Background to this inspection
Updated
22 October 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This inspection was carried out by one inspector.
Service and service type
Abbeyfield Deben Extra Care Society Limited is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with six people who used the service and one relative about their experience of the care provided. We spoke with eight members of staff including the registered manager, assistant manager, one team leader, three care staff and two members of the catering staff. We observed the interactions between staff and people using the service throughout our inspection visit.
We reviewed a range of records. This included five people’s care records and multiple medicines records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including training and audits were reviewed.
Updated
22 October 2019
About the service
Abbeyfield Deben Extra Care Society Limited is a residential care home providing personal care for up to 24 people in one adapted building. At the time of our inspection there were 22 people living in the service. The service does not provide nursing care.
People’s experience of using this service and what we found
There were systems to assess and mitigate the risks of avoidable harm and abuse. People received their medicines when they needed them, and medicines were managed safely. There were enough staff to meet people’s needs and safe recruitment processes were undertaken. Infection control processes in place, helped to reduce the risk of cross infection.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were supported by staff who were provided with training to meet their needs. People’s dietary and health care needs were assessed and met. Where concerns about people’s health were identified, they were supported to have access to health care services. The environment was well maintained and accessible for the people who lived there.
People were cared for by kind and considerate staff. People were consulted about the care they were provided with and their choices were acted on. People’s rights to privacy, independence and dignity were met.
People’s care needs were assessed, planned for and met. People’s choices about their end of life decisions were documented. People had access to social activities to provide stimulation and reduce the risks of loneliness and isolation. There was a complaints procedure in place and complaints and concerns were addressed.
There were systems to assess and monitor the service people received. This helped the management team to identify and address shortfalls. People’s views were sought about the service and these were used to drive improvement.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 12 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Abbeyfield Deben Extra Care Society Limited on our website at www.cqc.org.uk.
Enforcement
Since the last inspection in February 2017 we have prosecuted the registered provider for an offence under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 12(1) refers to failure to provide safe care or treatment resulting in avoidable harm to person using a service or exposes a service user to a significant risk of exposure to avoidable harm. Prior to our last inspection a person fell down stairs at the service and died. The registered provider pleaded guilty and were fined at Magistrates court in September 2019. Our previous inspection of 23 February 2017 (published 12 April 2017) was prompted in part by this incident. Because the incident was subject to a criminal investigation and as a result the previous inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk related to the environment. At that inspection we examined those risks and found the service had assessed and mitigated the risks of avoidable harm.
The 2014 Regulations make it a criminal offence to fail to comply with Regulation 12(1) where the failure to provide safe care or treatment results in avoidable harm to a service user or exposes a service user to a significant risk of exposure to avoidable harm. The 2014 Regulations took effect on 01 April 2015 and coincided with a transfer of enforcement responsibility for health and safety incidents in the health and social care sector from the Health and Safety Executive and local authorities to CQC.
At this inspection of 1 October 2019, we checked that people were safe and found the service assessed risks to people and took sufficient action to reduce the risks.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.