Archived: Victoria Avenue

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.

People were protected from harm and abuse by staff who had the skills and knowledge to recognise and report safeguarding concerns. Risks to people were identified and reduced through appropriate strategies. People were supported by staff who were recruited safely and staffing levels were appropriate to meet people’s needs. People had their medicines administered by staff as prescribed and these were managed safely. Processes were in place to monitor and learn from accidents and incidents

People’s needs were assessed and plans were put in place so staff could provide consistent care. Staff received relevant training and regular supervision, ensuring best practice was embedded. People were supported to have meals of their choice and their health needs were met. The environment had been adapted to meet people’s 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.

People were supported by kind and caring staff who took the time to build trusting and respectful relationships. Staff communicated with people in the way they understood and promoted their independence and inclusion in their local community. Staff maintained people’s privacy and dignity and supported people to maintain important relationships.

People engaged in a wide variety of activities within the service and the local area. Care plans were person centred and were reviewed and updated as people’s needs changed. Information was presented to people in the format that worked for them. People and their relatives could discuss their end of life wishes and a care plan was available to record this information. A complaints policy was in place.

The provider had systems in place to monitor and address any quality shortfalls. People and their relatives were provided opportunities to feedback to the service and this was used to drive improvements. The registered manager promoted an open and honest culture and worked to ensure people had a good quality of life.

Further information is in the detailed findings below.

This inspection took place on 31 March and 4 April 2016 and was unannounced. The service was last inspected in April 2014 and was found to be compliant with the regulations inspected at that time.

At the time of the inspection, two people were living at the service.

There was a registered manager in post. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff had been trained to recognise the signs of abuse and how to report any suspected abuse to the proper authorities. This training was updated on a regular basis. Staff had been recruited safely and were provided in enough numbers to meet the needs of the people who used the service.

People’s medicines were handled safely by staff who had received training in this area. Information was available for staff which described how they should support people to be safe and not at risk of harm. Staff respected people’s diversity and right to lead a lifestyle of their own choosing.

People were provided with a well-balanced nutritional diet which was of their choosing. People were supported by the staff to prepare their own food when appropriate, and to use local restaurants, cafes and bars for meals out. They were also supported by staff to socialise with their friends and families.

Staff had received training in how meet the needs of the people who used the service, which was updated regularly, and they had the opportunity to gain further qualifications. People were protected by legislation and by staff who had received training in how to uphold people’s human rights if they needed support with making informed decisions and choices. People were supported to access health care professionals when needed. They were also supported to attend hospital and dental appointments.

People were cared for by staff who understood their needs and were kind and caring. Staff respected people’s right to privacy and upheld their dignity. People or their representatives were involved with the formulation of care plans and regular reviews were held. Staff supported people to be as independent as possible and to experience different things to expand their knowledge and lives.

Staff supported people to lead a full and active lifestyle. They used local amenities and facilities which included sports centres, educational facilities, shops, bars and restaurants. Detailed information was available for staff which described the person and their preferences for care.

The registered provider had a complaints procedure in place which people could access. Others were also encouraged to raise concerns, complaints and to make suggestions. All complaints and concerns were investigated to the complainants’ satisfaction.

The registered manager had a range of audits and checks in place which ensured people lived in well-run, safe and well-led service. People’s views were actively sought. The registered manager held meetings with people’s relatives and other stakeholders to gain their views about how the service was run. The registered manager also held meetings with the staff so they could contribute to the running of the service.

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

We used a number of different methods to help us understand the experiences of people who used the service, because they had complex needs which meant they were not able to tell us their experiences.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with the staff supporting people who used the service and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service caring?

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. Staff demonstrated a good understanding of the needs of the people who used the service and could describe subtle non-verbal signs people used to communicate their feelings and thoughts.

Risk assessments were completed which ensured staff knew how to keep people safe. People had been involved with the formulation of their care plans and where needed people had been supported to make informed decisions. Health care professionals, for example doctors, speech therapists, occupational therapists and psychologists, had been consulted and their advice sought when people needed more specialist care and attention.

Is the service responsive?

The service had a complaints procedure which people could access. People were therefore assured that complaints were investigated and action would be taken as necessary. The provider consulted with people about how the service should be run and any issues were addressed. People were consulted about their care needs.

Staff followed instructions from visiting health care professionals for example doctors and district nurses. This ensured people received the care and attention they required to meet their needs.

Is the service safe?

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly, therefore not putting people at unnecessary risk.

The manager set the staff rotas, they took people's care needs into account when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure people's needs were met.

The provider had policies and procedures in place for staff to follow to report any abuse they may witness or become aware of. Staff also received training about how to keep people safe.

Is the service effective?

People's health and care needs were assessed with them and they were involved in writing their plans of care. Specialist dietary needs had been identified in care plans where required. People were provided with a wholesome and nutritious diet and their dietary needs were monitored. Health care professionals were consulted if required.

People's care plans detailed the person's preferences and their method of communication. This enabled the staff to identify when the person was not happy or felt uncomfortable with any given situation.

Is the service well led?

The provider consulted with people about how the service was run and took account of their views. Relevant persons who had an interest in the care and attention people received had also been consulted and their opinions taken into account about how the service was run. Staff received training which equipped them to meet the needs of the people who used the service. The provider also gave staff the opportunity to gain further qualifications.

People who used the service engaged with their key worker on an individual one to one basis to discuss their likes, dislikes and care and support needs.

One person who used the service told us, 'I like to play football in the garden and play darts at the pub' and 'I like taking the dog for a walk.'

A relative told us, 'The staff always keep me informed when there is a need for other healthcare intervention.'

We found that quantities of drugs administered matched with the Medication Administration Record (MAR) entry.

We saw there was a complaint procedure in place which was displayed in people's own rooms.

We found the records to be up to date,accurate and signed by the person who used the service or their representative which ensured they were involved in care planning and delivery of support.