.

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.

Staff had developed very good relationships with people, were caring in their approach and treated people with respect. Staff upheld people's human rights and treated everyone with great respect and dignity.

People were supported to access health care professionals when required. They received varied and nutritious diets. They were supported to receive their medicines and manage their finances safely. We have made a recommendation about the management of people’s finances.

People were provided with opportunities to follow their interests and hobbies. They were supported to take holiday and to be part of the local community.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 this service was requires improvement (published 31 May 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At the last inspection the provider had failed to notify us of Liberty safeguards. This was a breach of regulation and we issued a fixed penalty notice. The provider successfully appealed against the fixed penalty which was withdrawn.

At this inspection we found improvements had been made and the provider was no longer in breach of regulation 18.

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the all reports link for Eastbourne Avenue on our website at www.cqc.org.uk.

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.

Eastbourne 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. Eastbourne Avenue provides care and support for up to seven people who have a learning disability or autistic spectrum disorder. At the time of our inspection there were seven people living in the home.

The service had a registered manager in place. 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.

We previously inspected Eastbourne Avenue in November 2015, at which time the service was meeting all regulatory standards and was rated ‘Good’. At this inspection we found the service had deteriorated to Requires Improvement.

At this inspection we found that there was a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. This related to the Registered Manager failing to notify the Care Quality Commission of incidents regarding receipt of a Deprivation of Liberty Safeguard authorisations. We are dealing with this outside the inspection process.

You can see what action we told the provider to take at the back of the full version of the report.

People felt safe living at the service. Staff had completed training in safeguarding people and the registered manager actively raised any safeguarding concerns with the local authority.

Risks to people’s safety and wellbeing were assessed and managed. Environmental risk assessments were also in place.

There were enough staff to meet people’s needs. Staff continued to be recruited in a safe way with all necessary checks carried out prior to their employment.

People continued to receive their medicines in a timely way and in line with prescribed instructions. Staff had their competencies checked regularly and medicines audits were completed by the registered manager.

Staff received up to date training, regular supervisions and an annual appraisal to support them in their roles.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported to see a range of health professionals and information about healthcare interventions were included in care records.

People told us the service was caring. Staff treated people with dignity and respect when speaking with them and providing them with support.

People had access to advocacy services if they wished to receive support. Some people had active advocacy services involved in decision making relating to specific aspects of their care.

People had a range of care plans in place that were detailed, personalised, reviewed regularly and included people’s personal preferences.

There was a wide range of activities available for people to enjoy in the home. People were also supported, to regularly access activities in the local community including going to local colleges, music cafes and bowling.

There were audit systems in place to monitor the quality and safety of the service. The views of people and relatives were sought by the registered manager via annual questionnaires. Comments from the last questionnaires received in December 2017 were positive.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Below is a summary of what we found.

Is the service safe?

People were cared for in an environment that was safe, clean and hygienic. Equipment at the home had been well maintained and serviced regularly, therefore not putting people at unnecessary risk. There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available on call in case of emergencies. One relative told us, 'The staff know him and he feels safe there. He's well looked after and I think the way they treat people is excellent.'

Is the service effective?

People told us that they were happy with the care that was delivered and their needs were met. It was clear from our observations and from speaking with staff that they had a good understanding of the people's care and support needs and that they knew them well. People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. Staff had received training to meet the needs of the people living at the home.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People told us they were able to do things at their own pace and were not rushed. Our observations confirmed this. One person told us 'It's canny here, the staff are really nice and my key worker X; he's a canny man'. A relative told us, 'The staff are lovely; they're all nice and very caring.'

Is the service responsive?

People's needs had been assessed before they moved into the home. People told us they met with their key workers once a month to discuss what was important to them. Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and care and support was provided in accordance with people's wishes. People had access to activities that were important to them and were supported to maintain relationships with their friends and relatives.

Is the service well-led?

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. Relatives were able to complete an annual customer satisfaction survey. Staff told us they were clear about their roles and responsibilities. We saw that staff were given the opportunity to complete an annual employee satisfaction survey. This helped to ensure that people received a good quality service at all times.

People who used the service and their relatives had commented upon the care that had been provided. They said 'they 'like the home and the friendly staff', 'like all food and activities', 'the home is excellent' and staff 'listen, talk things over, support and hold meetings'.

During this inspection we also checked on the safety and suitability of the accommodation and environment. We saw the communal areas were clean and tidy and bedrooms were spacious, well decorated and personalised by individual service users.

People spoken to had access to their care plan and we were told that any changes in their care had been discussed with them and their family members.

During our observation we saw people were treated with consideration and respect. We reviewed three care records and saw that people's preferences and care needs had been well documented. Staff were knowledgeable about people's care needs and what they should do to support them. There were enough staff to meet people's needs.

We saw the results of the questionnaires completed by people who used the service. They commented that they knew they had a key worker in place and that they all felt that they were listened to, and that their issues were dealt with appropriately and speedily. People who used the service said they felt 'good about the home', there was a 'choice of activities', the staff were 'friendly' and they enjoy 'planning the weekly menu and planning their holidays'.

People who used the service had also said that they 'knew who to talk to' if they had a complaint and they felt 'involved and encouraged' in decision making within the home.

Family members had commented that the 'atmosphere is homely, care provided and the activities are very good; the way the home is run and organized is excellent, staff are friendly, helpful and the support given is excellent. Very informative and kept up to date with all aspects of care'.

We saw how staff talked with people who used the service in conversation and responded to any questions or issues they had. People said they were very happy with the service provided by staff and they said they were courteous and polite.