Abbeycrest Nursing Home is registered to provide accommodation for up to 70 older people who require personal or nursing care. The home has four units of which two provides specialist dementia care. On the day of our visit there were 69 people living in the service.
This was an unannounced inspection on 11 November 2014. At our previous inspection in August 2013 the provider was meeting the requirements of the law in all the standards.
The registered manager has been registered since July 2013. 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 and associated Regulations about how the service is run.
People were kept safe by staff who knew how to identify abuse. There were signs displayed throughout the service informing people and those who represented them of how to raise concerns. The service carried out safe recruitment practices by ensuring relevant checks were undertaken before staff could begin to work. This meant people were protected from receiving unsafe or inappropriate care, treatment and support. Risk assessments were put in place to manage identified risks and clearly showed what actions staff should take to minimise the risk of harm and injury to people. These were regularly reviewed and updated. There was sufficient staff to meet people’s needs. We observed call bells were responded to in prompt manner. Medicines were safely managed and regular checks were undertaken to ensure the building and safety procedures such as checking fire exits and carrying out fire drills regularly occurred.
People received care, treatment and support from staff who were supported effectively in their jobs roles. Staff spoke positively about their learning experience and told us they were clear about the requirements of the job roles. This was supported in staff records which evidenced they had received regular supervision, appraisals and had undertaken relevant training.
Procedures were in place to ensure there was staff with the right skills to meet people’s individual needs. The service acted in accordance with the Mental Capacity Act 2005 (MCA) and the Deprivation of (DoLS). This meant people who may lack capacity to make specific decisions were protected and authorisation was sought before people were lawfully deprived of their liberty. Care records evidenced people giving consent before care, treatment and support was delivered.
People told us they had a positive experience in regards to food. We observed people were supported to have enough to eat and drink and were offered a wide variety to choices. Staff were engaged with people throughout the lunch time period and had good knowledge of people’s food preferences. The food on offer was prepared by staff who were trained and knew how to make nutritional healthy meals. There were effective measures in place to support people who were at risk of malnutrition or who had specialist dietary needs. This included the involvement of nutritional specialists and other relevant health professionals. The chef had recently been recognised by the organisation for their work.
People spoke positively about the care they received and were supported by staff who had good knowledge of their care, treatment and support needs. Care was planned around people’s choices and personal preferences. This was observed during our visit and evidenced in care records reviewed. We observed people being treated in a respectful and dignified manner with care needs being met with consideration and patience. We saw staff calming and re-assuring people who were confused and distressed with sensitivity and kindness. Observational records showed the service monitored staff practices to ensure people were being cared for appropriately.
People received care that was responsive to their needs. People told us they were listened to. This was supported by care records which showed people and those who represented them were involved in identifying what their care and support needs were. This covered areas such as, likes, dislikes, cultural, religious and spiritual support required. Care plans and risk assessments were regularly carried out, up to date and reflected people’s changing needs.
Informal meetings took place with people and management. This gave people the opportunity to talk in a relaxed environment about any ideas or concerns. A review of meetings notes showed discussions held and actions taken.
People told us the service dealt with their complaints satisfactorily. A review of complaints register showed all complaints were investigated and appropriate action taken.
The service ensured people received consistent co-ordinated, person centred care when they moved between different services. This was evidenced in hospital transfer information sheets completed for people being admitted into hospital.
People were supported to follow their interests. A range of activities were on offer to meet people’s social needs. The service had a structured program to improve people’s well-being through outdoor activities. For example a pathway was constructed from the home to a nearby park to give people easy access. The service’s ‘Make a Wish’ project was established to enable people to do things they had always wanted to.