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Inspection Summary


Overall summary & rating

Good

Updated 4 November 2015

The inspection took place on 23 September 2015 and was unannounced.

Abbey Chase Nursing Home provides accommodation, nursing and personal care for up to 62 older people. The service does not admit people for whom dementia is a primary diagnosis.

There was a registered manager in post. 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 and associated Regulations about how the service is run.

The service had not implemented the principles of the Mental Capacity Act 2005 (MCA) or adhered to the Act’s Code of Practice. Some of the people living at the service lacked capacity and needed support in making decisions about their care and treatment. Mental capacity assessments had not been carried out to establish people’s capacity and identify the support they needed to make decisions. Any decision made on behalf of a person who lacks capacity must be made in that person’s best interests. No best interests meetings had been held, which meant there was no evidence that discussions had taken place to establish the best interests of people who lacked capacity.

There were restrictions on people’s freedom of movement within the service that had not been authorised. For example a number of people had rails installed on their beds. The registered manager advised that no applications for DoLS authorisations had been made to the DoLS Supervisory Body. This meant the provider had not received the proper authorisation to put these restrictions in place.

There were enough staff deployed to meet people’s needs safely and promptly. People told us staff were available when they needed them. They said staff supported them in a way that kept them comfortable and maintained their dignity. Relatives told us there were enough staff to make sure their family members received the care they needed. Staffing rotas were planned to ensure staff with appropriate knowledge and skills were available in all areas of the service.

People were supported by staff that had the skills and experience needed to provide effective care. Relatives told us that staff knew their family members’ needs well and provided consistent care. Staff had induction training when they started work and access to ongoing training. Staff shared information about people’s needs effectively. The provider made appropriate checks on staff before they started work, which helped to ensure only suitable applicants were employed. Staff understood safeguarding procedures and were aware of the provider’s whistle-blowing policy.

Risks to people had been assessed and measures implemented to reduce these risks. There were plans in place to ensure that people would continue to receive their care in the event of an emergency. Health and safety checks were carried out regularly to keep the premises and equipment safe for use. People’s medicines were managed safely. Medicines were stored and recorded appropriately and staff who administered medicines had regular training and competency assessments. People were supported to stay healthy and to obtain treatment if they needed it. Staff monitored people’s healthcare needs and took appropriate action if they became unwell. People’s nutritional needs were assessed when they moved into the service. Where people had individual needs related to their diet and nutrition, relatives said that staff worked hard to ensure these needs were met. People told us that they enjoyed the food provided and that they could have alternatives to the menu.

Staff were kind and sensitive to people’s needs. People had positive relationships with the staff who supported them. Relatives said that staff provided compassionate care and were professional and caring. The atmosphere in the service was calm and relaxed and staff spoke to people in a respectful yet friendly manner. Staff understood the importance of maintaining confidentiality and of respecting people’s privacy and dignity.

People’s needs had been assessed to ensure that the service could provide the care they needed. Care plans had been drawn up from the initial assessment to make sure that people received the support they needed. Relatives told us they were encouraged to contribute to their family member’s care plans.

People had opportunities to give their views about the care they received and the provider sought feedback from relatives, healthcare professionals and staff. People said they would feel comfortable making a complaint and were confident that any concerns would be dealt with appropriately. Staff told us they had opportunities to express their views and raise any concerns they had. Any complaints received had been responded to appropriately. Records relating to people’s care were accurate, up to date and stored appropriately. The provider had implemented an effective quality assurance system to ensure that key areas of the service were monitored effectively.

We identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Inspection areas

Safe

Good

Updated 4 November 2015

The service was safe.

There were sufficient staff deployed to meet people’s needs in a safe and timely way.

Staff supported people in a way that maintained their comfort and safety.

Staff understood their responsibilities should they suspect abuse was taking place.

There were plans in place to ensure that people’s care would not be interrupted in the event of an emergency.

People were kept safe by the provider’s recruitment procedures.

People’s medicines were managed safely.

Effective

Requires improvement

Updated 4 November 2015

The service was not always effective.

The service had not implemented the principles of the Mental Capacity Act 2005 (MCA) or adhered to the Act’s Code of Practice.

People were supported by staff that had the necessary skills and experience to provide effective care.

Staff received appropriate support from their managers and had access to regular supervision and appraisal.

Staff had access to the training they needed to deliver effective care.

Staff shared and communicated information about people’s needs effectively.

People’s nutritional needs were assessed and individual dietary needs were met.

People were supported to stay healthy and to obtain treatment when they needed it.

Caring

Good

Updated 4 November 2015

The service was caring.

Staff were kind and helpful.

People had positive relationships with the staff who supported them.

Staff communicated with people effectively and provided support in a sensitive way.

Staff understood the importance of maintaining confidentiality and of respecting people’s privacy and dignity.

Responsive

Good

Updated 4 November 2015

The service was responsive to people’s needs.

People’s needs had been assessed to ensure that the service could provide the care and treatment they needed.

Care plans had been reviewed regularly to ensure they continued to reflect people’s needs.

People had opportunities to take part in activities.

The provider sought the views of people who used the service, relatives, healthcare professionals and staff about the quality of care and support.

Complaints were managed and investigated appropriately.

Well-led

Good

Updated 4 November 2015

The service was well led.

The management team provided appropriate leadership and support to staff.

There was an open culture in which people were encouraged to express their views and contribute to the development of the service.

Staff had opportunities to discuss any changes in people’s needs with their managers, which ensured that they provided care in a consistent way.

Records relating to people’s care were accurate, up to date and stored appropriately.

The provider had implemented effective systems of quality monitoring and auditing.