28 September 2016
During a routine inspection
The last inspection was undertaken on 22 and 28 September 2015. We found that the service was rated 'good' and was meeting the required standards.
We inspected 12 Tavistock Avenue on the 28 September and 5 October 2016 and found that the service had continued to meet the standards.
The home did not have a registered manager in post. The registered manager had left the service six weeks before the inspection commenced. There was a new manager who was in the process of registering with CQC. 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.
At this inspection we found there were sufficient numbers of staff deployed to provide care safely to people living in 12 Tavistock Avenue. The manager had not informed us about incidents that required reporting which is required to help keep people safe from the risk of harm. The person were supported by staff who had undergone a recruitment process to ensure they were suitable to work in a care setting. However there were inconsistencies in the recruitment of staff depending on when they were recruited. We saw that when agency staff were used the manager did not always complete the same level as robust checks as they did for permanent staff.
Risk assessments were completed and reviewed to help staff to manage risks, Although the records were not always updated to reflect the current position. The persons medicines were managed safely and there was a process in place to for the safe ordering, storage and disposal of the persons medicines.
Staff did not feel supported by the manager and felt that they were constantly being criticised about how the service operated and spoken to in a condescending way. Staff had received training but some of the refresher updates had not been provided. We saw there were arrangements in place for staff to have an induction when they commenced their employment to help support them to carry out their roles effectively.
The persons nutritional needs were met and their food and fluid intake and weight were kept under review. The person was able to choose what they ate from the menu. However the menu was under review at the time of our inspection as the new manager felt that more ‘healthier options’ should be introduced.
The persons relatives and staff told us they were supported to maintain their health and well- being and had access to a range of health professionals. We saw that the person had a purple folder which contained a summary of healthcare appointments and records of key events.
Staff spoke to people in a kind, caring and compassionate way. We observed good interaction between staff and people and relatives confirmed this to be the case.
The persons dignity was privacy was maintained. However the person did not always get choices about how they spent their time.
The person received care that was responsive to and met their needs. Staff were aware of the persons individual needs and how to meet these, however due to management changes they were not always able to accommodate the persons needs and wishes. The person was provided with some opportunities to participate in activities mainly in the community.
There was a complaints policy and procedure in place and we saw evidence of one complaint from the other service which we say had been investigated and responded to by the Manager. There were no complaints for the person who lived at 12 Tavistock Avenue.
The person received care that was monitored appropriately by staff. The persons care plans were regularly reviewed. Audits were not effectively reviewed to ensure actions were completed, and notifications were not consistently sent to CQC when required.