About the service Abbot Care Home is a care home providing personal and nursing care to up to 117 people some of whom may be living with dementia. At the time of our inspection there were 102 people using the service. The service is set across 3 floors in 1 adapted building.
People’s experience of using this service and what we found
Our visit on the 29 August 2023 found poor infection prevention and control (IP&C) practices relating to the cleanliness of the premises and equipment which needed to improve. The provider took immediate action. Our follow up visit on the 4 September 2023 confirmed action had been taken to prevent the spread of infection and ensure the premises were clean, uncluttered and equipment removed.
Although the provider had taken immediate action to address the issues above, the governance systems were not always being used effectively to identify and drive the required improvements. The IP&C audit had not identified the issues we found during the inspection.
People received their medication on time by qualified nursing staff and were generally managed safely, however we did find the providers medication audit had not identified the issue we found, relating to some liquid medicines being past their date of expiry when opened.
Risk management was not always effective. Risks were identified, however controls in place were not always followed effectively and some people’s information was consistent across their care plans. We have made a recommendation about the management of risk assessments.
The majority of people and their relatives felt there were not enough staff and staff did not have enough time to spend with them. People told us they felt safe. There were appropriate policies and systems in place to protect people from the risk of abuse. Safe recruitment systems were in place to ensure staff were suitable to work with people.
People generally enjoyed the meals provided; however, improvements were required to ensure the dining experience was a positive time for all.
Staff were positive about the new manager at the service. There was a complaints procedure in place and complaints were being responded to.
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.
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 11 December 2021).
Why we inspected
The inspection was prompted in part due to concerns received about the safe care and treatment of people using the service. A decision was made for us to inspect and examine those risks.
At our last inspection we recommended risk assessments for people should be more personalised, kept up to date and be more robust. At this inspection we found although the majority of risks assessments we reviewed had been updated we found the information was not always consistent across people’s care plans. Further improvements were required to ensure people's information was current and triangulated throughout their care plans.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Abbot Care Home on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to staffing and good governance. 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.