Abbey House

Updated 27 February 2024

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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 2 inspectors and an Expert by Experience on site. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. A further inspector provided remote support by making calls to staff.

Service and service type

Abbey House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Abbey House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We sought feedback from the local authority contracts monitoring team and reviewed the information they provided. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people who use the service and 4 family members to share their experiences of care received. We also spoke with 8 staff members including the registered manager, operations manager, deputy manager, senior care workers, care worker, activities coordinator and housekeeper.

We reviewed a range of records. This included 9 care records, 3 staff files in relation to recruitment and supervision, and multiple medication records. A variety of records relating to the management of the service, including policies and audits were reviewed.

Updated 27 February 2024

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

About the service

Abbey House is a residential care home providing personal care to up to 37 people. The service provides support to older people, some of whom are living with dementia and learning disabilities. At the time of our inspection there were 32 people using the service.

People’s experience of using this service and what we found

Right Support:

Medicines were not always managed safely. We found concerns with transdermal patch medication administration records. There were not always enough staff to meet people’s needs. People told us, and call bell audits demonstrated, people were waiting for prolonged periods of time for support. Some staff training was not up to date or completed. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Safe recruitment processes were followed

Right Care:

Infection prevention and control measures were not always robust, we identified multiple cushion covers and mattress covers to be soiled. People were not always supported in a person-centred way. People were safeguarded from the risk of abuse. Appropriate Deprivation of Liberty Safeguards (DoLS ) applications were in place for people. Staff knew people well; they had a good understanding of people's needs and the support they required.

Right Culture:

Quality assurance systems and service oversight was not always effective. Actions taken to drive improvements were not always effective. People using the service and their relatives found the registered manager to be approachable. The service sought the views of staff and people using the service. People told us they enjoyed the activities within the service. Staff felt supported by the manager.

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.

Why we inspected

The inspection was prompted in part due to concerns received about staffing, people’s needs not being met and the maintenance of the premises. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Abbey House on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to dignity, safe care and treatment, governance and staffing at this inspection.

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

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.