Abbotswood Court

We found the following examples of good practice.

Measures were in place and clearly communicated to prevent relatives & friends, professionals and others visiting from spreading infection at the entrance and on entering the premises. Automated entrance doors had been fitted to reduce touch point areas, along with an automated sanitising station at the entrance. Before entry, visitors were required to answer a set of questions and their temperatures were taken using a digital thermometer. An electronic signing in system had replaced the previous paper-based system.

Safe visiting was facilitated through the summer using three large garden gazebos, social distancing and an appointment system. A visiting room with separate entrance from the garden was also available during the winter. A Perspex screen and a hearing loop was fitted in the visiting area to assist communication while keeping to social distancing. An ozone machine was used to clean the visiting area after each visit.

People were encouraged to sit two metres apart during activities. All group activities were still taking place but with smaller numbers and some activities now taking place via Zoom, for example a recent Christmas carol concert with other homes in the Cinnamon group. One to one activities were conducted in people’s rooms and there was a new wellbeing programme to support those who had moved in and had to shield for 14 days without being able to see their families.

The staff room was arranged into ‘zoned’ areas and tables for staff working on each particular floor of the home. No more than two staff from each zone were permitted to use the staff room at any time.

Potential new admissions were tested for Covid-19 either at the hospital or before admission from the community by Abbotswood staff. A risk assessment was completed on admission. All admissions followed a 14-day isolation period in their bedrooms. There were specific laundry procedures for new admissions to the home, i.e. their clothes arrived 72 hours in advance of admission and were treated using ozone and labelled.

There were clear procedures in place for donning, doffing and disposal of personal protective equipment (PPE) and staff demonstrated knowledge of these. There were designated areas for donning and doffing PPE. Staff responded to the needs of people living with dementia, using eye contact and providing reassurance. Care plans contained relevant information about this. Staff used a tablet and text to support a person who was hard of hearing.

Staff were now being tested for coronavirus twice a week and people who use the service were having tests once a week, as well as twice daily temperature and oxygen saturation level checks.

Routine cleaning schedules had been enhanced with increased cleaning of contact points, such as doors, handles, handrails, and light switches, including communal areas and people’s bedrooms. A part of the Dementia community area had been closed off to provide an isolation wing, if needed, for those who lacked capacity to isolate for the 14 days in their own rooms.

Staff worked in specific areas as much as possible to reduce movements around the home. The service did not use agency staff; shifts were covered with regular staff by each member of the team stepping down to other roles, such as a team leader becoming a senior and seniors to care if staffing was a challenge. Staff had received specific and ongoing training including infection prevention and control (IPC) and handwashing. Staff told us the provider was supportive. Wellbeing discussions took place and there were timely return to work interviews. There was also a confidential counselling service available to staff.

During the early days of the pandemic the provider had been proactive in introducing twice daily temperature checks and oxygen saturation levels for people using the service. The provider had implemented an Infection Prevention team where representatives from all the support functions met virtually to discuss COVID-19, each care home and any support required. Regular virtual meetings with the home managers had taken place to cascade changes in guidance and practice. The provider had also set up a specific email address for managers and other staff to raise queries. As a result of the CQC ‘Closed Culture’ guidance the provider had reviewed their whistleblowing procedures and outsourced this in order to continue to promote safe care.

The service is registered to provide accommodation and residential or nursing care for up to 60 people. The service does not provide nursing care. At the time of our inspection the service was providing residential care to 42 older people some of whom were living with a dementia. The home is over two floors and bedrooms have en-suites. People have access to a number of sitting and dining areas. The first floor is accessed via a lift. The ground floor provides access to a secure garden area.

The service 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.

People and their families told us they felt the service was safe. Staff had been trained to recognise any potential signs of abuse or poor practice and understood their role in reporting concerns. Risks to people were assessed, regularly reviewed and staff understood the actions needed to minimise risks of harm to people whilst supporting their right to freedom and choice. People had their medicines ordered, stored and administered safely and risk assessments were completed and reviewed regularly for people who chose to self-administer medicines.

Staff had been recruited safely and provided with an induction and ongoing training and support to enable them to carry out their roles effectively. There were enough staff with the right skills to support people’s needs and choices.

Peoples eating and drinking needs were understood and met. This included allergies, likes and dislikes, textured diets and providing specialist crockery and cups to enable independence. People had a choice of hot and cold meal choices and snacks and drinks were always available throughout the home.

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. A complaints policy was in place and when people had used it they had been listened to and had outcomes explained to them.

People and their families described the staff as caring, kind and patient. Staff understood people’s individual communication requirements and this had enabled them to support people in making decisions about their day to day lifes. People had their privacy and dignity respected and were enabled to be as independent as possible. When appropriate people had access to healthcare and were supported to appointments.

Pre admission assessments had been completed and the information had been used to create with people their care and support plans. These included peoples individual care needs, interests and friends and family important to them. People were encouraged to share skills and knowledge and maintain links and be involved with the wider community. A range of activities was available in groups or on an individual basis both inside and outside the home. Activities included people, their families and friends, the staff and their families and the wider community. Peoples skills, knowledge and experience were recognised and they were used to continue old or develop new links with the community. This meant people felt involved and valued.

People, their families and staff spoke positively about the leadership of the home and described the culture as open and inclusive. Staff spoke positively about teamwork, understood their roles and responsibilities and felt supported and appreciated. Methods of communication to the staff team were effective and this enabled staff to work together with common goals. Staff wholeheartedly supported the registered manager’s ethos of people being involved in decisions about the service and being involved in their local community. They spoke proudly of examples were people had been able to share skills or enjoy links with the wider community.

Links had been established with clinical teams and provided opportunities for joint working and learning opportunities in falls management and infection control.

Quality assurance systems and processes were robust and effective in gathering information to support continually reviewing and improving service delivery and had been used to provide opportunities for staff learning.