Archived: Abbotsbury Residential Home

During our inspection on 7 May 2014 we set out to answer five questions. These were whether the service is 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, discussions with people who used the service and the staff that supported them. We also spent time looking at records. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that care was planned and delivered in a way that was intended to ensure people's safety and welfare.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Where applications had needed to be submitted, proper policies and procedures were followed. Relevant staff had been trained to understand when an application should be made, and how to submit one.

However, we found that there were shortfalls in relation to safeguarding people from the risk of abuse and the service is required to make improvements. For example, to ensure that they react promptly to any concerns raised.

Is the service effective?

People told us that they were happy with the care that they received and that their needs had been met. Care plans were written in a way which reflected people's choice and preferences.

We saw that the risk assessments and support plans had been reviewed monthly and where needed, updated to reflect the person's current needs. We looked at the care notes for people whose plans we had viewed and saw that care was delivered in accordance with the plans.

Is the service caring?

People told us that care and support was delivered in a way in which they preferred. We asked people whether the staff caring. One person described staff to us as, 'Lovely.' They went on to say, 'Everyone is nice.' They also told us, 'I get everything I need.' Another person we spoke with said of the care they received, 'It's grand.'

We observed staff interaction with people who used the service and staff appeared to know people well. Most of the staff we observed were attentive and kind. Staff we spoke with had a good understanding of the people that they were supporting.

Is the service responsive?

We found that the service responded to issues identified through their own monitoring systems. This enabled them to monitor trends in areas such as incidents, falls and complaints. Any trends identified were responded to and actions for minimising any reoccurrence were put in place.

We saw that where concerns had been highlighted during the monitoring process that the service had responded to these issues in an appropriate timescale to resolve them.

Is the service well led?

We noted that the manager was new to the service and was currently applying for their registration. They were being supported by the regional manager and a manager from within the organisation as a mentor. The staff, people who used the service and relatives we spoke with told us that they felt the manager listened to people, gave guidance and set a good example.

People told us that they knew how to make a complaint and we noted that the management had responded appropriately to complaints made by people who used the service.

The service carried out regular audits on care plans, medication and environment. We saw that where an audit identified an issue, an action plan was developed and there was a record of actions being completed.

Surveys were sent out annually to people who used the service, their relatives and staff. The manager had taken steps to address any issues identified. This included introducing holding a staff meeting to discuss the outcome of the surveys.

Personal care files showed that people and their families had been involved in the development of their care plans. This was confirmed in discussions we had with people using the service.

People told us the food was very good and they always had enough.

There was an effective complaints system in place. Comments and complaints people made were responded to appropriately and in a timely manner.

During this inspection on 21 March 2013 we noted that a number of improvements had been made to the way people's care was planned. Care records showed that plans were in place to guide staff on how to provide care to people who had medical conditions that impacted on their care, such as diabetes, urinary tract infections or constipation. Care records also showed that there were clear guidelines for staff on ways in which to manage the care given to people who were at risk of malnutrition or dehydration.

Staff we spoke with confirmed that the additional information and guidelines relating to people's medical conditions had been discussed at staff meetings and during individual one to one supervision sessions with their manager.

People we spoke with told us the care they received was satisfactory and their needs were met. One person said, 'It's brilliant here. The carers are excellent'. Another told us, 'I'm very happy here. This is my home. I've never regretted [coming here]'. Each person was called by their preferred name and people said staff treated them with respect. People were supported to make choices in all aspects of their daily lives and encouraged to be as independent as possible. A family member we spoke with said they would give the home 10 out of 10. Another told us, 'This home is very good. The caring is excellent'.

Each person had a care plan in place, based on an assessment that had been carried out to identify their needs. However, we found that not all care plans gave staff sufficient guidance to ensure that the person's needs were met safely.

People told us they felt safe at this home and they would be happy to talk to the manager if they wanted to discuss any concerns. People we spoke with, and the staff, had mixed views about whether there were enough staff on duty. The manager had considered this and was in the process of deploying staff differently so that there were more staff on duty during busier periods of the day.