Archived: Abbeyfield Shandford

Abbeyfield Shandford is registered to provide nursing and personal care for up to 26 people.

In September 2017 the provider increased the occupancy at the service from 25 to 26.

Abbeyfield Shandford is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. We regulate both the premises and the care provided, and both were looked at during this inspection. The home is a large detached house in the East Devon seaside town of Budleigh Salterton and is within walking distance of the towns amenities.

At our last inspection in July 2016 we rated the service Good. Although we rated the Effective domain as requires improvement because not all staff had received regular training and supervision. At this inspection we found the service was good in all domains as staff training needs had been met and supervisions was being provided regularly. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good.

The service was well led by the registered manager. The culture was open and promoted person centred values. People, relatives and staff views were sought and taken into account in how the service was run. There were effective systems in place to monitor the quality of care provided. The registered manager made continuous changes and improvements in response to their findings.

People remained safe at the service. People said they felt safe and cared for in the home. There were sufficient and suitable staff to keep people safe and meet their needs. Thorough recruitment checks were carried out. New staff received an induction that gave them the skills and confidence to carry out their role and responsibilities effectively. The registered manager had worked with staff to ensure they had completed the necessary training updates. Most staff had completed or were enrolled on higher level health and social care qualifications. Records showed staff were now receiving regular support and supervision.

People were protected because staff knew how to recognise signs of potential abuse and how to report suspected abuse. People’s care needs were assessed before admission to the home and these were reviewed on a regular basis. Risk assessments were undertaken for all people to ensure their individual health needs were identified and met.

People had a varied and nutritious diet. There was designated activity staff members to support people to engage in activities they were interested in, on an individual and group basis.

People knew how to make a complaint if necessary. They said if they had a concern or complaint they would feel happy to raise it with the management team.

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.

People were supported to lead a healthy lifestyle and have access to healthcare services. Staff recognised any deterioration in people's health, sought professional advice appropriately and followed it. People received their medicines on time and in a safe way.

Further information is in the detailed findings below.

Abbeyfield Shandford Residential Home is a care home providing personal care to a maximum of 25 older people. The home is a detached building in the town of Budleigh Salterton in the coastal area of East Devon. On the first day of the inspection there were 23 people living at the service, which included two people staying for a short stay referred to as receiving respite support.

At the last inspection in May 2015, two breaches of regulation were found. These were because the provider had not protected people by ensuring the safety of their premises and the equipment within it. They had also not ensured staff had the required documents and understanding to apply the Mental Capacity Act 2005 (MCA) appropriately for people they supported.

The provider wrote to us in July 2015 with an action plan to say what they would do to meet the breaches of regulation by the end of September 2015. At this inspection, we found they had followed their action plan and met the legal requirements.

The service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The registered manager had resigned and left the service two weeks before our visit. They had applied to CQC to remove their registration.

The provider had appointed a new manager to run the service. They were in the process of completing their application with CQC to become the registered manager at the service. The new manager had been at the service since the end of April 2016 working alongside the previous manager. This included an induction and a handover period which had been completed on the 1 June 2016. The new manager had regular contact with people working and living at the home and undertook an active role. They were very committed to providing a good service for people in their care and demonstrated a strong supportive approach to people, their relatives and staff. They were supported by a newly appointed deputy manager who had the same visions and values.

The provider ensured there were sufficient numbers of suitable staff to keep people safe and meet their needs. There were staff vacancies at the home which the manager was actively trying to fill. The staff undertook additional shifts when necessary to ensure staff levels were maintained. When gaps were not able to be covered agency care workers who had worked at the home before were used to maintain consistency.

The manager demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (MCA) 2005. They understood that where people lacked capacity a mental capacity assessments needed to be completed and best interest decisions made in line with the MCA. Appropriate applications to the local authority deprivations of liberties team had been made to deprive some people of their liberties. Staff had a good understanding about giving people choice on a day to day basis and were scheduled to receive refresher MCA training to help them understand their responsibilities.

People were supported by staff who had the required recruitment checks undertaken. Staff had received an in house induction but had not always completed the required booklets to demonstrate this. Not all staff had completed the provider’s mandatory training. The manager had recognised this and a programme of training was nearly completed to ensure all staff had undertaken the training and a more thorough induction. Staff were knowledgeable about the signs of abuse and how to report concerns and had completed training in safeguarding of vulnerable adults.

People were supported to eat and drink enough and maintained a balanced diet. People and a visitor were positive about the food at the service.

People said staff treated them with dignity and respect at all times and in a caring and compassionate way. People on the whole received their medicines in a safe way because they were administered appropriately by suitably qualified staff. People who chose had been assessed and were able to self-administer their medicines at the service. However improvements were needed to monitor they continued to take them safely. Where people had medicines prescribed as needed, (known as PRN), protocols were not in place about when and how they should be used. There were effective medicine procedures with regular auditing of medicines.

People had access to activities at the service. People were encouraged and supported to develop and maintain relationships with other people at the service to avoid social isolation. This was evident at mealtimes which were a sociable event. The manager recognised the importance of activities and had arranged an outing for ten people which people said they had been enjoyed. A new activity person was due to join the staff team and an event to attract volunteers to the service was also planned.

People’s needs and risks were assessed before and on admission to the home. Risk assessments were undertaken for people to ensure their health needs were identified. Care plans reflected people’s routines and wishes and reflected people’s changing needs. These gave staff guidance about how to support people safely. They were reviewed on a monthly basis or as people’s needs changed. People were involved in making decisions and planning their own care on a day to day basis. People said they were referred to health care services when required and received on-going healthcare support.

The home had a homely atmosphere with no unpleasant odours. The manager had taken action to complete work recommended in the fire risk assessment to ensure the premises were safe. There were audits in place to monitor the environment and required checks and servicing of equipment were undertaken. Maintenance issues which were identified by staff and audits were carried out by an external contractor who visited the service weekly.

The provider had a quality assurance and monitoring system in place. This included regular audits and an annual survey carried out by an external marketing company. This enabled the provider to assess the effectiveness of the service provided. The manager actively sought the views of people and staff through regular meetings. There was a complaints procedure in place and the manager was dealing with a concern in line with the provider’s policy and procedure.

There were 19 people living at Abbeyfields Shandford at the time of our inspection. We spoke with eight people who lived at the home four care workers and the manager.

People who lived at the home told us they were well looked after and were happy. One person said "I am really happy living here.'

People told us they were happy with their care. One person said "They (the staff) are always around if I need help'.

We saw that staff respected people's wishes and people told us they felt respected. People's privacy was protected by staff. We saw staff knock or doors and waited to be invited in before entering people's rooms.

People told us that they felt safe and knew what to do if they had concerns. One person said "I am well looked after and feel very safe and secure living here.'

Staff knew what to do if they suspected abuse or poor practice.

One care worker told us "I have lots of training, my mandatory training is up to date, I have regular supervision' and 'we all get on well together here".