About the service Abbey Village is a care home which is registered to provide accommodation and personal care to 34 younger and older people, some of whom may be living with dementia. At the time of our inspection, 31 people lived at the service. Accommodation is provided on one level and has a mixture of smaller and larger communal areas for people to use.
People’s experience of using this service and what we found
Risks to people’s health and wellbeing were not always identified and managed as records were not up to date. Records did not show fire safety processes were appropriately followed. Medicines processes did not always follow best practice. Governance systems continued to be ineffective at identifying and addressing shortfalls. The provider had not reviewed or improved their governance systems and there was a continued lack of oversight of the service.
Infection and control practices had improved, and current guidance was being followed. Systems were in place to protect people from abuse. The provider’s recruitment processes helped ensure only suitable staff were employed and staffing levels met people’s needs.
Staff had the relevant skills and experience to meet people’s needs. Staff supported people to access healthcare services and followed professional advice. People’s dietary needs were met, and people were provided with a varied and healthy diet, though records did not always show this. Improvements had been made to the environment and the provider was working to make further improvements to support people living with dementia.
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 registered manager promoted effective teamwork and supported their staff. They had developed good links with relevant healthcare professionals and was working on their development.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 17 October 2019) and there were two breaches of regulation. The service remains rated requires improvement and has been rated requires improvement for the last three consecutive inspections. The provider completed an action plan to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 6 and 9 September 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.
We undertook this focused inspection to check they had followed their action plan 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.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained the same as the last inspection. 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.
Enforcement
We have identified breaches in relation to medicines, the management of risks, record keeping, and addressing quality shortfalls.
Please see the action we have told the provider to take at the end of this report. Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.