The Avenue

Updated 25 February 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

The Avenue is a ‘care home’. People in care homes receive accommodation and nursing or 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with three relatives about their experience of the care provided. We spoke with four members of staff including the registered manager. We also spoke with a social worker, a GP and two day service managers. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included three people’s care records and medication records. We looked at two staff files in relation to staff support supervision as there had been no staff recruitment since the previous inspection. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 25 February 2020

About the service

The Avenue is a residential care home providing personal and nursing care to three people with learning disabilites at the time of the inspection. The service can support up to three people.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The leadership and team working within this service was exceptional. This ensured everyone received high quality and personalised support. The history of this service showed the registered manager, service manager and the staff team worked in partnership to continuously improve and this achieved the best outcomes for people. Everyone without exception, praised the leadership and compassionate approach within this service. Staff were responsive to people's needs, whilst supporting them to learn new skills to improve their health and well-being. Health professionals described the service as; "Superb" and "They are pretty special."

People received care and support that was truly individualised, flexible and responsive to their needs. We received overwhelming feedback of the positive impact this had on people and how they had changed people’s lives. We saw excellent examples of how the care and support people received enhanced and enriched their lives. Staff had the upmost respect for people's individuality and empowered them to express their wishes and make their own choices. People and others knew how to feedback any concerns or complaints about their experiences and were extremely confident about doing so.

Professionals and family members were extremely positive about how kind, caring and compassionate staff and managers were. Staff were highly motivated in providing consistent person-centred care. Relatives told us they felt they and their loved ones were listened to, valued, respected and included in every aspect of their care and support, and the development of the service. People’s independence and choice was promoted to the maximum and they were consistently supported to develop new skills. The registered manager and staff had formed strong trusting relationships with people and were described as often going above and beyond what was expected of them to enhance and enrich people’s quality of life. The registered manager, service manager and staff had been very compassionate in the way they supported people at the end stages of their life and after their death.

Staff received regular training, repeated induction programmes to keep their knowledge up to date, received supervisions, attended staff meetings and had regular practice checks. Staff we spoke to said that they felt very well supported and valued.

Accidents and incidents were managed appropriately and referrals were made to other professionals in a timely way when people living in the home were in need. Each relative we spoke with had no complaints and were very happy with the service being delivered.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 27 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.