Archived: Abbey Care Home

Abbey Care Home accommodates 20 people in one adapted building. The accommodation is arranged over two levels. All bedrooms had en-suite toilet facilities with a shared bathroom on each floor and a shower room on the ground floor. We inspected the service on 7 August 2017. This was an unannounced inspection. There were 14 people living at the service at the time of our inspection.

The service had 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.

At the last inspection on 24, 30 and 31 August 2016 we found two breaches of the Health and Social Care Act 2008 (regulated activities) Regulations 2014. We asked the provider to take action to make improvements relating to infection control practices, risk assessment, risk of harm when moving around the service and meeting peoples individual needs by the design and decoration of the service. These actions had been completed.

People told us they felt safe using the service and their relatives agreed. Staff received training to protect people from the risk of abuse, had appropriate guidance and knew how to report safeguarding concerns. Recruitment checks were in place to ensure new staff were suitable to work at the service. There were enough staff available to meet the needs of people using the service.

Risk assessments were completed and management plans put in place to enable people to receive safe care and support. Staff had good understanding about infection control procedures and used personal protective clothing such as aprons and gloves to prevent the spread of infection. There were systems in place to manage people's medicines so they received them when needed.

There were effective systems in place to maintain the safety of the premises and equipment. Lessons were learnt when accidents and incidents occurred to minimise the risk of reoccurrence.

People’s needs were assessed before they began using the service and they had access to healthcare professionals as required to meet their needs. Personalised care plans were in place and reflected people’s needs and were updated regularly.

Staff knew people they were supporting including their preferences to ensure personalised care was delivered. People were offered a choice of nutritious food and drink to maintain good health.

Staff had a good understanding of how to promote people’s privacy, dignity, independence and choice. Staff had a clear understanding of the application of the Mental Capacity Act 2005 and appropriate applications for Deprivation of Liberty Safeguards authorisations had been made.

Staff received regular supervision, annual appraisals and training in line with the provider’s policies to ensure they had the qualifications, skills and experience to support people using the service.

People using the service and their relatives told us the service was caring and we observed staff supporting people with kindness, in a caring and respectful manner. Staff protected people’s privacy and dignity and encouraged independence. People and their relatives knew how to make a complaint, however they told us they had not needed to.

People, their relatives and staff spoke positively about the registered manager. Staff had positive views about the leadership and staff culture of the service. The service had systems in place to seek the views of people and their relatives regarding the quality of the service. Quality monitoring systems were in place to identify areas of improvement.

The service had a manager who had been at the service for five months at the time of our inspection and was awaiting the outcome of her application to become the registered manager of the service. 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 inspected Abbey Care Home on 24, 30 and 31 August 2016. This was an unannounced inspection. At this inspection we found two breaches of the Health and Social Care Act 2008 (regulated activities) Regulations 2014 regarding infection control and premises.

The service was not always safe. People were at risk of harm when moving around the service. Staff did not always adhere to safe infection control practices. Risk assessments for people using the service were not always up to date.

The service was not always effective. The premises were in a poor decorative state. People told us they wanted more meal choices.

The service was not always responsive. peoples care plans were not always detailed. People told us there were not enough activities at the service they enjoyed taking part in.

The service was not always well led. Systems in place did not effectively monitor the quality of the service.

Staff received up to date training, supervision and appraisal. Staff had a good understanding of application of the Mental Capacity Act (2005). Staff had positive views about the leadership and staff culture of the service. People using the service and their relatives told us they found the manager to be approachable. Systems were in place to monitor the quality of the service.

People and their relatives told us they felt safe using the service. Staff knew how to report safeguarding concerns. Medicines were managed and administered safely. There were up to date systems in place to maintain the safety of the premises and equipment. We found recruitment checks were in place to ensure new staff were suitable to work at the service.

Appropriate applications for Deprivation of Liberty Safeguards had been made and authorised. People using the service had access to healthcare professionals as required to meet their needs.

Staff knew the people they were supporting. People using the service and their relatives told us the service was caring. Staff respected people’s privacy and encouraged independence. People and their relatives knew how to make a complaint. The service enabled people to maintain links with their culture and religious practices.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

This is a summary of what we found.

Is the service safe?

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People we spoke with told us they felt safe living in the home. We observed how people were supported by the staff. We saw staff treating people with respect and dignity.

People's individual files indicated risks to the person and how these could be minimised to ensure that they were supported as safely as possible. Staff had received training in relation to safeguarding of vulnerable adults, the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

Is the service effective?

People's needs were assessed and care and support was planned and delivered in a way that was intended to ensure peoples safety and welfare. We found that care plans were in place and included information about how to meet people's assessed and individual needs. Staff we spoke with had a good understanding of the individual needs of people. We saw assessments done to ensure people had capacity to consent to care and treatment.

Is the service caring?

People's views and experiences were taken into account and this informed how their care was delivered. Care records showed people had been involved and consulted about their care. People told us they felt happy and safe living at the home. One person said, 'The staff are so caring, I have settled in very quickly and it's such a nice place.'

Is the service responsive?

People's needs were assessed and care was delivered to meet their individual needs. We looked at seven care files. These provided information about people's needs. Care plans gave guidance for staff about how they should meet people's needs. Daily notes showed that people were being cared for and taking part in meaningful activities.

Is the service well led?

The service had a registered manager in place and a clear management structure. Staff we spoke with told us they found the management staff to be approachable and accessible. One person said, 'The management is great, professional, very hands- on and supportive and ready to teach you.' Staff received the support and guidance needed to carry out their duties and to meet people's needs. There were enough staff on duty to care for people living in the home.

Quality assurance and monitoring processes were in place. These included seeking the views of people who used the service.

People who use the service and their relatives were satisfied with the care and support provided at the service. One family member said " all the staff are very friendly, they know my dad and what he does and likes." Another person told us, "I always get a phone call if there is the slightest concern. They tell me everything." People were supported to access health and social care professionals when required with their consent. People who use the service and their families told us they were involved in making decisions around their care and support planning. However, we found that where people did not have capacity to consent, the provider had not acted in accordance with appropriate guidance on consent.

Staff told us they received appropriate training and support from the management team to carry out their roles.

People told us that they felt safe with the staff and they would raise any complaints or concerns with the manager or their relative or friend.