CQC report explained · a nursing home
What the CQC found at Avalon Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. The home had safe recruitment, safeguarding, infection control and risk management arrangements, although some medicines records and staffing practices needed improvement.
- Effective?
- Good
- This key question was not assessed during this focused inspection.
- Caring?
- Good
- This key question was not assessed during this focused inspection.
- Responsive?
- Good
- This key question was not assessed during this focused inspection.
- Well-led?
- Requires improvement
- Management systems had improved, but records were not always complete or up to date. Staff were not always following the medicines policy, oral hygiene was inconsistent and one accident was reported late to the CQC.
What inspectors found, December 2021
Avalon Nursing Home was rated Good overall; inspectors found safe care, but leadership, records, medicines practice and oral hygiene needed improvement.
This was an unannounced focused inspection. Inspectors visited on 27 October 2021 and continued discussions on 01 November 2021. They reviewed information held by the CQC, spoke with people, relatives, staff and health professionals, observed care, and checked care records, medicines records, staff files and management documents.
The home was rated Good for Safe. People told inspectors they felt safe and received the help they needed. Staff were safely recruited and trained. There were enough staff overall, although staff were stretched at busy times and support with drinks was not always consistent in the morning.
The home was rated Requires Improvement for Well-led, the same as at the previous inspection. Some care records, food and fluid charts and medicines records were incomplete. Oral hygiene was not always provided consistently. The provider had improvement plans and worked with health and social care professionals, but further changes needed to be completed and embedded.
People felt safe
People said they felt safe and received the help they needed. Relatives also gave positive comments about the care and staff.
“People received safe care and support from staff who had been appropriately recruited, trained to recognise signs of abuse or risk and understood what to do to safely support people.” from the report
Safe recruitment
Staff files contained employment histories, references and criminal record checks. Inspectors found staff were recruited safely before starting work.
“All staff files included key documents such as a full employment history, at least two references and a DBS check.” from the report
Infection control
The home had systems for visitors, protective equipment, testing, isolation and infection control training. Inspectors were assured about most infection prevention arrangements.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Incomplete care records
needs fixingSome records did not give staff all the current information they needed. This included a person who returned from hospital after an injury but did not have a care plan put in place.
“We found records relating to individual care delivery were not all complete and up to date.” from the report
Medicines recording
needs fixingThere were gaps in medicines administration records. Inspectors confirmed people had received their medicines, but staff were not always following the organisation's medicines policy.
“There were gaps in people's medication administration records (MAR).” from the report
Food and fluid monitoring
needs fixingCharts were not always completed consistently for people at risk of weight loss or dehydration. Staff needed to record when someone was asleep, drowsy or refusing drinks so they could try again later.
“Food and fluid charts were not all consistently completed for those people at risk of weight loss and dehydration.” from the report
Oral hygiene
needs fixingPeople were not always offered the chance to brush their teeth, and staff did not always return later if someone refused.
“Oral hygiene was not being undertaken in a consistent way.” from the report
Staffing at busy times
needs fixingStaffing levels were generally enough, but staff were stretched at times. This led to inconsistent help with drinks, particularly in the morning.
“There were times when staffing levels were stretched and resulted in people receiving inconsistent assistance with drinks at times, the morning specifically was noted.” from the report
- 01What changes have you made to ensure care plans and records are complete and kept up to date?
- 02How do you check that medicines are given in line with your policy and that every administration is recorded?
- 03How do you make sure people at risk of dehydration have their food and fluid charts completed properly?
- 04How are people offered oral hygiene, and what happens if someone initially refuses?
- 05How do you ensure there are enough staff and consistent help with drinks during busy morning periods?
This was a focused inspection of Safe and Well-led only; the Effective, Caring and Responsive questions were not assessed in this report. This explanation was written from the published report of 2 December 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2020
Rated Good overall; inspectors found safe, kind and responsive care, but the home’s leadership and records still needed improvement.
Inspectors made an unannounced visit on 15 January 2020. They spoke with 18 people, staff and professionals, observed care, looked around the home and checked care records, medicines, recruitment, training and management records.
People were found to be safe, well cared for and treated with kindness and respect. Staff understood people’s needs, medicines were handled safely, staffing levels were sufficient, and people’s health, food and drink needs were met.
The main weakness was record keeping and quality checks. Some care plans did not clearly show changes in people’s needs, and the first training record provided was not up to date. The home was rated Good for Safe, Effective, Caring and Responsive, but Requires Improvement for Well-led.
The overall rating improved from Requires Improvement at the previous inspection. Responsive improved to Good, while Well-led remained Requires Improvement.
Kind and respectful care
People and visitors consistently said staff were kind and caring. Inspectors saw people relaxed and comfortable with staff, who protected dignity and privacy.
“People were relaxed and cheerful in the presence of staff.” from the report
Safe staffing and medicines
There was a registered nurse on every shift, with other care staff and a first aider. Staff administering medicines had training and competency checks.
“There was always a registered nurse on duty supported by assistant practitioners, senior care staff and care staff.” from the report
Personalised activities and support
Care records included people’s preferences, beliefs and communication needs. Activities included music, quizzes, crafts, pet therapy and individual sessions.
“The planned activity programme was varied and included quizzes, music exercise classes, art and crafts, pet therapy and one to ones for people in their rooms.” from the report
Good end of life support
Staff had relevant training and care plans recorded people’s wishes, including religious preferences and resuscitation decisions. Families could stay with loved ones at the end of life.
“Staff demonstrated compassion towards people at the end of their life.” from the report
Improvement since the last inspection
The overall rating improved from Requires Improvement to Good. The Responsive rating also improved to Good.
“At this inspection this key question has improved to Good.” from the report
Care records were not always complete
needs fixingSome care plans did not clearly record changes in people’s health or give staff enough guidance. Inspectors said this had not affected people’s health and safety at the time and was immediately corrected, but the quality checks should have found it.
“there were still areas to develop to ensure people's documentation was consistently accurate” from the report
Training records needed better monitoring
needs fixingThe first training plan provided did not clearly show what staff had completed. An updated plan and certificates were sent to inspectors after the inspection.
“The training plan provided by the training lead during the inspection identified gaps” from the report
Supervisions were behind
minorStaff supervision meetings were not fully up to date. The home said this was being put right.
“It was acknowledged that staff supervisions were behind and this was being rectified.” from the report
Some daily care guidance was missing
needs fixingOne person’s records described health needs in detail but lacked guidance about daily life activities. Staff and relatives said there had been no impact at that time.
“The person's health needs were detailed in great depth but lacked guidance for daily life activities.” from the report
- 01How do you now make sure care plans are updated promptly after a fall or change in health?
- 02How is each staff member’s training recorded and checked as complete?
- 03Are staff supervisions now up to date, and how often are they held?
- 04What daily support and personal care guidance is recorded for each resident?
- 05What trips out are currently available for residents who want to take part?
This was an unannounced planned inspection covering all five CQC questions, including both the care provided and the care home environment. This explanation was written from the published report of 4 February 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Avalon Nursing Home
7 rated inspections over 6 years: the service has improved, from Inadequate to Good.
- December 2021Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2020Goodup from Requires improvementSafe: GoodWell-led: Requires improvement
- February 2019Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2017Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2017Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- July 2016Requires improvementup from InadequateSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2015InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 6 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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19 live-in carers within about an hour of East Sussex
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
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