CQC report explained · a residential care home
What the CQC found at 492 Maidstone Road
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Staffing levels were not always sufficient to meet people's needs, and agency staff were not always familiar with the people they supported. Risk assessments were in place, but some had not been updated when people's risks changed.
- Effective?
- Requires improvement
- Some staff training had not been refreshed and supervision did not always take place as often as the provider's policy required. People otherwise received support with food, healthcare and decision-making that met their individual needs.
- Caring?
- Good
- Staff treated people with kindness, compassion and respect. People were involved in choices about their care, and their privacy, dignity, communication and independence were supported.
- Responsive?
- Good
- Care plans reflected people's needs, interests and communication methods, and people were supported with activities and relationships. However, two planned activities could not take place because staffing was too low.
- Well-led?
- Requires improvement
- The home had a management structure and worked with health and social care professionals, but care records and quality monitoring were not always effective. Staff morale was low and some staff said they did not feel well supported.
What inspectors found, May 2020
Avenues South East - 492 Maidstone Road was rated Requires Improvement; inspectors found kind, responsive care but staffing, staff support and quality checks were not reliable.
This was an unannounced inspection on 24 February 2020. One inspector observed care, spoke with people, staff and relatives, and checked care plans, risk assessments, medicines records, training records and quality checks.
The home was rated Good for Caring and Responsive. Inspectors found staff treated people with kindness and respect, supported their choices and communication, and helped them take part in activities and keep in touch with relatives. Medicines, safeguarding and risk management were also generally handled safely.
The overall rating was Requires Improvement, with Safe, Effective and Well-led also rated Requires Improvement. Staffing was sometimes too low, staff training and supervision were not always up to date, and care records and quality checks did not consistently lead to improvements. The previous rating was Good, published on 16 September 2017.
Kind and respectful care
Inspectors found that staff knew people well and treated them with kindness, compassion and respect. People's privacy, dignity and independence were promoted.
“People were supported by staff who treated them with kindness, compassion and respect.” from the report
Medicines were managed safely
Medicines were stored, given and recorded safely. Staff had medicines training and their competence had been checked.
“People were supported to receive their medicines safely.” from the report
Individual risk planning
Risks such as epilepsy, choking, eating and drinking, medicines and behaviour had been identified and had plans to guide staff.
“Risks to people had been identified, assessed and had appropriate risk management plans specific to individual needs” from the report
Communication and choice
The home used pictures, communication boards and other methods to help people understand information and make choices.
“Information was also presented in easy read and pictorial formats where this was required.” from the report
Staffing was too low at times
seriousStaffing levels did not always meet people's needs. Two people missed planned activities on the inspection day, and agency staff were not always familiar with the people they supported.
“Staffing levels were not consistently maintained to ensure people's needs were met.” from the report
Training and supervision gaps
seriousSome mandatory training had not been refreshed, and supervision did not always happen in line with the provider's policy. Inspectors identified this as a breach.
“Staff were not always supported through, training and supervision.” from the report
Weak quality checks and records
seriousCare plans and risk assessments were sometimes only given a new review date rather than being rewritten. Quality checks identified problems but did not always make sure they were fixed.
“The systems and processes in place for assessing and monitoring the quality of the service was not always effective and did not always drive improvement.” from the report
Infection risk
needs fixingOne person's wound was repeatedly picked and touched other surfaces. Staff said more could be done to improve wound management and reduce the risk of infection and cross-contamination.
“However, people were not always protected from the risk of infections as one person had a wound which they continuously picked at to bleed and with which they touched other surfaces in the home.” from the report
The home needed refurbishment
minorThe environment was clean but parts of the home needed redecorating or repair. The provider said refurbishment was planned.
“The home environment was designed to meet people's needs; however, this required renovation.” from the report
- 01What staffing levels are now in place on each shift, particularly when people need one-to-one support or community activities?
- 02Have the permanent staff recruited after the inspection started work, and how do you make sure agency staff understand each person's needs?
- 03Have all staff refreshed their moving and handling and safeguarding training?
- 04How often does each staff member now receive supervision, and how is this checked?
- 05Have the care plans, risk assessments and quality checks been rewritten or improved so that changes and identified problems are acted on?
This was an unannounced planned inspection covering both the care and the premises and assessing all five CQC questions. This explanation was written from the published report of 19 May 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.
What inspectors found, September 2017
Avenues South East - 492 Maidstone Road was rated Good; inspectors found safe, kind and personalised care with strong management.
This was an unannounced, comprehensive inspection on 15 August 2017. One inspector and an expert by experience observed care, spoke with people and staff, contacted healthcare professionals, and checked care records, medicines, staff files, rotas, audits and policies.
The home supported four men with severe learning disabilities and complex needs, including autism, communication difficulties, visual impairment and behaviour that could cause distress. Inspectors found people were safe, medicines were given as prescribed, staffing levels were suitable and staff understood people's individual risks.
People received personalised support with food, healthcare, activities, relationships and communication. Staff treated people with dignity and respect. The manager used checks, meetings and feedback to monitor the service and make improvements.
The home was rated Good in all five areas and overall. This was unchanged from the previous inspection on 1 July 2015.
Safe medicines
Inspectors found that medicines were stored, administered and recorded safely. People received them as prescribed.
“Medicines were managed safely and people received them as prescribed.” from the report
Personalised support
Each person had an up-to-date support plan describing their needs, preferences and how staff should provide care.
“Each person had an up to date, personalised support plan, which set out how their care and support needs should be met by staff.” from the report
Respectful care
Staff used suitable communication methods, gave people time to express themselves and protected their privacy and dignity.
“Staff gave people their full attention during conversations and spoke to people in a considerate and respectful way using people's preferred method of communication wherever possible” from the report
Activities and relationships
People were supported to take part in activities, go into the community, pursue interests and keep in touch with family and friends.
“People remained active and participated in a variety of activities and events that met their social and physical needs.” from the report
Good oversight
The manager carried out regular checks and used action plans when records or other areas needed improvement.
“We found the audits routinely identified areas they could improve upon and the registered manager produced action plans” from the report
Inspectors raised no specific concerns in this report.
- 01How will you support my relative to communicate their choices and concerns?
- 02How often will my relative's support plans and risk assessments be reviewed?
- 03What training and supervision do staff have for my relative's specific health and behaviour needs?
- 04How will you involve our family in decisions about care, activities and healthcare?
- 05How can my relative or our family make a complaint in an accessible way, and how will it be investigated?
This was an unannounced comprehensive inspection covering all five questions; inspectors could not speak with everyone because some people had limited communication. This explanation was written from the published report of 16 September 2017 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 492 Maidstone Road
3 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- May 2020Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 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 24 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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39 live-in carers within about an hour of Kent
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Most charge £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
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