12 January 2023
During a routine inspection
About the service
Avenues London - 1a Webb Road is a residential care home that provides accommodation and personal care support for up to six people with complex learning and physical disabilities. At the time of our inspection the home provided support to six people in a purpose built building.
People’s experience of using this service and what we found
Right Support:
The model of care and setting did not always maximise people's choice, control and independence. There were not always enough staff to meet people’s needs. People were not always supported to maximise their independence or participate in activities of their choice within their local community. Activities were often group based rather than a reflection of people’s personal choices preferences and hobbies.
Risks to people were not always identified and there were not always risk management plans in place.
Staff understood their roles under the Mental Capacity Act staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Right Care:
People had personalised plans for their care but these were not always up to date. Records did not evidence if or how people were supported to identify or achieve their aspirations and goals.
Staff knew how to protect people from poor care or abuse. Medicines were safely managed. People were protected from the risk of infection. People’s nutritional needs were met. Staff received appropriate training to meet people’s needs. Staff enabled people to access health and social care support in the community. The service worked with people to plan for when they experienced periods of distress or anxiety. Staff had training on equality and diversity, and they considered people’s diverse needs.
Right Culture:
It was not evident that people were engaged or consulted about the running of the service. There were no residents’ meetings. Records of key worker meetings did not evidence how people’s views about the service were sought or acted on.
The service did not proactively consider aspects of people’s support needs with a view to increase their autonomy, their participation in activities of their preference, or empower them to lead fuller lives in the community.
The provider audited the quality of support provided to people. An action plan had been developed to address areas they had identified for improvement. However, this had not always identified issues we found, or actions had not always been addressed in a timely way.
Feedback about the new manager was positive. They and the provider were open and honest about the current shortfalls with the service. They had made some improvements to the service prior to the inspection. The provider and manager showed us how they had been working to address the culture and were aware it was a work in progress.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was Good (published 28 August 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Avenues London, 1A Webb Road on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to staffing levels, identifying risk, person centred care and governance of the service at this inspection.
We have made a recommendation the provider seeks best practice guidance on supporting people to lead more independent, fulfilled lives.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.