Abberdale Ltd t/a Abberdale House

We found the following examples of good practice:

The service was clean. There was regular cleaning of high touch point areas. Good governance ensured that this clean environment was maintained.

Visiting procedures were robust to reduce the risk of COVID-19. All visitors followed current government guidance, including: taking a COVID-19 test before entering the service, putting on suitable personal protective equipment (PPE) and only accessing safe and suitable areas of the service.

The service had previously experienced a COVID-19 outbreak. Staff spoke highly of the registered manager's oversight and management of this.

We found that the correct procedures were followed to reduce the risk of COVID-19 transmission around the care home. Training and competency checks ensured staff were skilled in infection control processes. Staff received regular spot checks to ensure that they were following this training.

We saw that staff followed best practice guidance and had good knowledge when spoken to. Information and ongoing government guidance in the

management of COVID-19 was shared with staff.

Staff participated in the testing and vaccination programme. We observed staff wearing the correct PPE throughout our inspection. Staff knew the current government guidelines for PPE use.

Staff spoke positively about the support they had received from the registered manager and provider.

People had been supported to participate in the COVID-19 testing programme and vaccination programme. People's individual risks in relation to COVID-19 had been assessed.

Abberdale Ltd t/a Abberdale House is a residential care service providing personal care and accommodation to people. At the time of the inspection the registered manager confirmed the service was providing personal care to 24 people.

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

People felt safe with staff from the service. Staff understood how to protect people from the risk of harm and understood potential signs of abuse. Care plans provided guidance for staff to follow, and staff had read the care plans. Staff went through a recruitment process so that the provider only employed suitable staff.

People received their medicines as prescribed and they were protected from the risk of infections through staff working practices. There were enough staff to meet people’s needs. Staff undertook induction and specialist training which provided knowledge and skills to do their job well and effectively meet people’s needs.

People were provided with care and support that ensured they had good nutrition and hydration. They had access to healthcare that maintained their health and wellbeing. 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.

Staff knew people well. People had developed positive relationships with staff which helped to ensure good communication and support. Staff respected people’s privacy and dignity. They supported people to be independent.

People and their representatives were involved and consulted when deciding how support was provided. Staff knew and understood the needs of the people using the service and care was provided based on their assessed needs. Staff were responsive to changes in people's needs to ensure people received timely intervention to maintain their health and well-being.

People and relatives knew how to raise any concerns or make a complaint. The provider responded to complaints by investigation and found solutions to put things right. The complaints policy provided information about how these would be managed and responded to.

People, relatives and staff spoke positively about the management and leadership of the service. People and relatives said staff were very friendly and caring, and they had built good relationships with them.

Systems were in place to monitor the quality of care and support people through quality assurance systems and processes to drive improvements within the service.

The service worked in partnership with external agencies to ensure people achieved good outcomes from their care and support.

Rating at last inspection:

The last inspection on 16 November 2016 rated the service as good.

Why we inspected:

This was a planned inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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

This inspection took place on 16 and 17 November 2016. The inspection was unannounced and was carried out by one inspector and an expert 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. Our expert for this inspection had experience of the care of older people and older people living with dementia.

A registered manager was in place. 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 and associated Regulations about how the service is run.

People using the service and their representatives we spoke with said they thought the home was safe. Staff had been trained in safeguarding (protecting people from abuse) and generally understood their responsibilities in this area.

People's risk assessments provided staff with information of how to support people safely.

Staffing levels were sufficient to ensure people were safe.

People using the service told us they thought medicines were given safely and on time.

There was systems in place to ensure that the premises were safe for people to live in.

Staff were subject to checks to ensure they were appropriate to work with the people who used the service.

Most staff had been trained to ensure they had the skills and knowledge to meet people's needs though more training was needed on relevant issues in order there was assurance to meet all the needs of people.

Staff generally understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have an effective choice about how they lived their lives, and the service had obtained legal approval for limiting people's choices when necessary for their best interests.

People had plenty to eat and drink, everyone told us they liked the food served and people were assisted to eat when they needed help.

People's health care needs had been protected by referral to health care professionals when necessary.

People and their representatives told us that staff were friendly and caring and we saw many examples of staff working with people in a kind and compassionate way.

There was some evidence that people and their representatives were involved in making decisions about their care, treatment and support, though evidence was lacking in some care plans.

Care plans were individual to the people using the service and covered their health and social care needs.

There were sufficient numbers of staff to ensure that people's needs were responded to in good time.

Activities were organised to provide stimulation for people, though activities tailored to people's needs had not been frequently provided.

People and relatives told us they would tell staff if they had any concerns and were confident they would be followed up to meet people's needs.

People, their relatives and staff were satisfied with how the home was run by the registered managers.

Management carried out audits and checks to ensure the home was running properly to meet people's needs.

At this inspection we found that the service had made sufficient improvements. People's care had been planned and delivered in a way that ensured people's health and safety. Care records had been regularly reviewed and updated and accurately reflected the care being given.

People we spoke with were happy with the care being provided and our observations showed they were comfortable and confident with staff. Staff were attentive to people's needs and demonstrated a genuine rapport with people who used the service.

During the lunchtime we used our SOFI (Short Observational Framework for Inspection) tool to help us see what people's experiences at mealtimes were. The SOFI tool allows us to spend time watching what is going on in a service. We saw that staff approaches were mixed with some staff taking more time to interact with people than others.

We found that care was provided in accordance with peoples' wishes and when people did not have the capacity to consent, legal requirements were met.

We looked at the care plans and records of four people who used the service. Daily records showed that people had received appropriate care, however some care plans had not been regularly reviewed and another was inaccurate. This meant that people may be at risk of receiving care that was inappropriate or unsafe.

We found appropriate arrangements were in place for the obtaining, recording and administration of medicine.

Staff had been appropriately screened to ensure they were suitable to work with vulnerable people. Staff we spoke with demonstrated a good understanding of the needs of people who used the service.

Records were stored securely and could be located promptly when required.

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We carried out this follow up inspection to see if the service had taken appropriate action to remedy this. We found that some improvements to people's care plans had been made but did not see sufficient evidence to make the service compliant with this regulation.

We did not speak with people who used the service at this inspection. Please see our previous report for details of people's experiences of the service.