This inspection took place on 10 May 2017 and was unannounced. This meant the staff and registered provider did not know we would be visiting.The Avenue provides care and support for up to three people who have a learning disability close to the centre of Darlington.
The service had a registered manager in place. 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.
We last inspected the service in December 2014 and rated the service as ‘Good.’ The domain of well-led was rated ‘Outstanding’ in December 2014 and remained ‘Outstanding’ at this visit.
The service specialises in providing person centred care and support. In the last two years it has supported two people using the service who had lived there for over twenty years to pass away peacefully at The Avenue as they wanted, with the support of their families and with successful multi-agency working.
The registered manager pro-actively worked with all agencies to ensure people’s choices were upheld and that the staff team went above and beyond to tenderly care for people at the end of their life in a manner that promoted their dignity.
Feedback from relatives and professionals was exceptional. The community matron, learning disabilities liaison nurse and the service’s GP all gave lengthy feedback to the Care Quality Commission. The GP wrote, “The Avenue showed care beyond what is normally observed from family members. It has been a complete privilege to work with this team.”
The registered manager continued to lead by example, ensuring they worked alongside staff members and ensuring that people’s needs were at the fore front of all activities and planning for the service. On the day of our inspection visit the registered manager had been shopping for people as they were taking everyone living at the home on holiday for a week.
There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The registered provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. The registered provider ensured that staff were provided consistently even employing staff who had worked with someone moving into the service to ensure an effective transition.
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.
The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.
The home was clean and suitable for the people who used the service and appropriate health and safety checks had been carried out.
Risk assessments were in place when required and accidents and incidents were appropriately recorded and analysed by the registered manager and service manager.
Appropriate arrangements were in place for the administration and storage of people’s medicines.
Staff received regular supervisions and appraisals. Staff training was up to date and each staff member had a personal development plan to ensure their learning needs were met. Staff had mandatory training to ensure they were working safely but also specialist training such as autism and cancer awareness.
Care records showed that people’s needs were assessed before they started using the service and care plans were written in a person-centred way. Person-centred is about ensuring the person is at the centre of any care or support plans and their individual wishes, needs and choices are taken into account.
People who used the service were consulted about activities and interests, and activities were arranged based on people’s likes and interests and to help meet their social needs.
The registered provider had an effective complaints procedure in place and people who used the service and family members were aware of how to make a complaint.
The service had excellent links with the local community and local organisations.
Staff told us they felt totally supported by the management team and were comfortable raising any concerns. People who used the service, family members and staff were regularly consulted about the quality of the service.