Background to this inspection
Updated
21 July 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 8 and 9 June 2016.
The inspection was carried out by one adult social care inspector, a pharmacist inspector, a specialist advisor who was a nurse 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.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the information in the PIR and also looked at other information held about the service and notifications we had received. A notification is information about important events which the service is required to send us by law. We also obtained the views of service commissioners from the local council who monitor the service provided.
During the inspection we spoke with 10 people and three visitors about their views on the quality of the care and support being provided. We spoke with the registered manager, provider and nine staff members including the activity coordinators, a housekeeper and the cook. We also spoke with a visiting health professional. We looked at documentation relating to seven people who used the service, four staff recruitment and training records and records relating to the management of the service. After the inspection we received feedback from three further health professionals.
Updated
21 July 2016
Abbey Grange Nursing and Residential Home provides accommodation for up to 42 people who require nursing and personal care. The home comprises of the main building over four floors and a self-contained bungalow attached to the home. During our inspection there were 23 people living at the home and two people living in the bungalow.
We inspected Abbey Grange Nursing and Residential Home in May 2015. At that Inspection we found concerns relating to four regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The regulations included; Need for consent, Safe care and treatment, Receiving and acting on complaints and Good governance.
The provider sent an action plan of how they would make improvements. During this inspection we saw some improvements had been made.
This inspection took place on 8 and 9 June 2016 and was unannounced.
There was a registered manager in post. 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.
Medicines were not always administered as they were prescribed, one person did not have medicines they required available and staff did not always look after people’s creams and ointments appropriately. Medicines were stored securely but not within safe temperate requirements.
The registered manager and provider had systems in place to monitor the quality of the service although these did not always identify shortfalls relating to mental capacity, medicines and poor record keeping relating to fluids.
Risks to people had been identified and plans were in place to reduce the risk. Some of the plans lacked information. Where people’s capacity had changed, this was not always clearly recorded in people’s care plans
People and their relatives said the home was a safe place. Systems were in place to protect people from harm and abuse and staff knew how to follow them. There were enough staff available to meet people’s needs. Safe recruitment procedures were in place.
Staff felt well supported and well trained. There were some gaps in staff training and the registered manager had plans in place to address. New members of staff received an induction which included shadowing experienced staff before working independently. Staff received supervision and told us they felt supported.
Care plans provided information about how people wished to be supported and staff were aware of people’s individual care needs and preferences.
Staff had built trusting relationships with people. People were happy with the care they received. Staff interactions with people were positive and caring.
People were complimentary of the food provided. Where people were at risk of dehydration accurate records were not always kept of how much fluid they had consumed. Care plans did not always accurately record people’s food preferences.
There were systems in place to receive feedback from people who use the service, their relatives and staff. An action plan had been developed in response to the feedback.
Mixed feedback was received about the activities provided. A new activity coordinator was in post and was finding out about people’s interests.
People and relative’s told us they were confident they could raise concerns or complaints with the registered manager and they would be listened to.
We found breaches 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 this report.