Abbcross Nursing Home

Abbcross Nursing Home is a care home registered to provide nursing and personal care to people, aged 65 years and over. It can support up to 28 people and at the time of the inspection, 24 people were living in the home. The home has three floors with adapted facilities and en-suite rooms.

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

People were protected from the risk of abuse. Medicines were administered to people as prescribed. However, we have made a recommendation for the provider to follow best practice guidance on managing medicines because protocols for certain medicines were not in place or contained incorrect information. Risks related to people's health and care needs were assessed and monitored. Some risk assessments required further development with more suitable guidance for staff, so they could provide safe care. We have made a recommendation about this.

Staff were recruited appropriately and there were suitable numbers of staff on each shift to meet people's needs. Systems were in place to record and monitor accidents and incidents in the home. People were protected from the risks associated with the spread of infection.

People's needs were assessed before they started to use the service. They 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 were supported by staff who were trained. Staff worked with other health care professionals to ensure people were in good health. People were encouraged to maintain a healthy balanced diet. They were provided food and drink that met their preferences and needs. We made a recommendation about reviewing people's fluid intake.

Staff were kind and compassionate towards people. They treated them with respect and their views were listened to and their requests acted upon. People received person-centred care. Care plans provided guidance on how to support people, in accordance with their choices and communication needs. Activities for people took place but the provider was working on improving the activities programme and used feedback from people and relatives to help with this.

People and their relatives were positive about the management team and could approach them with any concerns. Complaints were responded to appropriately. There was a positive culture in the home and equality, diversity and inclusion was promoted. The provider had systems in place to assess, monitor and improve the quality and safety of the services provided.

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 the service was Good (report published 7 January 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Abbcross Nursing Home is a care home. 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.

Abbcross is a purpose built 26 bed service providing accommodation and nursing care for older people, including those living with dementia. The service is accessible throughout for people with mobility difficulties and has specialist equipment to support those that need it. For example, hoists and adapted baths are available. 24 people were using the service when we visited.

The service had a registered manager. 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.

At the last inspection in September 2016, we found one breach of regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Systems were not in place to ensure that decisions made in people’s best interest were in accordance with Mental Capacity Act 2005. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to ensure they were compliant in this area.

At this inspection, we found that action had been taken by the registered manager and the breach was met. Systems were in place to ensure that decisions made in people’s best interest protected their human and legal rights.

People received their prescribed medicines safely. Medicines were administered by staff who were trained and assessed as being competent to do this.

Systems were in place to minimise risk and to ensure that people were supported as safely as possible. Staff were aware of their responsibilities to ensure people were safe and what to do if they had any concerns or suspected any abuse. They were confident that the registered manager would address any concerns.

Staffing levels were sufficient to meet people’s needs and to enable them to do be supported in a way that they wished. Staff received the support and training they needed to give them the necessary skills and knowledge to meet people’s assessed needs.

Care records contained information about people’s assessments, needs, wishes, likes, dislikes and preferences. Most records were computerised and were found to be up to date and appropriately completed.

People received safe care and treatment. They told us they felt safe at Abbcross and were supported by kind, caring staff who supported them and treated them with respect.

People were encouraged to do things for themselves and staff provided care in a way that promoted people's dignity. People were supported to receive the healthcare that they needed and their nutritional needs were met.

An activities worker was employed and social and recreational activities and events were available.

The registered manager and the provider monitored the quality of service provided to ensure that people received a safe and effective service that met their needs and had positive outcomes.

People were protected by the provider’s recruitment process, which ensured that staff were suitable to work with people who need support.

Staff felt the registered manager was approachable and supportive and gave them clear guidance.

Systems were in place to ensure that equipment was safe to use and fit for purpose. People lived in a clean, safe environment that was suitable for their needs.

Complaints and feedback were taken seriously and action was taken to address any concerns.

Staff provided caring support to people at the end of their life and to their families. This was in conjunction with the GP and the local hospice.

Abbcross is a purpose built 26 bed care home providing accommodation and nursing care for older people, including people living with dementia. The service is accessible throughout for people with mobility difficulties and has specialist equipment to support those that need it. For example, hoists and adapted baths are available. 25 people were using the service when we visited.

The service had a registered manager. 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 the last inspection in July 2015, we found three breaches of regulations. Systems were not in place to ensure that people received safe care and treatment and care and treatment was not designed in way that ensured people’s need and preferences were met. Records were not accurate and the quality of the service was not adequately assessed or improved.

At this inspection we found that action had been taken by the registered manager and the breaches were met. Risks were identified and systems put in place to minimise risk and to ensure that people were supported as safely as possible. Most records were now computerised and were found to be up to date and appropriately completed.

Systems were in place to monitor the service provided and people were asked for their feedback about the quality of service provided. Any issues identified were recorded and action taken.

People received safe care and treatment. Any wounds or tissue viability issues were reviewed at weekly clinical meetings to ensure that the necessary action had been taken.

Systems were in place to ensure that people were not being unnecessarily or unlawfully deprived of their liberty. However, systems were not always in place to ensure that decisions were made in people’s best interests.

People told us they felt safe at Abbcross and they were supported by kind, caring staff who supported them and treated them with respect. We saw several examples of this. However, we also saw two occasions when staff were not as caring and supportive as needed. We discussed this with the registered manager who agreed to address the specific issues.

People were encouraged to do things for themselves and staff provided care in a way that promoted people’s dignity.

People told us that the food was good and that they could have a drink when they wanted. People’s nutritional needs were met and if there were concerns about their eating, drinking or weight, this was discussed with the GP and support and advice were sought from the relevant healthcare professional. We have recommended that lunchtime arrangements and support be reviewed to ensure that people have a pleasant meal time experience and receive the support they need.

The arrangements for administering medicines were safe.

Systems were in place to safeguard people from abuse and staff were aware of how to identify and report any concerns about people’s safety and welfare.

Staff received training and support to carry out their duties and competently provided people with the support they needed and wanted.

The provider’s recruitment process ensured staff were suitable to work with people who need support.

An activities worker was employed and recreational activities and events were available.

People said that they were happy with the activities offered.

Complaints were taken seriously and concerns were addressed. People were happy to talk to the registered manager and managing director to raise any concerns that arose.

People lived in a clean environment that was suitable for their needs.

We found one 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.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People were satisfied with the care and support they received. Comments included "I like the staff, they're friendly and good to me."

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. People said they received their medicines correctly and they knew what their medicines were for. One person said "the little blue one (tablet) is to calm me down and help me to sleep."

Staff were appropriately supported to enable them to deliver care and treatment safely and to an appropriate standard. Staff comments included "yes I do feel supported" and "I feel I get enough training here."

There was an effective complaints system available. People's comments and complaints were responded to appropriately. One relative said they had made a complaint to the manager and their complaint was resolved to their satisfaction. They said "the manager's good. My comments were taken on board."

People were able to make choices about their care and support and were treated with respect. Their support and care needs were regularly assessed and a range of activities provided.

People and staff felt safe and supported in the service. Training was provided for staff, however not everyone had regular supervision and appraisals.

Audits and service reviews were carried out. These and relatives comments and suggestions were incorporated in developing the service.