Appleby

Updated 4 February 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 26 January 2022 and was announced. We gave the service 4 days’ notice of the inspection.

Updated 4 February 2022

About the service

Appleby is a care home providing personal and nursing care to 47 people aged 65 and over at the time of the inspection. One floor specialises in providing care and support for men who may display distressed behaviour. The service is registered to support up to 55 people. The regional manager confirmed that they would be submitting an application to reduce the number of people supported to 50 due to refurbishments within the building.

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

Lessons had been learnt since the last inspection and widespread improvements were evident. Medicines were administered safely and regular medicine reviews were held. People told us they felt safe and staff were aware how to raise any concerns. Risks had been assessed and steps taken to minimise occurrence and impact. Safe recruitment practices were followed and there were enough staff to meet people’s needs.

People’s needs, and preferences were assessed and documented in care plans which were regularly reviewed and updated. People’s healthcare needs were met, including an assessment of nutrition and hydration needs. Specialist advice was sought and followed when needed. Staff were well supported and said they attended relevant training which supported them to meet people’s needs.

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.

Staff had time to develop meaningful and trusting relationships with people, their families and visitors. Staff were responsive to people’s needs, recognising when people needed support which was provided in a timely manner and respected people’s privacy and dignity.

People, and family members, were involved in planning care and support. People and visitors were happy with the care they received and said they were included in decision making. Staff worked with other professionals and family members to provide people with compassionate care at the end of their lives. People and family members knew how to raise concerns and complaints.

The registered manager had left Appleby in July 2019. An acting manager was in post who was committed to ensuring people received good quality care. The manager had developed an inclusive culture which promoted openness and continuous learning. Following our inspection, the manager applied to become registered with CQC.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (22 September 2018) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.