We carried out a review of the data available to us about Avocet Court on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Avocet Court, you can give feedback on this service.
Avocet Court is a residential care home providing personal and nursing care to up to 153 people. The service provides support to adults. The service also provides support and care to people when they have left hospital and need additional support to go home, referred to as ‘discharge to assess’. At the time of our inspection there were 89 people using the service.
The service accommodates people across three separate units, each of which has adapted facilities. These were, Cilgerran House and Powys House, which provided personal and nursing care, and Harlech House which provided personal and nursing care for people living with dementia. There was a separate unit, where the management team, reception and administration, kitchen, coffee shop and laundry were located.
People’s experience of using this service and what we found
Since our last inspection, there had been a change in management of the service. Staff and relatives were positive about how the service was led and that the manager was approachable.
There were systems in place to provide people with a safe service. Lessons were learned when incidents and accidents occurred, and actions taken to reduce them happening again in the future. Staff were trained and guidance provided in people’s care records in how to keep people safe from abuse and avoidable harm.
People received their medicines where required and safely. Staffing levels were calculated to reduce the risks of people not receiving the care they required. These were kept under review and were adjusted where needed.
Infection control processes and procedures were in place to reduce the risks of cross infection. The service followed the most up to date guidance relating to the pandemic, this included the provision of personal protective equipment (PPE) for staff and testing. Visiting was managed safely which supported people to maintain relationships with their family and friends.
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 governance systems in place supported the management team to assess and monitor the service provided and identify and address any issues identified. The management team were knowledgeable about their role and responsibilities and what was happening in the service. People’s views were listened to and used to drive improvement.
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 requires improvement (published 2 October 2021). We found a breach of regulation relating to the governance systems in place for monitoring and assessing the service provided.
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
At our last inspection we recommended that the provider seek advice from a reputable source on their infection control procedures and the use of slings. At this inspection we found improvements had been made, people had their own slings and people staying in the service using the discharge to assess service were provided with disposable slings, all which reduced the risks of cross infection. We also recommended the risks associated with unguarded surfaces such as pipes and radiators required more detail in risk assessment to demonstrate effective oversight. At this inspection we saw records which evidenced that the areas were regularly checked and monitored to ensure people were safe.
Why we inspected
We carried out an unannounced focused inspection of this service on 23 August 2021 (published 2 October 2021). A breach breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve in their governance processes. We also made two recommendation in relation to safe care and treatment.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements, and actions taken in relation to our recommendations. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last inspection reports, by selecting the ‘all reports’ link for Avocet Court on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
The service accommodates people across three separate units, each of which has adapted facilities. These were, Cilgerran House and Powys House, which provided personal and nursing care, and Harlech House which provided personal and nursing care for people living with dementia. There was a separate unit, where the management team, reception and administration, kitchen, coffee shop and laundry were located.
People's experience of using this service and what we found
People and relatives praised staff for being kind and caring. We observed that staff were attentive and interacted with people in a respectful way.
Risks were not always assessed or effectively managed to keep people safe. People were using shared mobilising equipment which were not laundered between uses which presented a risk to people of acquiring infections. Risk assessments were not always adequately detailed. We have made a recommendation about the use of moving and handling slings and the risk assessment for hot water pipes and radiators.
Accidents and incidents were investigated to identify the cause and the actions needed. We received conflicting information about how falls were managed, but we observed that crash mats and call bells were in place. However, some call bell cords presented trip hazards and the manager agreed to ensure that staff were clearer about the use of portable alarms.
The manager used a dependency tool to establish the staffing levels to ensure there were enough staff on each shift to meet people's needs. Dependency levels were regularly reviewed. The manager told us that admissions in one part of the service had recently been halted on a temporary basis because of increased levels of dependency.
Staff knew how to safeguard people from the risk of abuse. They had a good understanding of how to recognise and report abuse and were confident the provider would take action in line with local safeguarding procedures.
People were supported by staff who had been recruited and employed after recruitment checks had been completed.
The home was clean and visits by relatives had been facilitated to the service in line with the government guidance which was welcomed by staff and people using the service.
Medicines were administered by staff who had been trained and we received positive feedback about how people received their medicines. Further work is needed on ensuring that people receive their topical medicines as prescribed.
A new manager had started work at the service in January 2021 and staff told us they were helpful and approachable. The new manager assured us that they were in the process of applying to register with the Care Quality Commission (CQC).
There were governance systems in place to monitor and assess the care provided. Audits on quality and safety had been completed but those in place had not identified the shortfalls we found in areas such as risk management and medicines.
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 14 December 2020).
Why we inspected
The inspection was prompted in part due to concerns received about how risks to people were managed. A decision was made for us to inspect and examine those risks in one part of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led in Harlech House.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Avocet Court on our website at www.cqc.org.uk.
Follow up
We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Avocet Court is a residential care home providing personal and nursing care for up to 153 adults. At the time of our inspection there were 79 adults and older people living in the service, some were living with dementia.
The service accommodates people across three separate units, each of which has adapted facilities. These were, Cilgerran House and Powys House, which provided personal and nursing care, and Harlech House which provided personal and nursing care for people living with dementia. There was a separate unit, where the management team, reception and administration, kitchen, coffee shop and laundry were located.
People’s experience of using this service and what we found
Since our last inspection there had been a change in the management of the service. The registered manager at our last inspection no longer worked at the service. A new manager was due to start in January 2021. In the interim, the service was being managed by the hospitality services manager/deputy manager and the clinical care manager.
There were governance systems in place to monitor and assess the care provided. Shortfalls were identified, and actions put in place to improve the service provided. Where incidents had happened, lessons were learned to reduce the risks of them happening again.
There were systems in place designed to reduce the risk of avoidable harm to people using the service, including abuse. Medicines were managed safely and available for people where required. There were systems to calculate the numbers of staff required to meet people’s needs, which was kept under review. Checks were made on new staff to reduce the risks of unsafe recruitment. Infection control processes and procedures reduced the risks to people and staff.
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.
People were being provided with a service which was responsive to their needs. Care records guided staff in how people’s specific needs were to be met. People’s records included their end of life care decisions. People were provided with the opportunity to participate in activity to reduce boredom and isolation. There was a complaints procedure in place. People’s views and concerns were listened to and used to drive improvement.
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 overall (published 26 November 2019).
Why we inspected
The inspection was prompted in part due to concerns received about the safe personal care provided, staffing and governance. We had raised safeguarding referrals regarding some specific concerns to the local authority safeguarding team, who are responsible for investigating concerns of abuse. A decision was made for us to inspect and examine risks to the people using the service. We undertook a focused inspection to review the key questions of safe, responsive and well-led only.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, responsive and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Avocet Court on our website at www.cqc.org.uk.
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.
Avocet Court is a residential care home providing personal and nursing care for to up to 153 people. At the time of our inspection there were 84 people using the service. The care home accommodates people across three separate units, each of which has adapted facilities. These were, Cilgerran House and Powys House, which provided general nursing care, and Harlech House which provided nursing care for people living with dementia. There was a separate unit, where the management team, reception and administration, kitchen and laundry were located.
People’s experience of using this service and what we found
There were times when people had to wait for their call bells to be answered, following our visits action was taken by the registered manager to develop a system to analyse response times. However, this improved system was not yet embedded to improve people's experiences.
Staff were recruited safely. The service was working to ensure there were enough staff to meet people’s needs, this included ongoing recruitment. Risks to people’s safety were assessed and guidance provided to staff to reduce the risks of avoidable harm and abuse. Infection control systems reduced the risks of cross infection. The service learned when things had gone wrong and put in systems to reduce them happening again. People received their medicines when they needed them.
People were supported by staff who were trained to meet their needs. 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. People’s health and nutritional needs were assessed, and staff were guided to how these were met. The environment was suitable for the people who used the service.
People told us the staff were kind and respectful. People’s rights to independence, dignity and privacy were promoted and respected. Staff knew the people they cared for well, including how their needs were met.
People’s care needs were assessed, planned for and guidance was provided to staff on how these needs were to be met. People’s preferences were sought and used to plan their care, including their end of life decisions. People had the opportunity to participate in activities. There was a complaints procedure in place and people’s concerns and complaints were investigated and addressed.
The service’s governance systems helped the provider and the registered manager to monitor and assess the service people received. Where shortfalls were identified, they were addressed. People’s views about the service were valued and used to drive improvement.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on January 2019 and this is the first inspection.
The previous rating for this service was good (published 8 June 2018). Since this rating was awarded the registered provider of the service and the name of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
The inspection was prompted in part by notification of a specific incident. This incident is subject to an investigation. As a result, this inspection did not examine the circumstances of the incident.
The inspection was also prompted in part due to concerns received about such as staffing and care provided. A decision was made for us to inspect sooner than the planned date for the comprehensive inspection and examine those risks. The registered manager had identified shortfalls and actions were taken to reduce future risks. We did find improvements were needed in how long people had to wait for their call bells to be answered, action was being taken to make improvements by the introduction of a system to analyse waiting times.
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.