We carried out this unannounced inspection of Abbeyfield House on Friday 11 March 2016. At the previous inspection in January 2014, we found the service was meeting each of the standards assessed.
Abbeyfield House is based in Gatley, Stockport and is part of Caritas Services Limited. The home provides personal and nursing care for a maximum of seven people with both physical and learning disabilities. At the time of the inspection, the home was fully occupied.
There was a registered manager in post. 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 told us they felt safe living at the home. The staff we spoke with demonstrated a good understanding of safeguarding procedures and how they would report concerns.
Medication was given to people by nurses who worked at the home, who we found had received appropriate training and were assessed by management to ensure this was done safely.
We looked at how the service managed risk and looked at the risk assessments in place for four people who lived at the home. Although these provided a clear description about how individual risks were being managed, two people’s risk assessments had not been reviewed since January 2015. The manager told us that these had fallen behind but would update them following our inspection. We were also unable to see any evidence of trends analysis following accidents and incidents, to help prevent future re-occurrences and promote learning. These issues meant there had been a breach of Regulation 12 (b) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in relation to Safe Care and Treatment because the service was not doing all that was reasonably practicable to mitigate any such risks.
We found the home had a robust recruitment procedure in place, with appropriate checks carried out before staff began working at the home, to ensure they were fit to work with vulnerable adults. During the inspection we looked at four staff personnel files which contained all appropriate documentation to show staff were recruited safely.
We looked at how the service ensured there were sufficient numbers of staff to meet people’s needs and keep them safe and reviewed the staff rotas. We found the home had sufficient skilled staff to meet people's needs, with staff and people who used the service telling us they had no concerns about the current staffing levels.
We found staff were given all of the training and support they needed to undertake their roles effectively. Two people who lived at the home had also given talks to staff about their experiences of living with different health conditions, with such as Asperger’s and Addison’s Disease. This allowed staff to gain a better insight into living with these types of conditions and how best to support people.
We observed staff being kind, friendly and respectful of people's choices and opinions. The atmosphere in the home was relaxed and the staff spoken with had a good knowledge of the people they supported. People were supported by staff to undertake activities of their choice and saw staff were flexible, based what people wanted to do.
People living at the home were supported with certain aspects of daily living, in order for them to improve their skills in these areas and maintain independence. This included support with food preparation, laundry and cleaning their bedroom.
The Mental Capacity Act 2005 (MCA 2005) sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. The Deprivation of Liberty Safeguards (DoLS) provides a legal framework to protect people who need to be deprived of their liberty to ensure they receive the care and treatment they need, where there is no less restrictive way of achieving this. From our discussions with managers and staff and from looking at records, we found staff had received training about the MCA and DoLS and were aware of then people may need a DoLS to be in place.
People living in the home were involved in the planning of the menus and went shopping with staff to local shops and supermarkets, if this was something they wanted to do. People, who were able to, were given support by staff to prepare their own meals. We found staff often prepared an evening meal for people, who were encouraged to contribute where possible.
People told us they felt the staff were caring and looked after them well. People also told us they felt treated with dignity and respect by staff, who promoted their independence.
Each person living at the home had their own care plan, which provided guidance for staff to follow about how they could meet people’s support needs. Each person also had a separate file, which contained lots of person centred information about what their likes and dislikes were and also their personal preferences.
We saw people had plenty of activities available to them and told us they had enough to keep them occupied. People were involved in discussions and decisions about the activities they would prefer, which would help make sure activities were tailored to each person. One person who lived at the home also attended college two days and week, whilst another person did voluntary work. Other people told us this might be something they would like to pursue in the future.
There was a complaints procedure in place. The procedure was available in an easy read format that could be understood by everyone who lived at the home. We looked at the complaints log and saw complaints had been responded to appropriately, with a response given to the individual complainant.
The staff we spoke with spoke positive about the management and leadership of the home. There were also various systems in place to monitor the quality of service within the home. This included regular audits, done by both the provider Caritas and also internally by the home manager. The home also sent out a satisfaction survey to people living at the home and analysed the feedback so they could respond to what people wanted.