Abbeyfield House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a positive learning culture where staff reflected on safety, listened to concerns and used incidents to improve care. Accidents and incidents were monitored and analysed to identify any trends and themes so that action could be taken to prevent any recurrence.

Oversight was recorded across different systems, including both paper-based and electronic formats, which sometimes made overall oversight more difficult. The provider was addressing this to strengthen consistency. A health professional told us, “Staff are very responsive to the needs of people and very vigilant when it comes to nursing/medical issues that need to be addressed, particularly where maintaining their safety is concerned. For example, if a patient falls they are keen to get a plan in place to minimise risk of recurrence or harm.”

The provider worked with people, families and health professionals to maintain safe systems of care and ensure continuity when people moved between services.

Staff completed pre-admission assessments and hospital passports so that key information followed people into and out of the service. Hospital passports initially did not include a body map, but this was addressed promptly after discussion with the registered manager. Regular handovers, “flash” meetings and multidisciplinary contacts meant staff shared information quickly when people’s needs changed. Health and social care professionals gave positive feedback about communication, highlighting the service’s responsiveness and the effectiveness of information sharing processes. One professional told us, “Their communication is excellent with other professionals.”

The provider and staff understood their responsibilities to protect people from abuse and neglect and to balance safety with people’s rights.

Safeguarding incidents were reported and managers reviewed information from paper and electronic systems to maintain oversight, although having multiple systems sometimes made this more complex. Staff had completed safeguarding training and external professionals described the home as open and transparent when they needed more support. People and relatives told us people were safe. One relative said, “They are absolutely safe.”

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met.

DoLS applications had been submitted to the local authority for authorisation, in line with legal requirements.

Staff involved people and those important to them in assessing and managing risks so care could be both safe and enabling. Electronic risk assessments supported staff to monitor falls, health conditions and day-to-day risks, and professionals reported that staff acted quickly when they noticed changes. One professional told us, “Staff take on board any advice, and action this, trying everything they possibly can to improve people’s wellbeing and reduce risk.” Action was being taken to further enhance safe eating and drinking practices for people who required a modified texture diet, building on the systems already in place to ensure staff continued to support people safely and effectively.

One person went out independently, and the appropriate safety measures were in place to support this. A Herbert Protocol was completed, and the person carried a mobile phone with the home’s telephone number saved so they were able to contact staff if required.

External professionals were also positive about how quickly staff acted to keep people safe. A health professional told us that staff responded quickly to people’s needs and acted promptly after incidents, such as falls, to reduce the risk of harm.

The provider did not always address environmental issues promptly. There had been a delay in completing required work on fire doors and addressing additional actions identified during a fire safety audit carried out by Northumberland Fire and Rescue Service. To seek assurances, we contacted Northumberland Fire and Rescue Service, who confirmed they were satisfied with the proposal submitted by the provider which included extensive fire safety upgrades, such as replacing a significant number of fire doors and frames, along with completing fire prevention and compartmentation remedial work throughout the building. This programme of work commenced following our site visits.

Routine environmental and equipment checks were carried out and no immediate concerns were identified. The environment was clean, comfortable and homely. People’s rooms were personalised and the outdoor spaces, including raised planters and a summerhouse, supported people’s wellbeing.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Many staff had worked at the service for a number of years. This stability supported continuity, close knowledge of people’s needs, routines and preferences. A health and social care professional told us, “Many of the staff there have worked there a while which in itself shows this is a good place to work but also ensure consistency and safety for people and reassurance to families.”

Staff received the training, supervision and appraisal needed to carry out their roles effectively. People and relatives told us staff were well trained. A relative told us, “They know what they are talking about.” One staff member said, “The training is sufficient to help me meet the needs of people, and when I have requested extra training, it has been provided.” Where learning needs were identified, such as supporting people with distressed behaviours or ensuring knowledge of diet levels and thickeners, management took prompt action to address them.

There were enough staff deployed to meet people’s needs. We observed staff supporting people in a calm, unhurried manner. Managers were introducing a rolling rota to strengthen continuity and ensure a more predictable staffing pattern for both staff and people.

Recruitment processes were safe. The provider completed the required pre-employment checks to ensure that only suitable staff were employed.

The provider assessed and managed the risk of infection and took steps to prevent it spreading. The service was clean, fresh and welcoming.

Staff followed infection prevention and control procedures in line with current guidance and their training, including the correct use of personal protective equipment and hand hygiene practices.

Overall, medicines were managed safely and people received their medicines as prescribed. We found some minor shortfalls in medicines recording, but these were addressed promptly once identified, and there was no evidence that anyone had been placed at risk of harm. Staff followed appropriate processes for the safe storage, administration and disposal of medicines.

Staff worked closely with pharmacy teams and health professionals to ensure people’s medicines were reviewed when their needs changed. A health professional told us they had a positive working relationship with the service and confirmed that any actions requested were completed in a timely manner. They said staff contacted them appropriately when seeking clarification about prescriptions or dosage instructions. Another professional told us, “Knowledge of medications is always very good, they know what to look for regards any side effects, but they do not rely heavily on medication preferring other ways to manage, which again is refreshing for a care home who often just want to sedate residents to fix issues, Abbeyfield do not do this.”