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Abbey House Residential Care Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 17 January 2017

Abbey House provides accommodation for up to 23 older people. The service is intended for older people, who may be living with a physical disability, sensory impairment or a dementia type illness.

This inspection took place on 4 and 6 October 2016 and was unannounced. There were 18 people living at the home at the time of the inspection.

We last inspected this service on the 28 November 2013 and found that the service was meeting the requirements of the regulations we inspected at that time.

The service did not have a registered manager in post; the last registered manager left the service and de-registered with the Care Quality Commission (CQC) in April 2015. A new manager had been appointed in August 2015 and was in charge of the day to day running of the service and managing staff. The manager intended to register with the Care Quality Commission but at the time of the inspection an application had not been submitted. 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 and relatives said overall Abbey House was a safe place. One person said, "I feel safe here...no one is horrid...” However, we found some shortfalls that could potentially impact on people’s safety and well-being.

Not all aspects of medicines management were safely dealt with. However most people received their prescribed medicines when they needed them.

There were not always enough staff to meet people’s individual needs. Staffing arrangements were not flexible to provide additional cover when needed, for example, during staff sickness and holidays.

Menus offered a balanced and varied diet for people; however the majority of people did not like the food. The manager and registered provider were aware of people’s views in relation to food and additional tasting and menu planning sessions had been arranged.

Not all risks relating to people’s care and support had been identified and responded to in a timely way. Guidance to show staff how best to support people whose behaviour may challenge them was not up to date and did not always reflect people's needs.

People were complimentary about staff’s approach and manner. They said staff were kind and caring. A relative said, “The staff are delightful.” However, staff did not always maintain people’s privacy and confidentiality.

Staff completed induction training when first in post which was based on nationally recognised standards and they spent time working with experienced staff to build their confidence and competence. Various training was provided for staff related to their roles. However, not all staff had completed the relevant training to ensure they had the ability to meet the more complex needs of some people. For example, how to manage long term conditions such as diabetes; or manage behaviour which may challenge the service.

The provider did not have effective quality assurance checks in place to monitor the quality of the service and drive improvement. The provider had not identified the areas for improvement we noted during our inspection. Staff felt the service was well-run by the manager and provider and said there had been improvements at the service since the manager was appointed. People felt the management team were approachable. The manager was aware of many of the areas which needed improvement. A deputy manager had recently been appointed. They would be assisting the manager with the running of the home.

People, or their representatives, were not routinely involved in planning and reviewing their care. Personalised care was not always provided as some people's care plans were out of date or contained inaccurate information. However the manager and staff were aware of people's care needs, which reduced the risk.

Staff understood their responsibility to protect people from the risk of abuse and were confident the manager and provider would act on any concerns.

People knew how to make a complaint. They said if they had a problem or concern they would speak with the manager or staff. Relatives also knew how to make a complaint. Complaints had been investigated and resolved by the manager.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Inspection areas

Safe

Requires improvement

Updated 17 January 2017

The service was not always safe.

There were not always enough staff to meet the needs of people who used the service.

Risks to people's health and safety were not being adequately identified and addressed in a timely way.

Not all aspects of medicines were safely managed.

Staff had a good understanding of safeguarding and how to report concerns.

Most aspects of staff recruitment were safe and ensured people were protected from unsuitable staff.

Effective

Requires improvement

Updated 17 January 2017

The service was not always effective.

The principles of the MCA were followed and staff obtained people’s consented to their care before they provided it. However, not all staff understood the principles of the MCA as they had not received appropriate training.

Parts of the environment were in need of refurbishment.

The meals offered were varied and nutritious but the majority of people reported they did not like the food on offer.

People were supported to access other health care services whenever this was required. However, recommendations from professionals were not always implemented in a timely way.

Caring

Requires improvement

Updated 17 January 2017

The service was not always caring.

Staff were caring towards people and we observed positive interactions with some staff. However, staff did not always have sufficient time to interact with people except when receiving care.

Staff did not always maintain people’s privacy and confidentiality.

Responsive

Requires improvement

Updated 17 January 2017

The service was not always responsive to people's needs.

Some care plans lacked up to date information about people’s needs, meaning staff did not always have the information they needed to provide personalised care.

Activities for people were limited and care staff did not have the time to support meaningful activity at the service.

Complaints had been taken seriously by the manager and had been resolved to the satisfaction of the complainant.

Well-led

Requires improvement

Updated 17 January 2017

The service was not always well led.

There was no registered manager at this service. A manager had been appointed but had not submitted an application to be registered.

The provider did not have an effective system for monitoring the quality of the service and driving improvement. Records relating to the care and treatment provided to people and running of the service were not always accurate or up to date.

People and their relatives said the management team at the service were approachable.