Abbotts Barton

Updated 5 September 2017

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 planned 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

The inspection took place on the 11 July 2017 and was unannounced; it continued on the 12 July 2017 and was announced. It was carried out by one inspector and an expert by experience. An expert by experience is a person who has person experience of using or caring for someone who used this type of care service.

Before the inspection we looked at notifications we had received about the service. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive. We also looked at information on their returned 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.

During our inspection we spoke with 15 people who used the service and three relatives. We spoke with the registered manager, the operations manager, clinical manager, quality manager, three nurses, and a specialist dementia nurse visiting the service, four care workers, two activity staff, the chef, two waiters and an administrator. We reviewed nine peoples care files and discussed with them and care workers their accuracy. We checked four staff files, care records and medication records, management audits, staff and resident meeting records and the complaints log. We walked around the building observing the safety and suitability of the environment and observing staff practice.

Updated 5 September 2017

The inspection took place on the 11 July 2017 and was unannounced. The inspection continued on the 12 July 2017 and was announced. Abbotts Barton is a residential nursing home situated on the northern edge of Winchester registered to provide accommodation for up to 60 people. There were 54 people using the service on the days of our inspection. Rooms are over three floors, single occupancy and all have an ensuite with a wash basin and toilet. Specialist bathrooms are available on each level of the home. There are a range of public areas including a lounge on each floor, dining room, library and café. There are communal secure gardens with good access from the building.

The home has a registered manager. 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.

People who were administering their own medicines were placed at an increased risk of harm because risk assessments and reviews were not being completed consistently. Medicines given by staff had been ordered, stored and administered safely including the application of topical creams.

People were supported by enough staff although people told us at times they felt they had to wait too long for help with care. Records showed us that the service had put actions in place that had reduced the length of time call bells were being answered. Staff had been recruited safely and had been given an induction and on-going training and support to enable them to carry out their roles effectively.

People felt safe and were cared for by staff that had been trained to recognise signs of abuse and knew the actions they needed to take if abuse was suspected. Risk assessments relating to peoples assessed risks had been completed and reviewed regularly and actions put in place to minimise risks to people. People had access to healthcare in a timely way and when appropriate.

The principles of the Mental Capacity Act were being followed. People had been supported to make their own decisions and records showed us that when they couldn’t decisions had been made in their best interest. Deprivation of Liberty Safeguards had been applied for when people needed their liberty to be restricted for them to live safely in the home.

Peoples eating and drinking needs were understood by both the catering and care staff including peoples likes, dislikes and any special dietary requirements. Menus provided a choice of nutritious meals and snacks which were available 24 hours a day.

People and their families described the staff as caring, kind and patient. Interactions between people and staff were relaxed and friendly. Staff had a good knowledge of people which enabled effective communication. People felt involved in decisions about their care and told us that they felt their privacy, dignity and independence was respected. A complaints procedure was in place and people felt if they used it they would be listened to and actions taken if possible.

Assessments had been completed and were regularly reviewed with people. The information had been used to create care and support plans which gave clear instructions on how a person wanted to be supported. Activities were available seven days a week and included group events in the home, individual activities specific to a person’s ability and interest and activities in the community.

Staff spoke positively about the organisation and the home and described the Registered Manager as approachable and effective. Communication was described as good and staff had a good understanding of their roles and responsibilities. The home had made links with the local university and was involved in a student nurse mentoring scheme and also provided a preceptorship scheme for newly qualified nurses. A ‘Clinical Excellence Conference’ had been held by the organisation which had focused on nurses continuing development ensuring safe and effective practice.

The home had quality assurance processes in place that led to improvements for people. This included a range of audits at both an operational and home level.