Archived: Abbeyfield Grove House Residential

Updated 12 August 2015

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 carried out 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 was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using care services or caring for older family members. During the course of the inspection we spoke with the chief executive officer, the operations and compliance manager, the registered manager, eight people who used the service and four members of staff.

We looked at four people’s care plans and risk assessments and other records relating to the management of the service such as training records, staff recruitment records, quality assurance audits and policies and procedures.

Before our inspection the provider sent the Commission 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 also checked all of the information we held about the service and the service provider, in particular notifications about accidents, incidents, and any safeguarding matters.

Following the inspection, we contacted the local authority safeguarding and commissioning teams. We did not receive any information of concern from either of these organisations.

Updated 12 August 2015

This inspection took place on 6 May 2015 and was unannounced. At the last inspection on 16 October 2013 we found was meeting all the regulations we looked.

The Abbeyfield Grove House Residential Unit provides accommodation and personal care for up to 16 older people some of whom are living with dementia. There were 14 people living in the home at the time of inspection.

The home has a registered manager. 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 home had a safeguarding policy in place which made staff’s aware of their roles and responsibilities. We found staff knew and understood how to protect people from abuse and harm and kept them as safe as possible. The care plans in place were person centred and contained individual risk assessments which identified specific risks to people health and general well-being, such as falls, mobility and skin integrity.

There were enough staff on duty to meet people’s needs and staff had undertaken training relevant to their roles. Staff said that they were well supported by the registered manager and senior management team.

There were procedures in place and guidance was clear in relation to Mental Capacity Act 2005 (MCA) that included steps that staff should take to comply with legal requirements. We staff we spoke with had a general working knowledge and understanding of the MCA 2005. The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood when an application should be made and how to submit one when required.

We saw arrangements were in place that made sure people's health needs were met. For example, people had access to the full range of NHS services. This included GPs, hospital consultants, community health nurses, opticians, chiropodists and dentists. However, we found although medication policies and procedures were in place they were not always followed which potentially placed people at risk of not receiving their medication as prescribed.

People told us they found the staff caring, and said they liked living at the home. Relatives gave us positive feedback about the care and support their family members received. Throughout the inspection we saw staff were kind, caring and patient in their approach and had a good rapport with people.

We saw people had been involved in planning their own care and the records we viewed had consent to care and treatment forms in place that had been signed by the person or their relative. Relatives told us they were involved in all aspects of family members care and treatment and kept informed of any significant changes in their general health or well-being.

Staff were careful to protect people’s privacy and dignity and people told us they were treated with dignity and respect. We saw information relating to people’s care and treatment was treated confidentially and personal records were stored securely.

People told us staff were responsive to their needs and when they asked for something this was provided. The activities plan for the home showed that activities took place every day of the week and people were encouraged to participate in local community events.

We saw the complaints policy had been available to everyone who used the service. The policy detailed the arrangements for raising complaints, responding to complaints and the expected timescales within which a response would be received.

Staff told us communication within the home was good and staff meetings were held to keep them up to date with any changes in policies and procedures or anything that might affect people’s care and treatment. Staff were confident senior management would deal with any concerns relating to poor practice or safeguarding issues appropriately.

Some concerns were raise about the effectiveness the quality assurance monitoring system in place. However, the registered manager told us the organisations had recently introduced a more robust management system which would quickly highlight any shortfalls in service provision so that immediate action could be taken.

We found one breach 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.