CQC report explained · a nursing home
What the CQC found at Park Avenue Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured about infection prevention and control. This included testing, protective equipment, cleaning, visitor arrangements, admissions and plans for preventing or managing outbreaks.
- Effective?
- Good
- Does the care work? Training, consent, food and drink, working with GPs and nurses.
- Caring?
- Good
- Are people treated with kindness and dignity?
- Responsive?
- Good
- Is care built around the person? Care plans, activities, complaints.
- Well-led?
- Good
- Is the home run well? The manager, the culture, how problems get found and fixed.
What inspectors found, February 2021
Park Avenue Care Home was inspected but not rated; inspectors found strong COVID-19 infection-control arrangements.
This was an announced, targeted inspection on 21 January 2021. It looked at how the home was preventing and controlling infections during the coronavirus pandemic.
Inspectors were assured that the home was using personal protective equipment safely, arranging testing, managing visitors and admissions, and keeping its infection-control policy up to date. They also found enhanced cleaning, trained staff and detailed infection-control risk assessments.
The home supported contact with families through visits where restrictions allowed, telephone calls, video calls and online relatives' meetings. The inspection was marked 'Inspected but not rated', so it did not provide an overall quality rating.
Testing and vaccination
The home had arrangements to test people and staff, with trained staff carrying out tests. People and some staff had received a first vaccine dose.
“The home had arrangements in place to test both people and staff for COVID-19, in line with the current guidelines on testing.” from the report
Cleaning and hygiene
Housekeeping staff had infection-control training and there was extra cleaning of frequently touched areas. Inspectors observed that the home was clean and well kept.
“We observed that the home was very clean and well kept.” from the report
Visiting arrangements
The home had visitor guidance, booked visits, protective equipment and a dedicated visiting room when restrictions allowed. Staff supported visits and cleaned the visiting area between visits.
“Visits were booked in advance, personal protective equipment (PPE) provided and staff cleaned the visiting area between each visit.” from the report
Keeping families in touch
People were supported to stay in contact with relatives by telephone and video calls. Online relatives' meetings allowed families in other countries to join.
“Links with families were maintained through regular communication and relatives' meetings held on line” from the report
Inspectors raised no specific concerns in this report.
- 01How have your COVID-19 testing arrangements changed since the inspection on 21 January 2021?
- 02What visiting arrangements are currently available, and how do you support people who cannot understand social distancing?
- 03How do you make sure staff use personal protective equipment safely and follow infection-control training?
- 04How often are high-touch areas such as door handles, key pads and hand rails cleaned?
- 05What is your current plan for preventing or managing an infection outbreak?
This was a targeted inspection of infection prevention and control under the Safe question; the service was inspected but not rated overall. This explanation was written from the published report of 4 February 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, December 2019
Park Avenue Care Home was rated Good; inspectors found kind, safe care and major improvements, with some staff training and record-keeping still being addressed.
This was an unannounced inspection over two days. Inspectors spoke with people, relatives and staff, observed care, reviewed care plans and other records, and contacted health professionals.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines management, personalised care, kind staff and good access to activities and healthcare.
There were some shortfalls. Staff did not always follow one person's safe eating plan, some staff were not yet clear about fire evacuation, essential training was not fully up to date, and some mental capacity records were incomplete.
The previous rating was Requires Improvement, published in November 2018. Inspectors found that improvements had been made in activities, leadership and management, and that the provider was no longer breaching regulations.
Improved leadership
Families and staff described major improvements in communication, morale and management since the new registered manager arrived.
“The home is transformed and thriving. Previously there was no leadership in place. We are kept very well informed and I no longer worry.” from the report
Kind and respectful care
Staff knew people well and supported their privacy, dignity, choices and independence.
“We observed staff knew people well and interacted warmly with them.” from the report
Safer medicines
Medicines were stored, administered and monitored safely. Staff had training and competency checks.
“Medicines were managed, administered and stored safely.” from the report
Activities and engagement
The home had appointed lifestyle coordinators and introduced a wider range of activities, including trips, pet therapy and music.
“People and their relatives were all enthusiastic about the range and level of activities now offered and improvements made by the new registered manager.” from the report
Learning from problems
The home used audits, incidents, complaints and feedback to identify improvements and share learning with staff.
“The registered manager had created a robust system to identify and share learning.” from the report
Safe eating practice
seriousStaff did not follow one person's care plan about safe positioning during a meal. Inspectors said this created a possible choking risk, although the manager acted during the inspection.
“However, for one person, we observed staff did not follow their care plan to ensure they were positioned safely to eat their meal which posed a possible risk of choking.” from the report
Fire procedure knowledge
needs fixingNot all staff understood the fire evacuation process when inspectors spoke with them. Training was being provided during the inspection.
“Not all staff we spoke with were aware of the fire evacuation process” from the report
Training still being completed
needs fixingEssential staff training was not fully up to date, although the manager had plans to address the remaining gaps.
“Staff training was not fully up to date across areas the provider considered essential.” from the report
Mental capacity records
needs fixingSome mental capacity assessments and best-interest decisions were not fully or clearly recorded. The manager introduced revised records during the inspection.
“For one person recently admitted to the home we found MCA assessments had not always been fully recorded but this was addressed at the inspection.” from the report
- 01How do you check that staff follow each person's eating, drinking and choking-risk plan at every meal?
- 02How many staff have now completed the essential training that was outstanding at the inspection?
- 03How do you make sure every member of staff understands the fire evacuation process, including night staff?
- 04How are mental capacity assessments and best-interest decisions recorded and checked for completeness?
- 05How do you monitor whether all residents, including people cared for in bed, receive activities suited to their interests and abilities?
This was an unannounced planned inspection covering all five CQC questions, the premises and the care provided; it followed the previous Requires Improvement rating. This explanation was written from the published report of 12 December 2019 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 Park Avenue Care Home
5 rated inspections over 4 years: the service has held its Good rating throughout.
- February 2021Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- December 2019Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2018Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2016Goodstayed GoodEffective: Good
- April 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 14 December 2010.
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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