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Inspection Summary


Overall summary & rating

Requires improvement

Updated 27 February 2019

The inspection took place on 28 and 29 November and 4 December 2018, and the first day was unannounced. Adbolton Hall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Nursing care is provided at this service.

Accommodation for up to 53 people is provided over two floors. There were 32 people using the service at the time of our inspection. Adbolton Hall is designed to meet the needs of older people living with or without dementia.

We previously carried out a comprehensive inspection in February 2018 where we rated Adbolton Hall as Inadequate. As a result, this service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

The service did not have a registered manager at the time of our inspection visit. 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. The service had a manager in post, who had applied for registration.

People were not consistently kept safe from the risk of acquiring infections. Risks associated with people’s health needs were not consistently assessed and measures put in place to reduce potential harm. People's needs were not fully met by the adaptation, design or decoration of Adbolton Hall. Since our last inspection, the provider had made a range of improvements, but there was further work to be done in this area. Records relating to people’s care were not always stored securely. Relatives felt involved in discussing and reviewing their family members’ care. However, people were not always involved in reviews of their care, particularly where they were less able to communicate their needs.

The provider undertook audits of all aspects of the service to review the quality of care, and identify areas where improvements were needed. However, we identified areas where audits had not picked up issues. This meant there was a risk issues with the quality of the service would not be identified and monitored consistently.

People were kept safe from the risk of abuse. Accidents and incidents were reviewed and monitored to identify trends and to prevent reoccurrences. The provider had ensured staff were of good character and were fit to carry out their work. People’s medicines were managed safely. There were enough staff to meet people’s needs.

People were supported to maintain their health. Staff helped people access healthcare services when required. People's right to private and family lives were respected, and they had access to independent statutory advocacy services.

People's consent to care was sought for daily personal care activities. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The provider was working in accordance with the Mental Capacity Act 2005 (MCA), and people had their rights respected in this regard.

People received their personal and nursing care from staff who had training to enable them to meet people’s needs effectively. People and relatives spoke positively about the quality of the food. People were supported and encouraged to have a varied diet that gave them sufficient to eat and drink.

Peopl

Inspection areas

Safe

Requires improvement

Updated 27 February 2019

The service was not consistently safe.

People were not consistently kept safe from the risk of acquiring infections. People’s medicines were managed safely. Staff we spoke with were confident about reporting concerns, and were aware of the provider’s safeguarding and whistleblowing policies.

Effective

Good

Updated 27 February 2019

The service was Effective.

People were supported by staff who were trained to meet their needs. People were supported to maintain their health. People were supported and encouraged to have a varied diet that gave them sufficient to eat and drink.

Caring

Requires improvement

Updated 27 February 2019

The service was not consistently Caring.

Records relating to people’s care were not always stored securely. The provider had not ensured people who required additional support with communication had their needs met. People and relatives were positive that staff supported them with care and dignity.

Responsive

Requires improvement

Updated 27 February 2019

The service was not consistently Responsive.

For people who were less able to communicate verbally, there was not always evidence how staff sought their views, wishes and aspirations. People had support to maintain interests and hobbies. People and relatives knew how to raise concerns or make a complaint.

Well-led

Requires improvement

Updated 27 February 2019

The service was not consistently Well-Led.

The provider had not ensured their quality assurance system was consistently effective in identifying issues and ensuring action was taken to improve the quality of care. Staff felt supported by the manager to carry out their work. The provider had a long-term plan to improve the service environment.