Archived: Abbeygate Care Centre

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who use the service, the staff supporting them and from looking at records. We looked at four people's care records.

Is the service safe?

People we spoke with told us they felt safe and comfortable living at the service. One person who used the service told us, "I'm very happy here and the staff looks after me very well'. A visiting professional told us, 'The staff are capable and competent, they do make sure they report any concerns with people's health'.

We found that improvements had been made to ensure that people's mental capacity was assessed and included in their care plan. This meant that staff had access to information about people's ability to make daily decisions. Staff we spoke with told us where people lacked capacity to give their consent verbally they would use their knowledge of the people or speak to people's relatives in deciding what was in the best interests of people. We found that staff had guidance in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). This is legislation that makes provision relating to people who lack capacity, and how decisions should be made in their best interests when they do so. At the time of our inspection no applications had needed to be made.

Some people required the use of bedrails to prevent them from falling from their bed. There was no record that people or their representatives had consented to the use of this equipment. There was no record of the reasons for the use of the equipment to ensure that this was the most suitable and safe method for them.

We saw that records for the management and review of risks to people's health were not always up-to-date. For example people at risk of falls or weight loss did not have their risks reviewed and recorded consistently to identify the action necessary to reduce the risk.

The provider had a system in place to ensure that the frequency of people falling was reviewed. However the falls analysis did not identify trends or patterns so that falls could be reduced. The analysis of falls was six monthly which meant people could have a number of falls before patterns or trends were reviewed. The provider had not considered utilising the services of the falls clinic to source help and advice to reduce falls or look at for example the times that individuals were more likely to fall. This is important so that managers and staff learn from events such as accidents and incidents, to reduce the risks to people and help the service to improve.

There had been improvements to the management of infection control. There were no apparent risks present when we looked around the home and we found the environment was visually clean. People we spoke with told us they were satisfied with the cleanliness of the building. One person told us, 'My room is lovely always fresh and clean'. A visiting relative told us, 'I think it is a lovely home, clean, homely and smells really nice'.

Is the service effective?

One visitor said, 'The care is always discussed with me and I see the care plan. I think they manage my (relative) health needs very well as there has been changes'.

We found that care plans and risk assessments were in place but not all had been updated so that they reflected people's current needs. People who used the service, relatives and visiting professionals did tell us that they were happy people's needs were met. However information was not always consistently updated to show people's needs were reviewed and their care was effectively planned.

We saw the service cooperated with others such as the visiting health professionals. This meant that staff took into consideration external professional advice in order to promote people's health and wellbeing with regard to the risk of pressure sores. We saw people had the correct equipment to meet their health care needs.

We saw staff supporting people at risk of not eating enough. People who used the service told us the food was good. We saw that care plans provided staff with some guidance to meet people's personal choices or routines of the day.

Is the service responsive?

We observed staff interacting with people and saw that these interactions were positive and caring. People were complementary about the staff. One person told us, 'The staff are very caring they can't do enough'. We saw some people engaging in a singing activity and one person told us, 'We like chatting, bingo and board games'. We saw that staff spent time with and talked with people with more complex needs such as dementia.

People we spoke with said they were not kept waiting for assistance and we saw staff were responsive to people's needs. Staff told us, 'We only have twelve people here so it's nice the staff levels have not been reduced'. Staff told us there was enough staff to meet people's needs and we saw they were organised so that a staff member was always present in the lounge to respond to people.

Is the service well-led?

The service has a registered manager who is also the provider. Compliance actions had been issued at our previous inspection to this service. At this inspection we saw that improvements had been made in relation to assessing people's capacity. We saw that people who used the service were protected from the risk of infection because staff were following infection control procedures and the provider had implemented infection control systems to ensure a clean and hygienic environment.

However we found at this inspection that people were not always protected from the risks of unsafe or inappropriate care because accurate and appropriate records were sometimes not maintained. People received the care that they needed but there was a continuing issue with the update and management of people's records.

People's consent was sought before staff provided care and support.

We found that care plans did not provide staff with sufficient information to ensure people's care and treatment needs were met. However, the care staff we spoke with demonstrated a good understanding about how to care for people. One person we spoke with told us, 'I am happy here and my needs are met.' Another person told, 'I am satisfied with the care I receive.'

We found that arrangements were not effective in reducing the risk and spreading of infection.

We found that appropriate checks had been undertaken before staff began to work at the home. This meant that suitable staff were being employed to provide care and support for people.

People and staff we spoke with told us that they felt able to raise concerns about the service. Complaints were investigated and resolved as far as was practicable to the satisfaction of people using the service.

People's dignity and independence were respected. We saw staff provided people with care in a way that meant they were able to make choices about their daily routines. A visitor told us that the 'staff involve in every aspect' and kept them up to date in respect of their relative's well being.

People's needs were assessed but care was not always planned and delivered in line with their individual care plan. Staff told us that they recognised the symptoms of poor health and when to respond. This meant staff knew how people's health should be promoted and when other health care services should be contacted.

We saw staff provided care for people in a positive manner but we saw some occasions where staff had not followed people's care plans. This meant that safe care was not always promoted.

Two staff we spoke with told us that they knew what abuse was and how this should be reported. We spoke with one person and four visitors who felt that people were safe.

We spoke with one person who told us that they 'get on very well 'with staff. One visitor told us that the staff were 'always cheerful, obliging' and 'very friendly' which meant there was 'a nice atmosphere'.

Two staff told us they were 'very well supported' by the provider.

The provider sought people's opinions and acted upon them. This meant that people were satisfied with the service that they received.