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Reports


Inspection carried out on 11 July 2017

During a routine inspection

The inspection took place on the 11 July 2017 and was unannounced. The inspection continued on the 12 July 2017 and was announced. Abbotts Barton is a residential nursing home situated on the northern edge of Winchester registered to provide accommodation for up to 60 people. There were 54 people using the service on the days of our inspection. Rooms are over three floors, single occupancy and all have an ensuite with a wash basin and toilet. Specialist bathrooms are available on each level of the home. There are a range of public areas including a lounge on each floor, dining room, library and café. There are communal secure gardens with good access from the building.

The home has a registered manager. 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 who were administering their own medicines were placed at an increased risk of harm because risk assessments and reviews were not being completed consistently. Medicines given by staff had been ordered, stored and administered safely including the application of topical creams.

People were supported by enough staff although people told us at times they felt they had to wait too long for help with care. Records showed us that the service had put actions in place that had reduced the length of time call bells were being answered. Staff had been recruited safely and had been given an induction and on-going training and support to enable them to carry out their roles effectively.

People felt safe and were cared for by staff that had been trained to recognise signs of abuse and knew the actions they needed to take if abuse was suspected. Risk assessments relating to peoples assessed risks had been completed and reviewed regularly and actions put in place to minimise risks to people. People had access to healthcare in a timely way and when appropriate.

The principles of the Mental Capacity Act were being followed. People had been supported to make their own decisions and records showed us that when they couldn’t decisions had been made in their best interest. Deprivation of Liberty Safeguards had been applied for when people needed their liberty to be restricted for them to live safely in the home.

Peoples eating and drinking needs were understood by both the catering and care staff including peoples likes, dislikes and any special dietary requirements. Menus provided a choice of nutritious meals and snacks which were available 24 hours a day.

People and their families described the staff as caring, kind and patient. Interactions between people and staff were relaxed and friendly. Staff had a good knowledge of people which enabled effective communication. People felt involved in decisions about their care and told us that they felt their privacy, dignity and independence was respected. A complaints procedure was in place and people felt if they used it they would be listened to and actions taken if possible.

Assessments had been completed and were regularly reviewed with people. The information had been used to create care and support plans which gave clear instructions on how a person wanted to be supported. Activities were available seven days a week and included group events in the home, individual activities specific to a person’s ability and interest and activities in the community.

Staff spoke positively about the organisation and the home and described the Registered Manager as approachable and effective. Communication was described as good and staff had a good understanding of their roles and responsibilities. The home had made links with the local university and was involved in a student nurse mentoring scheme and also provided a precept

Inspection carried out on 8 and 9 December 2014

During a routine inspection

Abbotts Barton is registered to provide accommodation and support for 60 older people who may require nursing care, who may also be living with dementia. The home provides long stay or short stay nursing care. The home was purpose built with accommodation on two floors and a passenger lift for access. The home has a range of lounges, dining areas and gardens.

We undertook an unannounced inspection of Abbotts Barton on 8 and 9 December 2014. This inspection was completed to check that improvements to meet legal requirements planned by the provider after our inspection on 24 September 2013 had been made. This is because the service was not meeting some relevant legal requirements.

At our previous inspection in September 2013 we asked the provider to take action to make improvements in respect of staffing levels. Following our inspection the provider sent us an action plan detailing the improvements they would make. At this inspection we found improvements had been made.

On the day of our visit 58 people were living at the home.

A registered manager was not 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. The day to day management of the home was being overseen by an acting manager and the providers operations and quality assurance managers.

Staff understood the needs of the people and care was provided with kindness and compassion. People, relatives and health and social care professionals told us they were very happy with the care and described the service as excellent. One health care professional said, “I have no concerns at all over the welfare of people living at Abbotts Barton”. People were supported to take part in activities they had chosen. One person said, “I can do whatever I want here. The staff are lovely people and work hard”.

Staff were appropriately trained and skilled and provided care in a safe environment. They all received a thorough induction when they started work at Abbotts Barton and fully understood their roles and responsibilities. Staff completed training to ensure the care delivered to people was safe and effective.

The acting manager assessed and monitored the quality of care consistently involving people, relatives and professionals. Care plans were reviewed regularly and people’s support was personalised and tailored to their individual needs. Each person and every relative told us they were continually asked for feedback and encouraged to voice their opinions about the quality of care provided.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Whilst no-one living at the home was currently subject to a DoLS, we found that the acting manager understood when an application should be made and how to submit one.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests

Referrals to health care professionals were made quickly when people became unwell. Each health care professional told us staff were responsive to people’s changing health needs. One health care professional said staff, “Always contact us if they are unsure or need advice”.

Staff spoke with people in a friendly and respectful manner. The service had a personalised culture and people told us they were encouraged to raise any concerns about possible abuse. One member of staff said, “The home is managed well. If we have concerns we can speak to the acting manager about them”.

Inspection carried out on 24 September 2013

During a routine inspection

When we visited there were 55 people using the service. We spoke with the registered manager, the deputy manager, six members of staff and 13 people who use the service.

Everyone said they were asked for their consent before care was given. One person said �They always ask if they can treat me, the carers are lovely people.�

People�s needs were assessed and care was delivered to support people�s safety and welfare. People�s care was reviewed and updated regularly. One person said �I feel safe and happy here.�

We saw that communal areas of the home looked clean, tidy and well maintained. Everyone told us that staff washed their hands before providing treatment or care and they all wore aprons and gloves when providing care.

People had to wait to be taken to the toilet because there were not enough staff to meet their needs.

We saw records which showed that various audits had been carried out during 2013 such as care plan audit, cleaning audit and a laundry audit. This meant that the provider was regularly checking the quality of the service provided.

Cleaning schedules had not been completed appropriately and this meant that it was not possible to tell from the records whether the cleaning had been carried out.

Inspection carried out on 18 March 2013

During a routine inspection

When we visited there were 53 people using the service. We spoke with the deputy manager, 10 members of staff, 12 people who use the service, or their relatives. The registered manager was on annual leave.

People were treated with respect and kindness by staff. If necessary, they were supported with their meals and there were a range of activities on offer both in the home and in the wider community.

People�s needs were assessed and care was delivered to support people�s safety and welfare. Staff had a good understanding of people�s needs, and any changes were discussed at staff handovers. People�s care was reviewed and updated regularly; however, most people were not aware of the contents of their care plans.

We found that staff were well supported with opportunities for training, development and review. Staff reported that they felt valued working at the service and they were familiar with the safeguarding procedures to keep people safe.

The service responded to complaints appropriately. The complaints procedure was available for people using the service and relatives to refer to; however some people were not aware of this.