Archived: Abbeyfield - The Dynes

Updated 18 October 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was carried out to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection was carried out on 16 September 2016 and was unannounced. The inspection was carried out by one inspector.

For this inspection we had not asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Before the inspection we looked at records that were sent to us by the registered provider and the local authority to inform us of significant changes and events. We spoke with the local safeguarding team and commissioning team to obtain their feedback about the service.

We looked at four people’s care plans, risk assessments and associated records. We reviewed documentation that related to staff management and agency staff recruitment files. We looked at records of the systems used to monitor the safety and quality of the service, menu records and the activities programme. We also sampled the services’ policies and procedures.

We spoke with six people who lived in the service and one of their relatives to gather their feedback. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with the registered manager, five care staff, and housekeeping as part of our inspection.

At our last inspection in August 2015 the service was rated 'Requires Improvement.'

Updated 18 October 2016

Abbeyfield - The Dynes is a residential care home offering personal care and accommodation to older people and those living with dementia. The service is provided across two floors and is registered to accommodate a maximum of 35 people. There were 35 people using the service at the time of our inspection. The service does not provide nursing care. The service can offer a respite service.

This inspection was carried out on 16 August 2016. One inspector carried out this unannounced inspection.

There was a manager in post who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

At our last inspection, in August 2015, we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches related to the management of risks to people’s safety, infection control, staff skills, meeting people’s health needs, the suitability of the premises and record keeping. The registered manager sent us an action plan detailing the action they would take to become complaint with the regulations. This inspection took place to check that the registered provider had made improvements in these areas. We found that the required improvements had been made.

Risks to people’s wellbeing were assessed and staff knew what action they needed to take to keep people safe. Accidents and incidents were recorded and monitored to identify how the risk of recurrence could be reduced. The service was clean and hygienic. Staff understood how to reduce the risk of infection spreading in the service and they followed safe practice. People were protected by staff that understood how to recognise and respond to the signs of abuse.

Staff had completed in depth training in dementia and we saw that this had positively influenced their practice when caring for people. Staff were knowledgeable about how to meet the emotional needs of people living with dementia and skilled and sensitive in their approach. The décor of the premises had been improved to provide a more stimulating and suitable environment for people living with dementia. People were able to enjoy different themed areas of the service, which provided them with a pleasant living environment and also helped them find their way around the service.

Staff identified and met people’s health needs. Where people’s needs changed they sought advice from healthcare professionals and reviewed their care plan. Records relating to the care of people using the service were accurate and complete to allow the registered manager to monitor their needs. Medicines were stored, administered, recorded and disposed of safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

There were a sufficient number of staff on duty at all times to meet people’s needs in a safe way. The registered provider had systems in place to check the suitability of staff before they began working in the service. People and their relatives could be assured that staff were of good character and fit to carry out their duties.

Staff communicated effectively with people and treated them with kindness and respect. People’s right to privacy was maintained. They promoted people’s independence and encouraged people to do as much as possible for themselves. Personalised care and support was provided at an appropriate pace for each person so that they did not feel rushed. Staff were responsive to people’s needs and requests. Improvements had been made in the skills of staff to meet people’s emotional needs. People were more actively engaged in social activities and tasks than at our last inspection.

Staff understood the triggers to people becoming anxious and how best to respond, but this was not always included in their care plan. We found that people living with dementia did not always have care plans in place to guide staff in responding if they became confused or disorientated either in time or within the premises. We have made a recommendation about this.

The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people’s freedom had been submitted and the least restrictive options had been considered. Staff sought and obtained people’s consent before they helped them. People’s mental capacity was assessed when necessary about specific decisions. When necessary, meetings were held to make decisions in people’s best interest, following the requirements of the Mental Capacity Act 2005.

People had enough to eat and drink and were supported to make choices about their meals. Staff knew about and provided for people’s dietary preferences and restrictions.

People were involved in making decisions about their care and treatment. Clear information about the service and how to complain was provided to people and visitors. The registered provider sought feedback from people and used the information to improve the service provided.

There was a system for monitoring the quality and safety of the service to identify any improvements that needed to be made. The registered provider had a clear and effective improvement plan for the service and had made a number of positive changes since our last inspection.