Archived: Abbey House

Updated 22 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

This inspection took place on 7 August 2018 and was unannounced.

This inspection was carried out by four inspectors and two Experts by Experience. An Expert-by-Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to the inspection we looked at information we held about the service. This included previous inspection reports and statutory notifications. Statutory notifications are specific events the provider has to notify the Care Quality Commission about under law. We gathered feedback from commissioners of the service and spoke with one health professional.

During the inspection we observed care practice and used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We looked at five people's care records, three staff files and other records relating to the management of the service.

We spoke with, 17 people using the service and eight visitors and relatives. We spoke with the registered manager, deputy manager, one nurse, two team leaders, six care staff, the chef, two activity staff, a housekeeper and maintenance person.

Updated 22 September 2018

This inspection was carried out on 7 August 2018 and was unannounced.

Abbey House 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.

Abbey House accommodates up to 74 people in a three-storey building divided into six units. At the time of the inspection there were 33 people using the service, who were accommodated on two floors.

At the last inspection on 3 August 2017 we found two breaches of The Health and Social Care Act 2008 (Regulated Activities) 2014, relating to the safety of people, records and the systems for monitoring the service. At this inspection we found some improvements had been made. However, we found additional concerns.

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.

Systems to monitor and improve the service were not effective and the registered manager did not have a clear overview of the service and the quality of care being provided to people. Systems for gaining and acting on feedback from people were not always effective.

Systems for monitoring accidents and incidents were not effective. There was not always records of any action taken as result of accidents and incidents and not always evidence of investigations being completed.

Risks to people were not always identified and where risks were identified there were not always effective plans in place to manage those risks. Medicines were not managed safely to ensure people received their medicines as prescribed and were kept pain free.

People did not always receive specific food and drink to meet their dietary needs and risks associated with people’s health needs were not effectively managed.

Care plans were not always accurate and up to date and did not reflect people’s needs. Care plans did not contain information regarding guidance or changes to people’s care needs following visits from health professionals.

There were not sufficient staff deployed to meet people’s needs. Staff were required to move between units to help colleagues, this meant people sometimes had to wait for care and support.

We saw kind and caring interactions. However, people were not always treated with dignity.

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.

We identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.”