Abbeyfield London Polish Society

Abbeyfield London Polish Society is a Domiciliary care service that provides personal care for older people. At the time of the inspection seven people were using this service. People all lived in one adapted house.

Each person had their own bedroom and shared communal spaces such as the lounge and dining area.

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

At this inspection we found some aspects of the recruitment process could be improved to reflect more clearly the steps the provider had taken to ensure staff suitability for their caring role. However, recruitment was undertaken in a safe manner.

The registered manager had risk assessed to ensure people’s safety and there was good guidance and information for staff to mitigate the risk of harm to people.

Relatives spoke very positively about the care their family members received and several people and staff described the service as a, “family home.” People were provided with a range of activities to entertain and to support them to remain cognitively and physically active.

People had person centred plans and were provided with personalised care and support. People’s diverse needs were met by staff who spoke people’s preferred language and were able to provide traditional meals and understand people’s customs and traditions.

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 supported people to have their medicines in a timely manner and staff ensured people were supported to have access to health and social care professionals.

The registered manager held daily meetings with staff to hand over information, provide training and review policies and procedures to ensure staff had the right knowledge and skills to provide good care.

People and their relatives spoke well of the registered manager as they felt they were approachable, and any concerns would be addressed.

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

Rating at last inspection and update

The last rating for this service was good overall on 20 April 2017(published on 6 July 2017). They were found to be outstanding in caring and good in all other key questions.

At this inspection this service has been rated good in safe, effective, caring, responsive and well-led. The rating overall is good.

Please see the action we have told the provider to take at the end of this report.

Follow up

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

Abbeyfield London Polish Society offers a supported living service and personal care for up to eight people. At the time of our inspection there were seven people living at the service who were all receiving the regulated activity of personal care. Each person living there had access to the communal facilities such as a lounge, dining room and a garden.

At the last inspection on 13 and 14 June 2016, we found the provider was not meeting the regulations relating to safe management of medication and good governance.

Following the inspection the provider sent us an action plan detailing how they would make improvements. At this inspection, we found that improvements had been made and that the provider had been working consistently towards meeting legal requirements fully.

There was a registered manager in post who had been managing the service for the past 28 years. 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.

The service had made improvements in relation to medicines administration and medicines were administered, stored and disposed of in a safe way. Staff had followed the medicines administration process, which was regularly monitored and audited by the registered manager.

The service had procedures in place for the safeguarding of vulnerable people and these were being followed. All staff working at the service received safeguarding of vulnerable adults training.

People had risks to their health, safety and welfare assessed and recorded in their care plans. Staff knew the identified risks, therefore, they were able to support people in a safe way.

There was a process in place for the reporting of incidents and accidents and there was a clear audit trail of all accidents and incidents that took place at the service.

There were enough staff on each shift to be able to care for people and respond to their changing needs effectively and without delay.

The service had robust recruitment procedures in place to ensure only suitable staff were employed at the service.

All staff working at the service had the experience and the knowledge of working with people who use the service. Additionally, to ensure that people had been cared for effectively, staff received regular external training and ongoing formal supervision and appraisal, and day-to-day support from the registered manager.

The service was working within the principles of the Mental Capacity Act 2005 (MCA). People's capacity had been assessed by the service. People had consented to their care and support where they were able to do so. Staff received MCA and Deprivation of Liberty (DoL) training and had good understanding of its principles.

People were supported to maintain a sufficient and nutritious diet and meals were provided in line with people’s nutritional requirements as well as their individual dietary preferences.

People were supported to maintain good health and had access to healthcare services. The service had made suitable and prompt referrals to external health professionals to ensure people received appropriate medical assistance and they remained in good health.

People and all the family members we spoke with were very complementary about staff and they were happy with the care and support offered by the service. The interactions between people and staff were exceptionally kind, caring and compassionate and the atmosphere at the service was relaxed and homely.

Staff visited people who used the service in hospital to ensure the continuity of care and ongoing emotional support.

Staff was happy to go an extra mile to ensure people lived happy and comfortable life’s and all their needs had been met.

The service promoted inclusion and independence for all the people living there. People were encouraged to participate in various daily tasks related to running the service.

People told us staff respected their dignity and privacy and they felt comfortable when receiving personal care.

Family members and friends could visit at any time and staff welcomed their presence and participation in the life of the service.

People’s needs were assessed before their admission to the service. People and their relatives were welcomed to visit the service prior to their admission to understand how the service worked and what would be offered to them if they lived there.

Each person living at the service had an individual care plan that was person centred and consisted of information on people’s lives prior to living at the service as well as on their current care needs and preferences. All care plans were reviewed regularly and people and their relatives participated in the planning and reviewing of their care.

People using the service had ongoing access to meaningful and stimulating activities throughout the week. People could participate in a range of group exercises and activities and one to one re- enablement sessions.

The service had a complaints policy and procedure in place that was available in the communal area of the service and people and their relatives knew about this procedure.

The service had introduced a survey that was designed to collect feedback about the service they provided. The registered manager was in the process of gathering all surveys in order to analyse the feedback received and use the data to inform the service’s improvement plan.

The registered manager had made continuous improvements with regards to the leadership and governance of the service. They had implemented a new, computer based care planning and service management system to ensure the smooth running and monitoring of the service.

Staff knew what was expected of them and felt comfortable approaching the registered manager with any work queries and challenges.

People who used the service and their family members knew the manager well and they spoke fondly about their commitment to the service and people who used the service.

External professionals gave positive and complementary feedback about the care and support provided by the staff and the registered manager to people who lived there.

The service was last inspected on 22 January 2016 when we found seven breaches of the Health and Social Care Act 2008 and associated regulations. Following the inspection the provider sent us an action plan detailing how they would make improvements. At this comprehensive inspection we found the provider had taken action to address the breaches we had identified and improvements were made.

Abbeyfield London Polish Society offers personal care support for up to eight people. At the time of our inspection, eight people were living at the service, of whom six were receiving personal care. The house consisted of eight bedrooms and each person living there had access to the communal facilities such as the lounge, dining room and garden. All the people and staff living at the service were Polish. We found issues with the current registration of this service as, in effect, the service is provided and managed as a care home but is not currently registered as such. We will take up this issue with colleagues in Registration following the publication of this report.

There was a registered manager in post who had been managing the service for the past 27 years. 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.

The provider had taken action to meet the concerns identified at the inspection of 22 January 2016 and had put systems in place for the recording of received medicines. However, staff did not always follow the procedure for the recording and safe administration of medicines. This meant that people were at risk of not receiving their medicines safely.

The provider did not undertake medicines audits therefore they failed to identify medicines errors.

Improvements had been made in relation to the management of risk. The risks to people’s safety were identified and managed appropriately. The provider had processes in place for the recording and investigation of incidents and accidents.

The provider had put systems in place to ensure people received their support safely. We saw a variety of health and safety checks conducted on a regular basis by staff and external agencies.

Improvements had been made to fire safety, and we saw that the provider carried out regular fire checks and fire drills. All people using the service had personal emergency evacuation plans (PEEPs) in place.

Improvements had been made to the training of staff, and we saw that all staff were receiving training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty.

The provider was aware of their responsibilities and had acted in accordance with the MCA and the DoL. People’s capacity had been assessed by the service. People had consented to their care where they were able to do so and nobody was being deprived of their liberty.

Recruitment procedures were in place to ensure that only suitable staff were appointed to work with people who used the service.

There were enough staff on duty to keep people safe and meet their needs, and there were contingency plans in place in the event of staff absence.

There were appropriate procedures in place for the safeguarding of vulnerable people and these were being followed.

Staff treated people with kindness and dignity and took into account their human rights and diverse needs.

People’s nutritional and healthcare needs had been assessed and were being met.

A range of activities were organised and a therapist visited twice a week and was developing an activity program with each person who used the service and engaging people in exercises.

Assessments were carried out before support began to ensure the service could provide appropriate care. Care plans were developed from the assessments and reviewed regularly.

There was a complaints procedure in place and people and their relatives knew how to make a complaint. They felt confident that their concerns would be addressed. Relatives were sent questionnaires to gain their feedback on the quality of the care provided.

People using the service, their relatives and the professionals we spoke with thought the home was well-led and the staff and management team were approachable and worked well as a team. The staff told us they felt supported by the registered manager and there was a culture of openness and transparency within the service.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which related to safe care and treatment and quality assurance. You can see what actions we told the provider to take at the back of the full version of this report.

Abbeyfield London Polish Society offers housing and personal care for up to 8 people. At the time of our inspection there were 8 people living at the service of which 5 were receiving personal care. The home consisted of 8 bedrooms and each person living there had access to the communal facilities such as a lounge, dining room and garden.

There was a registered manager in post who had been managing the service for the past 25 years.

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.

The registered manager did not have a full understanding of all the requirements related to the delivery of regulated activities.

Some of the staff team’s practices put people at risk of harm.

People’s medicines were not managed safely because there were not stored correctly. The administration of medicines was not recorded and there were no mechanisms in place to ensure regular stock checks of medicines were carried out.

Risks to people’s health and safety were not assessed and recorded correctly, therefore, there was no clear guidance for staff on how to minimise identified risks and how to keep people safe from injury.

There were no regular fire tests and fire drills and people did not have Personal Evacuation Emergency Plans (PEEPS) in place. Therefore, there was a risk that people using the service and the staff wouldn’t know how to act in case of a fire.

Staff did not receive MCA and DoL training and the requirements of The Mental Capacity Act 2005 (MCA) were not always followed. There were no mental capacity assessments in place therefore it was not possible to determine whether people could make decisions about specific aspects of their care.

People’s nutritional and dietary needs were assessed however they were not always reviewed and the health professionals’ guidelines were not available, therefore staff did not know how to serve food safely.

There were no robust recruitment procedures in place to ensure suitable staff were appointed to work with people who used the service.

There were not enough staff on duty and there were no contingency plans to ensure adequate cover in case of sudden staff absence.

People and their relatives were involved in the planning of their care, however, due to complex care planning systems, people’s needs were not always conveyed adequately and there was a risk of important care details and guidance being missed.

There were no robust quality assurance systems in place to ensure on-going monitoring of different aspects of the service delivery.

There were no systems in place to actively seek feedback from different stakeholders, therefore, they did not have the opportunity to evaluate the care offered by the service and influence its development.

There were some systems in place to ensure people lived in a safe environment and various periodic tests being carried out by external contractors.

Staff received safeguarding vulnerable adults training and were able to describe potential signs of abuse. They were aware of the provider’s safeguarding policies and procedures.

Staff received a variety of training that included medicines administration, safeguarding, manual handling and food hygiene. One staff member was in the process of completing their NVQ 2 in Health and Social Care.

Relatives told us the staff knew and understood the needs of their family members. They were happy with the service they received.

People told us they enjoyed the food and that an adequate choice of meals was offered to them. People’s personal culinary likes and dislikes were taken into consideration and people had access to fresh fruit at any time.

Family members and health professionals were pleased with the care provided by the Abbeyfield London Polish Society. They described staff as caring and “going the extra mile” for people using the service.

People’s dignity and privacy was respected and people’s independence was encouraged.

Staff told us family members could visit at any time and relatives confirmed that this was the case.

The service had a complaints policy and procedure in place that was displayed on the information board in the communal area.

People using the service and their relatives spoke warmly about the registered manager and the staff. External health professionals had a positive experience of their partnership work with the service and were happy with the care offered to people using it.

We found seven breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.