Archived: Mengham Avenue

At the last inspection, the service was rated Requires Improvement and we identified three breaches of the Health and Social Care Act 2014. These were Regulation 11 (Consent to care and treatment), Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance).

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe, Effective and Well led to at least good.

At this inspection we found that these issues had been addressed and the rating for the service is Good.

Mengham Avenue is a ‘care home’. People in care homes receive accommodation and 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. This home is not registered to provide nursing. The care home accommodates five people in one adapted building. There were five people living at the home on the day of our visit.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was 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.’

People received safe care as they were supported by staff who knew how to protect them from harm. Staff were aware of people’s individual risks and plans were in place to minimise these while maintaining the person’s independence. Staffing was arranged based on people’s individual needs and what activities were happening in the home. Staffing was flexible to suit the people living at the home.

The registered manager supported staff by arranging training so staff developed the skills to provide care and support to people and supervision to support them in their daily roles. People were supported by staff who knew their individual dietary requirements and how to support them in the right way. People had access to healthcare professionals when they required them.

People were supported to have 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 treated with compassion which had a positive impact on their well-being. People we spoke with told us that all staff spoke kindly to them and they felt happy and comfortable in their home. Staff helped people to make choices about their care and the views and decisions they had made about their care were listened and acted upon.

People participated in a range of activities inside and outside of the home.

Staff liaised with other health and social care professionals and ensured people received effective, coordinated care in regards to any health needs.

An appropriate, well maintained and clean environment was provided that met people’s needs.

People were involved in the planning and review of their care and support. People were supported to continue with their hobbies and interests which promoted their independence and confidence. Information was provided to people should they wish to raise a complaint.

Systems were in place to monitor and assess the quality and safety of the care provided. There were opportunities for people and relatives to feedback their views about their care and this was used to improve the service. Staff were supported to carry out their roles and responsibilities effectively, so that people received care and support in line with their needs and wishes. The checks completed focused on people’s experience of care. Where areas for improvement were identified, systems were in place to ensure lessons were learnt and used to improve the service delivery.

Further information is in the detailed findings below.

Mengham Avenue is a care home without nursing which provides accommodation for up to five adults with a learning disability.

At the time of our visit there were five people using the service.

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.

We found staff were recruited safely and there were enough staff to provide people with the care and support they needed. Staff received appropriate training and support to make sure they had the skills and knowledge to deliver person centred care.

We observed staff to be kind, caring and patient in their approach to people. Staff were bright and cheerful and this was clearly appreciated by the people who used the service. We found staff helpful and friendly during our visit.

People using the service had good opportunities to participate in a variety of activities and were very much part of their local community. They were also involved in having a say about how the service was managed.

The house was well maintained, clean and tidy. Everyone had their own bedroom which they had personalised with support from staff. The communal areas were comfortable and felt very ‘homely.’

Although staff had received training there was a lack of understanding about the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards which meant the service was not always working within the principles of the MCA. Better systems needed to be in place in relation to providing people with support managing their finances in order to clearly show the best interest process had been adhered to.

Generally we found people’s healthcare needs were being met, however, we found although staff had involved a dietician, their advice had not been actioned. This meant the identified nutritional risk had not been mitigated. Medicines were managed safely and stored securely in people’s bedrooms.

People who used the service were involved in planning the menus and preparing the meals.

A complaints procedure was in place but no concerns or complaints had been raised about the service.

We found there were no robust procedures in place to monitor the quality of the service and this meant issues were not identified or resolved. We found shortfalls in managing risks to people, following best interest processes and the overall governance of the service.

We identified three breaches in regulations. These were regulation 11 (Consent to care and treatment), regulation 12 (Safe care and treatment) and regulation 17 (Good governance). You can see what action we told the provider to take at the back of the full version of the report.

People had their needs and wishes assessed and recorded in order to ensure that the service could meet their individual needs.

Each person living in the home had a detailed plan of care in place that included people's individual needs and aspirations and also recorded physical and emotional healthcare needs.

Records we examined showed us that the staff team had received training in protecting people from risk of abuse and those that spoke with us were aware of their responsibility to report concerns.

The staff team received training relevant to their role and received supervision and support from the manager.

There were processes in place to audit and monitor the quality of the service being provided.

Comments we received from a family member included. 'I feel that X is very lucky to be in the home, she gets great support from a group of staff who really care.'

We found that care was planned in accordance with people's wishes, preferences and in their best interests. There were adequate numbers of suitably skilled and experienced staff. We saw that the provider regularly assessed the quality of the service. Training and supervision was not up to date for all staff but the manager had highlighted this and provided an action plan to their line manager to rectify this.