Archived: Sixth Avenue

Updated 9 December 2014

The inspection team consisted of two adult social care inspectors, a pharmacist inspector and a specialist advisor who specialised in learning disabilities.

We spoke with the registered manager, regional manager, deputy manager and four care workers.

Some people who lived at the service were unable to communicate with us verbally because of the nature of their condition. We therefore spoke to staff and observed their practices to determine how care and support was carried out. One person who was able to communicate with us said that she was happy at Sixth Avenue. Following our visits to the service, we spoke with two relatives by phone to obtain their views.

We contacted a number of health and social care professionals by phone to find out their opinion of the service. These included an aromatherapist; a care manager from the local NHS trust; a team leader from the local NHS trust; a district nurse; two community nurses; a member of the community dietetic team from the local NHS trust; a speech and language therapist and an occupational therapist. We consulted a local authority contracts officer; a local authority safeguarding officer; a local authority best interests’ assessor and a member of staff from the local Healthwatch organisation. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.  

We spent time looking at a variety of records during our inspection. These included four people’s care records and one staff file to check recruitment procedures. We also examined training files, policies and procedures, minutes of meetings, surveys and other relevant documentation.

Before our inspection, we reviewed all the information we held about the service. 

This report was written during the testing phase of our new approach to regulating adult social care services. After this testing phase, inspection of consent to care and treatment, restraint, and practice under the Mental Capacity Act 2005 (MCA) was moved from the key question ‘Is the service safe?’ to ‘Is the service effective?’

The ratings for this location were awarded in October 2014. They can be directly compared with any other service we have rated since then, including in relation to consent, restraint, and the MCA under the ‘Effective’ section. Our written findings in relation to these topics, however, can be read in the ‘Is the service safe’ sections of this report.

Updated 9 December 2014

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service

The inspection was carried out over two days. We visited the service unannounced on 23 July 2014 with two adult social care inspectors and a pharmacy inspector. We visited the service again on the 5 August 2014 with an adult social care inspector and a specialist advisor in learning disabilities.

This was our first inspection of Sixth Avenue since Community Integrated Care had taken over the service in September 2013.

53 and 55 Sixth Avenue are two purpose built adjacent bungalows with easy access between the two buildings. The service is situated in a residential area of Blyth and provides places for up to eight people with learning disabilities and mental health needs who require care and support. There were four people living at the service on the days of our inspection.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The manager informed us and records confirmed that training in certain areas had lapsed. In addition an appraisal system was not yet in place after Community Integrated Care took over the service in September 2013.

This was a breach of regulation 23 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the action we have asked the provider to take can be found at the back of this report.

Staff knew what action to take if abuse was suspected. Safe recruitment procedures were followed. Staffing levels were based on the needs of the people who lived there.

We found that the service was meeting the requirements outlined in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

We saw that people were asked about their preferences and choices. People received food and drink which met their nutritional needs.

Staff who worked at Sixth Avenue were knowledgeable about people’s needs and we saw that care was provided with patience and kindness and people’s privacy and dignity were respected. One completed relative’s questionnaire stated, “[Name of person] has been in two homes prior to Sixth Avenue and without doubt this is the best yet.”

The service had gone through a period of change. Community Integrated Care had taken over the service in September 2013. Prior to this the service had been run for a number of years by the local mental health NHS Trust. Staff explained that they were still adjusting to working for a new provider.

The manager explained that they were in the process of “changing direction” for part of the service. They were going to provide an “enabling service” for people who lived in the second bungalow. The service had historically looked after and supported people with learning disabilities but an enabling service would help people to live a more independent life. People who lived in the second bungalow would be more physically able and staff would take on a more supporting role. The manager told us that this change of direction would include supporting people with other needs such as those with mental health conditions.

Some staff informed us that morale, although improving, was still low at times. The manager and regional manager had recognised this and were working on ways to improve job satisfaction. Despite the significant changes which had occurred, health and social care professionals felt that these had not impacted on the care and support which people had received. One health and social care professional stated, “It’s been a difficult time with all the changes but it doesn’t seem to have affected the level of care.”

The registered manager assessed and monitored the quality of care. Surveys were carried out for people who lived there and their representatives. Audits and checks were carried out to monitor a number of areas such as health and safety, medication and support plans.