Archived: Abbeville Residential Care Home

Updated 2 December 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 checked 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.

This inspection took place on 25 September 2017 and was unannounced. The inspection team consisted of three inspectors, one of whom specialised in medicines and an expert-by-experience.

An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before we carried out the inspection we reviewed the information we held about the service This included statutory notifications that the provider had sent us over the last year. A statutory notification contains information about significant events that affect people's safety, which the provider is required to send to us by law. We also liaised with the local authority.

Before the inspection, the provider completed a 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. We also contacted the local authority for their views on the service.

During our inspection we spoke with seven people and a relative of another person living in the home. We also spoke with the manager, the provider, two care staff and the cook. We viewed the care records for three people in depth, records relating to incidents for seven people and the medicines records for all 20 people living in the home. We also looked at records in relation to the management of the home. These included the recruitment files for three staff members, staff training records, compliments and complaints, quality monitoring audits and minutes from meetings held.

Updated 2 December 2017

This inspection took place on 25 September 2017 and was unannounced. At the time of this September 2017 inspection there were three breaches of regulations outstanding from our previous comprehensive inspection of April 2017 and an urgent focused inspection of August 2017. These breaches related to supporting people with social engagement, safety relating to medicines administration and infection control and governance arrangements. This September 2017 inspection found that no progress had been made in these matters and that the provider remained in breach of these regulations.

In addition the provider was further found to in breach of regulations relating to supporting people nutritionally, adherence to the Mental Capacity Act 2005, dignity and respect and the reporting of notifiable incidents to the Care Quality Commission (CQC).

Abbeville Residential Care Home provides accommodation and care for up to 38 older people, some of whom may be living with dementia. At the time of this September 2017 inspection there were 20 people living in the home.

There was a manager in post who told us that they were in the process of applying for registration. 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 found that people were not always receiving their medicines as prescribed for them and found a number or errors over and above what the service had identified themselves. One of these related to the administration of warfarin, a high risk medicine. These errors put people’s welfare at risk.

The infection control issues we found at our previous inspection in August 2017 had not been addressed. People’s bedding was often unclean. This put them at risk of infection spread by cross contamination. We found unsecured toilet seats, which again had been an issue at our previous inspection.

Where risks to people’s welfare were identified, appropriate follow up actions were not always taken.

Improvements had not been made since our inspection in April 2017 in the assessment of people’s mental capacity to make their own decisions. The same issues remained.

Some people’s meal time experiences were poor. Two people were not suitably positioned to enable them to eat comfortably. One person, who required significant support and encouragement with their nutrition did not receive this.

Some people reported that their preferences for support to be provided in a specific way were disregarded and that some staff was not respectful towards them.

The service did not provide sufficient support for people to engage with others or to follow their own interests or hobbies. This had been a long standing problem at the service that not been addressed.

The provider’s quality assurance systems had not helped ensure that people received a good standard of care and support.

The provider has experienced considerable difficulty in making improvements at this service since 2015. In April 2017 we found that whilst a few concerns remained the provider had made significant improvements. Whilst the service had been in ‘special measures’ from December 2015 to April 2017 the provider had been unable to sustain and build upon the improvements we found in our inspection of April 2017. Consequently, this service has returned to special measures.

The overall rating for this service is ‘Inadequate’ and the service is therefore ‘special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.