Aveley House provides personal care and support to adults who live in their own homes in the geographical areas of Rochford, Rayleigh, Castle Point, Basildon, Harlow and surrounding areas. It is a large service and employs over 350 staff.

The service has a registered manager 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.

We carried out an unannounced comprehensive inspection of this service on 28 September 2015. A breach of legal requirements was found as people who used the service were not protected by safe medication procedures and there were issues around the safe administration and recording of people’s medication.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach and also improvements they were to make. We undertook a comprehensive inspection over a number of days and this included 4, 5, 17, 24 and 26 October and 9 November 2016 to check that they had followed their plan and to confirm that they now met the legal requirements. During our visit we found that safer systems were in place to assist people with the management of their medication and to help ensure people received their medication as prescribed. Robust quality assurance systems had also been introduced to monitor people’s medication and take appropriate action when needed.

Staff showed a good knowledge of safeguarding procedures and were clear about the actions they would take to help protect people. Risk assessments had been completed to help staff to support people with everyday risks and help to keep them safe.

Recruitment checks had been carried out before staff started work to ensure that they were suitable to work in a care setting. Staff told us that they felt well supported to carry out their work and had received regular supervision and training.

There were generally sufficient numbers of staff, with the right competencies, skills and experience available to help meet the needs of the people who used the service, but this needed to be monitored continually.

Where needed people were supported to eat and drink sufficient amounts to help meet their nutritional needs and staff knew who to speak with if they had any concerns around people’s nutrition. People were supported by staff to maintain good healthcare and were assisted to gain access to a range of healthcare providers, such as their GP, dentists, chiropodists and opticians.

People had agreed to their care and been asked how they would like this to be provided. People said they had been treated with dignity and respect and that care staff provided their care in a kind and caring manner. Assessments had been carried out and care plans had where possible been developed around each individual’s needs and preferences.

The Care Quality Commission monitors the operation of the Mental Capacity Act (MCA) 2005 and are required to report on what we find. The MCA sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. The DoLS are a code of practice to supplement the main MCA code of practice. The registered manager had a good understanding of MCA and mental capacity assessments had been requested from the appropriate government body where people were not able to make decisions for themselves.

People knew who to raise complaints or concerns to. The service had a clear complaints procedure in place and people had been provided with this information as part of the assessment process. This included information on the process and also any timespan for response. We saw that complaints had been appropriately investigated and recorded.

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Those people spoken with said they had been part of the assessment and care plan process and their choices had been taken into consideration. They added that they had been able to make decisions about their care and how they wanted this to be provided.

People using the service told us that they had had contact with management and that they were able to express their views about the service.

They had been made aware of the complaints procedure and confirmed they had received written documentation during the assessment.

There were systems and procedures in place to help staff identify concerns and respond appropriately to the signs and allegations of abuse. One person reported “to know she was at ease with them (staff) coming in and out was a great help to all of us.”

People we spoke with were complimentary about the service and made positive comments. Comments taken from the provider’s quality assurance included “All the carers that have tended to ‘X’s’ needs have been of the highest quality and professionalism,” “Due to the professionalism, efficiency and caring of your carers my health both physically and mentally has improved. I now feel able to make a step towards independence and a more normal life” and “I am writing to express my grateful thanks for all you kindness, help and support you and your staff have shown in their excellent care of ‘X’.”

This inspection took place over a number of days and included September 28, 29 and 5, 6 and 8, 26 and 30 October 2015.

Aveley House provides personal care and support to adults who live in their own homes in the geographical areas of Rochford, Rayleigh, Castle Point, Basildon, Harlow and surrounding areas. It is a large service and employs over 400 staff.

The service has a registered manager 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.

Safe systems were not always in place to assist people with the management of their medication or to help ensure people received their medication as prescribed.

Staff showed a good knowledge of safeguarding procedures and were clear about the actions they would take to help protect people. Risk assessments had been completed to help staff to support people with everyday risks and help to keep them safe.

Recruitment checks had been carried out before staff started work to ensure that they were suitable to work in a care setting. Staff told us that they felt well supported to carry out their work and had received regular supervision and training.

There were generally sufficient numbers of staff, with the right competencies, skills and experience available to help meet the needs of the people who used the service.

Where needed people were supported to eat and drink sufficient amounts to help meet their nutritional needs and staff knew who to speak with if they had any concerns around people’s nutrition. People were supported by staff to maintain good healthcare and were assisted to gain access to a range of healthcare providers, such as their GP, dentists, chiropodists and opticians.

People had agreed to their care and asked how they would like this to be provided. People said they had been treated with dignity and respect and that staff provided their care in a kind and caring manner. Assessments had been carried out and care plans had where possible been developed around each individual’s needs and preferences.

The Care Quality Commission monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and are required to report on what we find. The MCA sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. The DoLS are a code of practice to supplement the main MCA code of practice. The registered manager had a good understanding of MCA and DoLS and mental capacity assessments had been requested from the appropriate government body where people were not able to make decisions for themselves.

People knew who to raise complaints or concerns to. The service had a clear complaints procedure in place and people had been provided with this information as part of the assessment process. This included information on the process and also any timespan for response. We saw that complaints had been appropriately investigated and recorded.

The service had an effective quality assurance system and had regular contact with people who used the service. People felt listened to and that their views and opinions had been sought. The quality assurance system was effective and improvements had been made as a result of learning from people’s views and opinions.