Avalon Teesside Services

Avalon Teesside Services is a domiciliary care agency providing personal care and support to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of inspection 10 people were receiving personal care.

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

Relatives and an advocate were happy with the service and the care people received. They were complimentary about staff calling them “kind,” “caring” and “helpful.” Comments included, “Staff are very, very caring, and treat [person] like a family member” and, “They are all most attentive. [Person] always smiles and is happy to see them. I would know 100% if my [family member] was not happy.”

There were systems in place to keep people safe. Staff safeguarded people from abuse. Risks to people’s health, safety and well-being were managed. There were enough staff to meet people’s needs and safe recruitment processes were followed. A relative told us, “There are enough staff. In all the years they've helped us, I've never had a problem. I think they must have a very robust interview process, because the staff we've had, are so good.” Medicines were safely administered and managed. The provider learned from previous accidents and incidents to reduce future risks. The provider and staff protected people from the risk or spread of infection.

The service was well managed. The provider, registered manager and staff promoted a positive culture in the service. Relatives and an advocate were complimentary about staff and the care people received. The provider had an effective quality assurance process in place which included regular audits and spot checks. People, relatives and staff were regularly consulted about the quality of the service through regular communication, surveys and reviews.

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

Rating at last inspection

The last rating for this service was good (published 14 August 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we decided to undertake a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings of this inspection. We found no evidence during this inspection that people were at risk of harm. Please see the Safe and Well-led sections of this full report.

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Avalon Teesside Services on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Avalon Teesside Services is a domiciliary care agency that provides personal care and support to people in their own homes and also in supported living and shared lives schemes. It provides a service to older and younger adults, people with a learning disability or autism, children aged between 13 and 18 and people living with a dementia.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

There were examples of exceptional practice and this is reflected in the outstanding rating in the well led section of the report. Staff had meaningful input into the way support was delivered and morale was high.

The service was led by a very strong management team who supported staff well. The registered manager felt well supported by the provider. The values set out in the service’s mission statement were being put into action and ensuring people lived a full life was very much at the heart of service delivery. Links had been established with the local community and good relationships existed with external health and social care professionals.

The registered manager carried out a variety of audits and regular checks to ensure the service was delivered to a high standard. Staff and people who used the service were asked for their feedback and this was acted upon to make positive changes.

People were cared for safely by staff who understood safeguarding procedures and knew how to raise any concerns. Risks were assessed and plans put in place to minimise them. Accidents and incidents were recorded and monitored to reduce future risk. People received their medicines as prescribed.

Staff had access to a wide range of training to ensure they had the necessary skills and knowledge to support people effectively. People were supported to access healthcare and to have a healthy diet appropriate to their needs.

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.

Staff were passionate about their work and promoted dignity and independence. People who used the service and their relatives were happy with the support they received and told us staff were friendly.

Support plans contained very detailed information about people, their likes and dislikes and how best to meet their needs. People were engaged in a variety of activities and supported to access the community they lived in. There was a procedure in place to deal with concerns or complaints and records we saw showed this was followed appropriately.

Further information is in the detailed findings below.

Avalon Teesside Services is a domiciliary care agency that provides personal care support to people with a wide range of health conditions. The service also supports people in a ‘Supported Living Scheme’ and 'Floating Support Scheme' undertaking activities which are not regulated by CQC. These additional support activities enable people to attend work and college placements, access local social and leisure facilities and carry out daily living tasks in their own homes.

The service had a registered manager who had been registered since September 2014. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 who used the service told us they felt safe, that care staff carried out their tasks in a caring manner and that they had confidence in the service. Staff had received training in how to safeguard people from harm and knew how to respond to any allegation of abuse. Staff were aware of the whistle blowing procedure which was in place to report concerns and poor practice. Risk assessments were centred on the needs of the individual. Potential risks to people had been identified and plans put into place to enable them to live as safely and independently as possible.

There were sufficient staff employed to provide consistent and safe care to people, with people receiving care from the same team of staff for most of the time. The service carried out appropriate checks to ensure suitable staff were employed.

People received their medicines in a safe way and staff had received training in the types of medicines people received. Staff recorded medicines taken by people in an appropriate medicines record sheet.

Staff received regular training both mandatory and specialist which provided them with the knowledge and skills to meet people’s needs in a person centred manner. They were supported by the registered manager and senior management team in respect of supervision and informal support.

The registered manager and staff had a good understanding of the Mental Capacity Act 2005 and had received training in this area to meet people’s care needs. Care staff had also received awareness training in the Mental Capacity Act.

Staff helped ensure people who used the service had food and drink to meet their needs and supported people with preparing meals where requested. Staff knew people’s care and support needs which were detailed in care plans describing how people wished to be supported. People were involved in making decisions about their care. There were regular home visits spot checks carried out by the service to monitor the quality of service and the care practice carried out by staff.

Privacy and dignity of people was promoted by staff and they treated people with respect. People who received care remained independent and in control of their decision making and choices. People had access to health care professionals to make sure they received appropriate care and treatment. The service maintained accurate and up to date records of people’s healthcare and GP contacts in case they needed to contact them.

People received care that was responsive to their needs and centred on them as individuals. People’s needs were assessed and care plans gave very clear guidance on how they were to be supported. Records showed that people and their relatives were involved in the assessment process and review of their care.

People were supported to access activities of their choice.

A complaints procedure was available and people we spoke with said they knew how to complain, although no one said they had needed to. The service maintained records of compliments and complaints and recorded how these were resolved.

People had the opportunity to give their views about the service. There was regular consultation with staff, people and/or family members and their views were used to improve the service. Regular audits were completed to monitor service provision and to ensure the safety of people who used the service.

We carried out this inspection in order to review the improvements that the provider had told us had been made within the service. Due to the nature of the service this inspection was announced 24 hours before it commenced. The inspection was completed by an adult social care inspector and they have used the findings from the visit to answer two of our five key questions, Is the service effective? and is the service well led?

Is the service effective?

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We found that the provider had an effective training programme that was delivered to staff. We saw that additional specific training, beyond that identified as mandatory, was identified following assessment of the needs of people who used the service. This training was provided to staff to ensure they could provide safe and effective care to meet the needs of those people.

All staff were supported within the workplace with regular appraisal and supervision sessions, where professional development was discussed.

Is the service well led?

We found that there were systems in place to ensure that the quality of the service provision was monitored and improved where necessary. We saw that where the effectiveness of these systems was questioned, the provider took action to develop and implement new ways of working with a view to improving that process.

Following completion of a staff and 'customer' survey we found that the provider had taken action to address comments and concerns raised by people who used the service, and staff, to improve the service and their experience.

We found that incidents that occurred within the carrying on of the regulated activity were appropriately reported, investigated and actioned. These investigations occurred locally within the service to ensure that any immediately required actions were completed to ensure the safety and welfare of people who used the service. They were also reviewed at frequent intervals at director level.

Please note that the name of a registered manager who was not in post appears on the front of this inspection report. This is because at the time of our visit they remained registered with us. Action is being taken separately from this process to address this.

The provider had effective communication with other professionals involved in people's care, thus people received coordinated care.

The provider had taken action to reduce the risk of people being subject to abuse and had ensured that staff were aware of what action to take if they were concerned that someone they supported was being abused. People who used the service told us they felt safe.

The provider had not made sure that all staff were up to date with their mandatory training and staff did not receive regular and frequent supervision.

The provider had systems in place for monitoring the quality of support people received, however the service did not have a proactive approach to quality assurance and did not always respond to issues in a timely manner.

The organisation had a complaints process in place and when we looked at the complaints received, we could see that the policy had been followed.

Staff employed by the service had undergone a recruitment process which involved being interviewed by people who used the service. Pre employment checks such as, references and criminal records bureau checks had been carried out. People who used the service were supported by staff who had the skills and knowledge to carry out their role in a safe and appropriate way. Where people had specialised equipment, staff had received the correct training to enable them to support people safely.