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Abbey Chase Nursing Home Requires improvement

We are carrying out checks at Abbey Chase Nursing Home. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 8 March 2018

The inspection took place on 30 January 2018 and was unannounced.

The last inspection of the service was on 23 September 2015 when we rated the service Good.

Abbey Chase Nursing Home is a care home with nursing for up to 62 people. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection 61 people were living at the service. The majority of people were over the age of 65 years. People living at the service had a range of complex healthcare needs. Some people were living with the experience of dementia. Some people were being cared for at the end of the life. The majority of people had funded or part funded their own care, with the local authority commissioning approximately one third of the places at the service. The home was divided into two units, East Wing and West Wing. A registered nurse worked in each unit along with care assistants, senior care assistants and a team leader. The provider employed additional staff to coordinate and facilitate activities.

The provider, Abbey Chase Residential and Nursing Homes Limited, is a private organisation. In 2017 the provider became part of the CHD Living Group. CHD Living operates a number of care services in London and South East England.

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.

At this inspection we rated the service Requires Improvement in the key questions of Safe, Caring, Responsive, Well-Led and overall.

People were not always safely cared for. Some of the practices of the staff placed people at risk of harm. For example, cleaning products and other potentially hazardous items were not stored securely. Medicines were not always stored securely. The staff did not promptly respond to call bells or when people needed attention. Fire doors were not always properly maintained so people would be placed at risk in the event of a fire. Some of the bathrooms and toilets were dirty and the staff had not followed procedures to prevent and control the spread of infection.

People were not always treated with dignity and respect. For example, the staff sometimes ignored people who talked to them and did not always speak with them when offering support. The staff talked about people where others could hear without respecting the person's privacy. We witnessed examples where a person was supported to move through the home without proper covering so that parts of their naked body were exposed. The staff supporting the person did not demonstrate and awareness that this was inappropriate. In another example, the staff stopped a person from eating their lunch so that a medical professional could examine them rather than ask the professional to wait for the person to finish their meal. The staff did not communicate with the person and did not explain what was happening to the person, apologise, make an effort to keep their meal warm or ask for the person's consent.

The provider had systems to monitor and assess the quality of the service and to identify and mitigate risks. However, they had failed to operate these effectively.

We found three breaches of Regulations during the inspection. These were in respect of safe care and treatment, privacy and dignity and good governance.

We are taking action against the provider for failing to meet regulations. Full information about CQC’s regulatory responses to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

People living at the service and their relatives were happy there. They liked the staff and felt the service was well managed. People told us they were asked for their opinions about their care and had consented to their care and treatment. People felt their needs were being met, although some people told us they had to wait for care.

There were enough suitable staff to care for people and to meet their needs. The staff received the information, training and support they needed to carry out their roles. The procedures for recruiting staff were designed to make sure the staff were suitable.

There were procedures in place to protect people from the risk of abuse. The staff were familiar with these. Accidents and incidents were appropriately responded to, recorded and analysed so that the provider and staff could learn from these. People were able to raise concerns and complaints. They felt listened to and had opportunities to discuss how they felt about the service.

The staff worked closely with other agencies, such as healthcare teams, to make sure people's needs were being met. People had access to medical services when needed and nurses were on duty throughout the day and night.

People were able to make choices from a range of freshly prepared meals. Snacks and drinks were available whenever people wanted these.

Some of the staff were kind and caring towards people. They knew them well and people felt they had good relationships with them.

There was a positive culture at the service. People using the service, visitors and staff felt they could speak with the registered manager and that they would be listened to. The registered manager had systems for checking the service was being delivered in a way which people wanted and which met their needs. The provider's representatives regularly visited the service. They had identified areas needing improvement and they worked with the staff to ensure that improvements took place.

Inspection areas

Safe

Requires improvement

Updated 8 March 2018

Some aspects of the service were not safe.

Some risks to people's safety and wellbeing had not been mitigated and people were placed at risk because of some staff practices.

The environment was not always clean or safely maintained.

Cleaning products were not stored securely.

Medicines were not always stored securely so there was a risk that they could be misused.

There were systems, processes and practices to safeguard people from abuse.

There were enough staff to meet people's needs and keep them safe.

The provider had systems to learn from mistakes and when things went wrong.

Effective

Good

Updated 8 March 2018

The service was effective.

People's needs and choices were assessed so effective care could be delivered.

The staff had the skills, knowledge and experience they needed to deliver effective care and support.

The environment was suitably designed and met the needs of people living at the service, although the provider had identified that modernisation of some areas was needed.

The provider acted in accordance with the Mental Capacity Act 2005 and people had consented to their care and treatment.

The staff worked with other organisations in order to meet people's healthcare needs.

People had a choice of freshly prepared nutritious food and drink.

Caring

Requires improvement

Updated 8 March 2018

Some aspects of the service were not caring.

People were not always treated with dignity and respect.

Sometimes the staff focussed on the tasks they were performing rather than people's wishes and feelings.

People felt the staff were kind and caring and we saw some examples of this.

People were able to express their views and be involved in planning their own care.

People were able to be independent if they wished to be.

Responsive

Requires improvement

Updated 8 March 2018

Some aspects of the service were not responsive.

People did not always receive personalised care which met their needs and reflected their preferences.

People knew how to make a complaint and there were systems for the appropriate response to these.

People being cared for at the end of their lives had the care and support they needed.

Well-led

Requires improvement

Updated 8 March 2018

Some aspects of the service were not well-led.

The provider's systems for identifying risk were not always operated effectively.

However, the provider did have a range of systems for auditing and improving the service and we could see that the way in which these had been implemented had resulted in changes for the better.

People were involved in making decisions about their care and the service.

People felt the service was well-managed.