Archived: Abbey Dean

This inspection was carried out by one inspector. We gathered evidence that helped us answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? Below is a summary of what we found.

The summary is based on our observations during the inspection, speaking with five people using the service, two of the staff supporting them, a relative who was visiting the service and from looking at records. They included care assessments and care records, staff rotas and records that related to the provider's quality assurance system.

Is the service safe?

People were treated with respect and dignity by the staff. A relative told us, 'Staff tailor their approach towards the individual. They are emotionally intelligent. They are respectful of people's dignity, independence and individuality.'

Systems were in place to make sure that the manager and staff learnt from events such as accidents and incidents. This reduced the risks to people and helped the service to continually improve.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made, and how to submit one. This meant that people would be safeguarded as required.

The manager and the care staff demonstrated how medicines prescribed to individual people had been stored and administered safely.

The registered manager set the staff rotas. The manager demonstrated how they took people's care needs into account when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure that people's needs were always met.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care. People said that they had been involved in writing them and they reflected their current needs.

Visitors confirmed that they were able to see people in private and that visiting times were flexible.

People have been provided with a varied and nutritious diet that has taken into account their individual needs.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People told us they were very satisfied with the care provided. A relative said, 'The staff have a friendly manner, compassionate and consistently kind'.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People completed a range of activities in and outside the service regularly. The home has its own adapted minibus, which helps to keep people involved with their local community.

People knew who to speak to if they were unhappy. A relative told us they had taken some concerns to the manager. They also confirmed they were satisfied with the outcomes.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

Is the service well-led?

The service had a quality assurance system. Records that we looked at showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. They told us they felt well supported in their work.

Staff had a good understanding of the ethos of the home and what was expected of them. This helped to ensure that people received a good quality service at all times.

We looked at the care records and medication administration record (MAR) sheets of nine people. Care records included guidance for staff to ensure medication had been administered to individual people in accordance with prescribed directions. Records also included, where possible, peoples' wishes and preferences. Medication records we looked at had been accurately maintained and ensured medication had been administered safely.

We spoke with a senior member of staff who was responsible for administering medication and observed people being given their medication at lunchtime. They demonstrated they understood what was expected of them with regard to ensuring medication had been administered safely.

We looked at care records and medication administration records (MAR). Care records included guidance for staff to ensure medication had been administered to individual people in accordance with their wishes and preferences. Medication records had not been accurately maintained and did not confirm that all medication had been administered as prescribed. Not all over the counter medication administered by care staff had been identified as a homely remedy and had not been risk assessed before administration.

We observed people being served and helped with the main meal of the day. The care staff on duty knew what support and encouragement people needed to maintain their independence.

We spoke with two members of staff, who were on duty. We found that they had a good understanding of their roles and responsibilities.

We also gathered evidence of people's experiences of the service by looking at a selection of records. This included care records, medication records and records of complaints that had been received.

We found that care records provided care staff with appropriate information to follow with regard to the delivery of care to ensure individual needs had been met. They also demonstrated that people had given consent to the care they had received. We found that the provider had in place a system for recording and investigating any complaint that been made.We also found that there were gaps in records of medication that had been administered. This meant people may not have received medication that had been prescribed to them.

We found that people were treated with dignity and respect by staff and involved in making decisions about their care and treatment. People told us that their individual needs were met. One person said "staff listen to me and get me what I need and want".

We found that people's care was planned and delivered in a safe way which reflected their individual choice and preferences. People told us that the home provided a range of events and activities and they were able to chose how they spent their time.

Although people told us they felt safe in the home, We have asked the provider to make some improvements to their policy, procedures and training on safeguarding and preventing abuse, to meet the required standard and ensure people are adequately protected.

People we spoke to were very positive about the standard of care they received from the staff and managers in the home. We found that the provider had good systems in place to ensure the quality of the service was of a good standard.