Archived: Abbey House

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.”

Medicines were not always stored securely and in line with manufacturer's guidance. People were not always protected against the risk of untoward incidents. The home did not always take action to mitigate the risks associated with weight loss.

Records relating to people’s care needs were not always accurate and up to date. The systems in place to monitor the quality of the service were not always effective.

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 received their medicines as prescribed. Staff administering medicines checked each person's identity and explained what was happening before giving people their medicine.

People told us they were safe. People were supported by staff who could explain what constitutes abuse and what to do in the event of suspecting abuse. Staff had completed safeguarding training and understood their responsibilities.

People were supported by staff who had been trained in the MCA and applied it's principles in their work. Staff told us, and records confirmed they had effective support. Staff received regular supervision (one to one meetings with their manager). Staff spoke positively about the support they received from the registered manager.

There were sufficient staff to meet people's needs. Staff were not rushed in their duties and had time to chat with people. Throughout the inspection there was a calm atmosphere and staff responded promptly to people who needed support. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.

People told us they enjoyed the food at the home. Staff understood people's needs and preferences. Staff were knowledgeable about the support people needed. Staff were kind and respectful and treated people with dignity and respect. Where people required special diets, for example, pureed or fortified meals, these were provided by kitchen staff who clearly understood the dietary needs of the people they were catering for.

The service sought people's views and opinions. Relatives told us they were confident they would be listened to and action would be taken if they raised a concern.

We found two breaches 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.