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Abbeyfield Residential Care Home - The Grove Requires improvement

We are carrying out a review of quality at Abbeyfield Residential Care Home - The Grove. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 16 February 2021

During an inspection looking at part of the service

About the service

Abbeyfield Residential Care Home – The Grove is a residential care home providing personal and nursing care to 26 people aged 65 and over at the time of the inspection. The service can support up to 32 people.

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

The management team at the service were not following government guidelines or adhering to lockdown regulations. New admissions to the home and people discharged from hospital were not isolated as per government guidelines, which placed people and staff at risk of contracting COVID-19. People were at risk due to infection and prevention control processes not being monitored or associated risks not being assessed correctly.

The quality and assurances systems in place were not effective, audits were not fully detailed, and records were not always present. The management team had not completed a fire drill since September 2019 and regular checks of the environment were not always documented or completed. The provider failed to ensure the quality and safety of the service were monitored effectively.

Medicines were not managed safely. People’s medicine and care records did not contain information for staff to follow to safely support people or contain person-centred information.

People had their dependency assessed regularly but this was not used to determine how many staff were required to support people safely. Staff told us that they felt there was always enough staff on duty, but relatives provided mixed reviews on staffing levels.

We have made a recommendation that the provider reviews their processes in place to calculate the number of staff required to safely support people.

The registered manager was open and honest with the inspectors during and after the inspection process. They acknowledged the concerns which had been highlighted to them and started to take action and were working towards resolving the issues.

Relatives told us they were very happy with the support provided to people by staff and felt they were safe. The staff team at the service was well established and staff could tell us the individual needs of each person.

Staff told us they enjoyed working at the service and had good relationships with the people they provided support to. Staff worked in partnership with other healthcare professionals.

People were actively engaged at the service and attended regular resident meetings. Feedback from these meetings was used by the registered manager to make improvements throughout the home.

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 12 February 2020).

Why we inspected

We undertook this targeted inspection to review the infection prevention and control arrangements in place at the service.

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.

We inspected and found there were concerns with the infection prevention and control processes and quality and assurance systems in place, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.

We have found evidence that the provider needs to make improvement. Please see the Safe and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

This report only covers our findings in relation to the Key Questions Safe and Well-led which contain th

Inspection carried out on 24 January 2020

During a routine inspection

About the service

Abbeyfield Residential Care Home – The Grove provides accommodation for up to 32 people with personal care needs. At the time of the inspection, 31 people were using the service. Some of the people were living with dementia.

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

People and family members told us the service was safe. Appropriate safeguarding procedures were in place and staff had been trained in how to protect people from abuse. Risks were well managed and the provider learned from accidents and incidents.

The provider carried out appropriate security and identification checks when they employed new staff. There were enough staff on duty to meet the needs of people. Staff were suitably skilled, experienced and supported in their role.

Systems were in place for the safe storage, administration and recording of medicines.

The premises were clean and appropriate health and safety checks had been carried out.

Regular assessments and reviews took place to ensure people’s needs were being met. People were supported with their healthcare needs and had access to healthcare professionals when required.

People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People and family members told us staff were kind and treated them with respect. People were given information in a way they could understand. Staff included people in the care planning process and their preferences and choices were clearly documented in their care records.

Staff protected people from social isolation. People were provided with the opportunity to take part in activities that were relevant and important to them. There were good links with the local community.

People and family members were aware of how to make a complaint and were encouraged to provide feedback. The provider monitored the quality of the service to make sure they delivered a high standard of care.

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 14 July 2017).

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.

Inspection carried out on 30 June 2017

During a routine inspection

Abbeyfield Residential Care Home -The Grove is registered to provide accommodation for personal and nursing care to a maximum of 32 people. At the time of inspection 32 people were living at the home. Care is provided to older people, including some people who live with dementia. Nursing care is not provided.

At the last inspection in June 2015 we had rated the service as 'Good'. At this inspection we found the service remained 'Good' and met each of the fundamental standards we inspected.

People said they were safe and staff were kind and approachable. There were sufficient staff to provide safe and individual care to people. People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. Systems were in place for people to receive their medicines in a safe way.

Appropriate training was provided and staff were supervised and supported. People were able to make choices about aspects of their daily lives. People received a varied and balanced diet to meet their nutritional needs.

The staff team knew people well and provided support discreetly and with compassion. People’s privacy was respected and relatives and friends were encouraged to visit regularly. People’s preferences in relation to their end of life care had been discussed and the service aimed to provide people with a home for the rest of their lives.

People were involved in decisions about their daily care requirements. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.

Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks. Staff knew the needs of the people they supported to provide individual care. Care was provided with kindness and people’s privacy and dignity were respected. Records were in place that reflected the care that staff provided.

A variety of activities were available within the home provided by staff, volunteers and local community groups. People were empowered to make meaningful decisions about how they lived their lives. People were encouraged or supported to go out and actively engage with the local community and maintain relationships that were important to them.

A complaints procedure was available. People told us they would feel confident to speak to staff about any concerns if they needed to. The provider undertook a range of audits to check on the quality of care provided.

People had the opportunity to give their views about the service. There was regular consultation with people and/ or family members and their views were used to improve the service. People had access to an advocate if required. Staff and relatives said the management team were approachable. Communication was effective to ensure staff and relatives were kept up to date about any changes in people’s care and support needs and the running of the service.

Inspection carried out on 4 and 5 June 2015

During a routine inspection

This inspection took place on 4 and 5 June 2015 and was unannounced.

We last inspected this service in October 2013, when it was found to be complying with all the regulations inspected.

Abbeyfield The Grove is a residential care home for older people, some of whom may have dementia. It does not provide nursing care. It has 32 beds and had 30 people living there at the time of this inspection.

The service had a registered manager who had been in post for over 20 years. 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 2008 and associated Regulations about how the service is run.

People were protected from harm and abuse. Staff had been trained to recognise and respond to any suspicion of ill-treatment or neglect. People told us they felt safe living in the home. Other risks to people were assessed and carefully managed to keep people safe.

Checks were carried out regularly on the safety of the building, systems and equipment, and plans were in place to respond to emergencies. Staff were alert to the risks of cross-infection. The home was very clean, tidy and well-maintained.

There were sufficient staff available at all times to respond to people’s needs safely and quickly. New staff were carefully checked as to their suitability to work with vulnerable people.

People received the support they needed to manage their medicines safely.

There was an experienced and well-established staff team that had the knowledge and skills necessary to meet people’s needs. Staff received regular training and professional development was encouraged. Staff also received appropriate levels of support, in terms of supervision and annual appraisal of their work performance.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005. These safeguards aim to make sure people are looked after in a way that does not inappropriately restrict their freedom. Staff had been trained in this important area and were aware of their responsibilities regarding protecting people’s rights.

People were asked to give their written consent to their plan of care, and told us staff members always asked for their verbal permission before carrying out any care tasks or other interventions.

People’s nutritional needs were assessed and any special diets required were provided. People were given good choice regarding their meals and their personal preferences were known and respected. They told us the food was very good.

People told us the staff were very caring in everything they did for them. They said they were treated with sensitivity, compassion and respect at all times, and that they were encouraged to make their own decisions and remain as independent as possible.

People’s care was planned with their full involvement, and included regular re-assessment of their needs and wishes regarding their care. Care plans were detailed and personalised to the individual. Regular reviews were held to give people the opportunity to discuss their care needs and suggest changes to how their care was being given.

There was a good social activities programme in place, with visiting entertainers and trips out, and people were also encouraged to pursue their own hobbies and interests.

Complaints were rare, but were taken very seriously by the service and resolved to the satisfaction of the complainant, wherever possible.

The service worked well with other professionals and services to ensure people received the care they needed, in the ways that they wanted.

The service was well-managed. The registered manager was very experienced and held in high esteem by people living in the home, staff and professionals. The service was open to suggestions for improvements and regularly asked people for their views about their care, and the service generally.

Effective quality assurance systems were in place and any deficits found were promptly and imaginatively addressed.

Inspection carried out on 2, 4 October 2013

During a routine inspection

People's care needs were carefully assessed before any care was given. Their care was properly planned and kept under frequent review, to make sure it continued to meet their needs. People told us they were very happy with the care they were receiving and spoke highly of the manager and her staff. One person told us the staff were �very obliging and very helpful.� Another said, �I am very settled, here. I have privacy, company, and can direct how care is given.�

People enjoyed a wide and varied diet, with plenty of choice on the menu and individual preferences noted and met. People spoke highly of the quality and quantity of the food.

The home was of a suitable design and layout to meet the needs of the people living there.It was warm, clean, comfortable and odour-free. It was well maintained and was checked regularly for any safety hazards.

There were sufficient numbers of suitably qualified, skilled and experienced persons to meet the needs of the people living in the home.

Inspection carried out on 17 December 2012

During a routine inspection

People living in the home told us they were very happy with the quality of the care they received. Comments included, "We are very well looked after, here. It�s much better than other homes I�ve seen. It�s a pleasure living here�; and, �They are very good, the girls, and they treat you with respect�.

People were always asked for their consent before staff gave them any care or treatment, and told us they were able to refuse any intervention by staff.

We saw that people were given their prescribed medicines at the correct times and in an appropriate manner, and that all medicines were safely stored.

Care had been taken to recruit suitable staff who had been thoroughly vetted before being employed in the home.

Very few complaints had been made to the home, but where any concerns had been raised they had been properly investigated. The manager and staff demonstrated that they listened to what people in the home and their representatives told them and responded appropriately.

Inspection carried out on 26 January 2012

During a routine inspection

People living in the home spoke highly of the care that they were receiving, and of the manager and all her staff. A typical comment was, �I�m very pleased with my care. The staff are very patient and very caring � I�d give them five stars plus � wonderfully kind�.

People told us that they were involved in deciding how their care was given, and said that staff were flexible and responsive if they wanted things done differently.

People said they felt safe living in the home. One commented, �I feel absolutely safe, and feel very lucky to be here�.

No one expressed any concerns about any aspect of the care or management of the home. People said they were confident that, if they did have any concerns, they could speak with the manager. They felt sure they would be listened to, and any problems would be resolved. All said that they were treated with respect by the staff.

We were told that staff appeared to be well trained. No one could identify any area where staff were unable to meet their needs in a competent manner.

People told us that they felt that staff and management asked their views and responded positively to what they told them. One said, �We�re listened to. Mrs Brown [home manager] is very understanding � she always puts residents first�.

We asked people how the home could be improved. None were able to suggest any necessary changes, and one person told us, �I wouldn�t change anything about the home�.