Archived: Abbeyfield Meadows

Below is a summary of our finding based on our observations, speaking with people who used the service, the staff supporting them and from looking at records. As part of the inspection we asked the following questions:

Is the service safe?

The service was in the process of implementing a new documentation system for the recording of information. We were told that the process would be completed by the end of September 2014.

Other records for checking the safety of the premises and equipment were available for inspection.

Is the service responsive?

We saw that where a change to the person's care and support needs had been identified the relevant care and support plans had been updated.

Is the service well led?

This service does not have a registered manager. The provider has arranged for two interim managers to be at the service each day. Staff and visitors told us that the interim managers were helpful and supportive.

We saw that improvements had been made to the records that were needed to protect people from the risks of unsafe or inappropriate care. The improvements now need to continue to further ensure the health, safety and welfare of people who used the service.

Below is a summary of our finding based on our observations, speaking to people who used the service and visitors, the staff supporting them and from looking at records. We considered our inspection findings to answer the questions we always ask '

Is the service safe?

Some people cannot make decisions because of frailty or ill health. Professionals and relatives were involved in taking and making decisions to ensure they were in the person's best interests.

The service placed people at risk because of unsafe handling of medication, so people did not always receive their medicines as prescribed and intended. We have asked the provider to tell us how they are going to improve their service in relation to medication practices.

Is the service responsive?

We saw staff were allocated to work in the two units of the service. People who used the service and visitors told us the staff were very good at supporting them. However, they told us there were not enough staff and they reported delays when support was required. We have asked the provider to tell us how they will ensure staffing levels are sufficient to provide care and support to people in a timely way.

Is the service caring?

Most people who used the service told us that the staff were good and they were satisfied with the care and support provided. We saw that staff in attendance were kind and courteous in their interactions with people.

Visitors told us that they were satisfied with the care provided. They told us of some difficulties encountered with the use of agency staff and their lack of knowledge of the individual's care and support needs.

Is the service effective?

District nurses and other health care professionals were consulted when additional advice and support was needed to meet the care needs of people who used the service.

Care records identified people's needs, choices and preferences but some were not reviewed or updated on a regular basis or when a change was identified. Records were not easily accessible because of the quantity of information in each person's file, meaning it was difficult to find information needed quickly. We have asked the provider to tell us how they are going to improve the recording and reviewing of people's care needs.

Is the service well led?

The service had systems in place to review the quality and safety of the service. These were not completed when they were required to be. We have asked the provider to tell us how they are going to improve the quality of the monitoring of the service.

The service does not have a registered manager. The assistant manager was in charge of the service and was being supported by the area manager of the company. We have asked the provider to tell us how they will make the necessary improvements to ensure the service was managed effectively and efficiently.

Improvements were needed to ensure that records were accurately completed, maintained and provided the necessary information to meet the needs of people who used the service.

At the time of this inspection 47 people were living at the service. We spoke with the regional operations manager and the interim manager, care staff, and a visiting health care professional. We spoke with relatives, visitors and the majority of people who used the service. Relatives and the healthcare professional told us they had no concerns and felt the care provided was good.

One person who used the service told us that the staff were good, but there were not enough of them, the food was satisfactory and sufficient for their needs.

Some people living at the home were unable to fully communicate with us, due to their health needs, so we used a short observational framework tool (SOFI) to observe the support they received and how they responded to it. We observed that staff interacted very well with people but that people had to wait for help and support from care staff.

We saw that systems were in place to ensure that medication was stored safely.

There were not enough care staff to meet the care and welfare needs of people who used the service in a timely way.

We saw that improvements were needed to ensure that people's care records accurately reflected the care and support care staff provided.

Some people were unable to speak with us, so we spent time in the communal area and observed the activity and interactions between people and staff. We saw that staff treated people with compassion and offered discreet assistance to those who required it.

We looked at the care planning documentation for three people who used the service to see how their care was provided and managed. We talked with staff who were aware of and able to discuss, people's care needs.

Staff told us their understanding of safeguarding vulnerable people and confirmed they had received training in this.

We observed that sufficient staff were on duty to meet people's needs in a timely manner. People told us the staff were friendly, helpful and supportive. Visitors told us that the staff were kind and caring.

The manager showed us that they regularly audited the service people received to maintain the high standards they expected.