Abbey Court

Abbey court is a residential care home with nursing providing personal care for up to 44 people. The service provides support to older people living with dementia. At the time of our inspection there were 43 people using the service.

People’s experience of using this service and what we found

Risks to people were regularly assessed and appropriate measures were in place to minimise risk. People's medicines were managed safely, and staff followed correct infection control procedures. Health and safety checks were regularly conducted. Accidents and incidents were recorded, and actions were taken to mitigate the risk of reoccurrence.

Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and knew how to do this. The service had enough safely recruited staff who were appropriately skilled and knew people's needs to help keep them safe.

People and their relatives spoke positively about the care and support they received. One relative said, “We trust the staff, they’re canny, they’re on the ball.”

The registered manager was clear about their role and responsibilities. The registered manager was well respected by staff. Staff felt well informed and supported to undertake their roles. There were effective systems in place to monitor the quality and standard of the service. The service worked in partnership with others including health professionals and the local community.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published January 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service is good. This is based on the findings of this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Abbey Court on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Abbey Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Abbey Court is registered to accommodate 45 people in one adapted building over two floors. At the time of the inspection there were 37 people accommodated at Abbey Court.

The current manager had been in post for eight months at the time of the inspection and had made an application to register with the Commission. Since the dates of the inspection site visits their application has progressed and they became the registered manager on 11 December 2017.

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.

We completed an initial walk around of the home with the deputy manager and carried out a further walk around with the registered manager to look at how safe the premises were. We found goods were stored in the under stairs areas on two fire escapes however this did not compromise the evacuation route. Clinical and general waste bins were open and the waste storage area was unsecured. Action was taken immediately to rectify these concerns and we have received assurances from the provider that all concerns have been resolved.

We also found during lunch time that a hot-lock trolley used for keeping food hot presented a trip hazard for people. This had been identified by the compliance manager and a permanent solution sought however the immediate risk had not been mitigated.

We found some concerns in relation to record keeping which had not been identified through the providers quality assurance systems. These related to some care records and two peoples medicine records.

We have made a recommendation about the maintenance and upkeep of records.

Safeguarding concerns, accidents and incidents and complaints had been logged. Lessons learnt in relation to safeguarding’s and complaints were recorded and had been used to improve practice.

Medicines were managed safely and a pharmacy auditor confirmed they had no concerns with regards to medicines management at Abbey Court.

End of life care was provided sensitively and with compassion. The deputy manager was very aware of the need to ensure family members, as well as the person, were supported at this difficult time.

Staff were able to spend time with people chatting and supporting them in a relaxed and friendly manner. Caring relationships were observed and people and relatives were complimentary about the approach of the staff.

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 support this practice.

Care documentation included information about people’s personal history, their likes and dislikes, past jobs and significant people and events. This information was used to get to know people, to plan activities and to develop support strategies. Care plans were detailed and specific to the person.

Risks were assessed and managed effectively. We found one person did not have a risk assessment in place for choking and the deputy manager was proactive in ensuring this was completed.

People were supported with their nutritional and hydration needs. Staff were offered praise during the handover in relation to the support they offered people to maintain a healthy fluid intake. Where specialised advice and guidance was needed there was active involvement from the external healthcare professionals.

People and their families where appropriate, had been involved in the planning of their care.

Safe recruitment practices were followed and there were enough staff to meet people’s needs. Supervisions with staff had been held regularly and annual appraisals were scheduled to be completed.

Relatives felt staff were well trained and able to meet the needs of their family member. A training matrix was in place and where gaps had been identified a plan was in place to ensure staff attended the required training.

Some activities were being provided however they were not well advertised as notice boards were not yet available due to the ongoing refurbishment. The environment was being developed to meet the needs of people living with a dementia.

Staff, people and relatives were complimentary of the management team and felt significant improvements had been made since the registered manager and deputy had been in post. Quality assurance systems were in place which evidenced that areas for improvement had been identified and that action had been taken to address these areas.