Abbey Village

Updated 28 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was completed by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Abbey Village is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Abbey Village is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with CQC to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used information the provider sent us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We sought feedback from Healthwatch, and the local authority. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people who used the service and 5 people’s relatives about their experience of the care provided. We received feedback from 5 health and social care professionals who worked with the service. We spoke with 9 members of staff including the registered manager, area manager, compliance manager, a team leader, senior carer workers, care workers and the cook. We also spoke with the provider’s nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 5 people's care records and 15 people’s medicines administration records. We looked at 3 staff files in relation to recruitment, training and supervision. A variety of other records relating to the management of the service, including audits and policies and procedures were also reviewed.

Updated 28 January 2023

About the service

Abbey Village is a residential care home providing accommodation and personal care for up to 34 younger adults and older people who may be living with dementia. At the time of our inspection there were 32 people using the service.

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

Systems were in place to store, administer and record medicines used. However, information to support staff to safely administer medicines was not always available. We made a recommendation regarding the safe management of medicines.

People felt safe using the service. Staff were trained to identify and respond to any safeguarding concerns. We received mixed feedback about staffing levels and made a recommendation about continuing to monitor staffing levels and staff deployment in response to this feedback.

People’s needs were assessed; care plans and risk assessments provided guidance for staff on how to provide safe and effective care. Systems were in place to ensure lessons were learned if things went wrong.

Staff followed appropriate infection prevention and control guidance. The environment was generally clean, tidy and appropriately adapted to meet people’s needs. The provider had a plan in place outlining further planned renovation and redecoration work.

Staff were safely recruited. A robust system was in place to induct and train new staff and monitor their performance.

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.

The service was well-led. The registered manager promoted a person-centred culture within the service. Audits and checks were used to monitor the service provided and support continuous improvements.

For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk.

Rating at last inspection and update

The last rating for this service was requires improvement (published 2 September 2020) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an announced focused inspection of this service on 9 and 16 July 2020. Breaches of legal requirements were found. We undertook this focused inspection to follow up on action we told the provider to take at the last inspection and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective and well-led which contain those requirements.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Abbey Village on our website at www.cqc.org.uk.

Follow up

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