Aveley Lodge

At our last inspection on 19 September 2016 we found improvements were needed to ensure the providers governance arrangements identified shortfalls and reflected the action taken to address these. This included, ensuring applications to deprive people of their liberty were made to the local authority for authorisation and ensuring people received their medicines as prescribed by their GP.

At this inspection we found the required improvements had been made, however we found the systems for monitoring risks to people needed improving. For example, where unexplained bruising or skin tears had occurred, no incident report was completed, just a body map. The charts did not show what action had been taken to investigate what had happened, or if the appropriate authorities were informed if after investigation they remained 'unexplained'. However, the deputy manager could tell us, in detail about each incident and what follow up action had been taken to ensure people's health, safety and welfare. The registered manager took immediate action during the inspection to revise the form, which incorporated a body map and process for reporting incidents.

Aveley Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as 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 is a 25 bedded residential home providing care and support to older people, some of whom may be living with dementia. The premises was well maintained, bright, welcoming and clean. On the day of our inspection there were 24 people living in the home.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission 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.'

People told us Aveley Lodge was a safe and secure place to live. People had been informed of what they needed to do to keep safe, including fire safety and how to raise concerns. Staff knew the process to follow and whom to inform both within the organisation and to outside agencies if they witnessed or had an allegation of abuse reported to them.

People were provided with the support they needed to promote their independence and freedom, yet minimise the risks. People received their medicines when they needed them.

There was enough staff available to meet people's needs. Staffing numbers had been calculated based on the needs of the people using the service. Thorough recruitment and selection processes were in place which ensured staff recruited had the right skills and experience. The provider was committed to providing a

continuous cycle of training that ensured staff had the right skills and knowledge to meet people's needs. A buddy system was used to ensure new staff were supported. Staff spoke consistently about the service being a good place to work. They felt supported, received regular supervision and had access to plenty of training opportunities.

People were supported to eat and drink and maintain a balanced diet. Staff were aware of people's dietary needs and the support they needed to eat their meal. Mealtimes were a positive, sociable experience for people with a good ratio of staff present to ensure they received the support they needed to eat their meal.

The provider had worked hard to create positive and lasting links with community health services. People were supported to maintain their health. Their records confirmed they had access to a range of healthcare services including the GP, optician, specialist nurses and dietician.

People were supported to express their views and make decisions about their care. People's ability to make decisions was assessed in line with the requirements of the Mental Capacity Act (MCA) 2005. Where appropriate Deprivation of Liberty Safeguard (DoLS) authorisations were in place to lawfully deprive people of their liberty for their own safety.

The management team and staff were fully committed to ensuring people received the best possible care. Staff understood people's human right to be treated with respect and dignity and to be able to express their views. Technology and a 'pen pal' scheme helped people to stay in contact with family and friends.

Aveley Lodge provides good care and a wide range opportunities for people to engage in activities that enhance their well being. The arrangements for social activities were designed to meet people's individual needs. Activities were arranged to make 'People happy, mobile and to give purpose to their lives. The management team and staff were guided by people's wishes and aspirations when it came to arranging activities.

Staff understood the importance of supporting people to have a good end of life as well as living life to full whilst they were fit and able to do so. People had been provided with the opportunity to discuss their experiences of bereavement and express their own wishes for their end of life care.

The service was managed by a dedicated management team and staff that were approachable and easy to talk to. The management team and staff demonstrated a shared responsibility for promoting people's wellbeing, safety and security. Staff were aware of the provider's five key principles of care, dignity, respect, independence, information and choice and how these linked to the core vision and values of the service.

People and their relatives were encouraged to share their views and provide feedback about the service. The feedback obtained from surveys completed in 2017 and 2018 was overwhelmingly positive.

Aveley Lodge is an important part of the local community. The provider, people using the service, their relatives and staff have raised monies for other charities, including the local church. The provider had several schemes, including a staff bonus in place to drive improvement and reward staff that use their initiative. The service and staff had also won many care awards, including most recently the National Family Business Award 2018.

The five questions we ask about services and what we found