Abbey Wood Park Care Home

Abbey Wood Park care home is a residential care home providing personal and nursing care to up to 39 older people with physical disabilities and or sensory impairments and people living with dementia. At the time of the inspection, 30 people were living in the home.

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

Everyone we spoke with told us they felt safe living at the home. There were enough staff deployed to ensure people’s needs were met in a timely way. Risk assessments were in place and robust, and accidents and incidents were scrutinised for patterns and trends. Infection control procedures were in place; particularly in response to COVID-19 and the home was visibly clean and tidy. Medications were well managed; the environment was safe and secure and staff were recruited and selected safely.

People were supported to have maximum choice and control over 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 were appropriately trained and supervised to enable them to carry out their roles. People were supported to eat a balanced diet.

People said the staff were kind and caring, and we observed warm and familiar caring interactions between staff and people throughout the duration of our inspection.

Care plans were person-centred and reviewed regularly to ensure any changing needs were taken into account. There was a complaints policy in place, which was made available in different formats to support people’s understanding. There had been no recent complaints, however everyone we spoke with told us they knew how to complain.

All people knew who the management team were. Staff told us the manager led by example and was ‘there for support’. The manager welcomed feedback and was clearly proud of the home and the staff team. All notifications had been sent to CQC, and the manager understood what was expected of them. Staff told us they enjoyed working at the home, and they felt they could approach the manager, deputy manager, provider and senior staff to help them develop further in their roles or if they had any concerns.

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 requires improvement (published 27 May 2021)

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended the provider review and make improvements to systems and processes in relation to recruitment, following advice from health care professionals and staff training. At this inspection we found improvements had been made in all areas.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 19 and 25 March 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve in relation to safe care and treatment, staffing, safeguarding, MCA and governance.

We undertook this comprehensive inspection to follow up on action we told the provider to take at the last inspection. We also checked whether the Warning Notice we previously served in relation to Regulation 12 and Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

Follow up

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

Abbey Wood Park care home is a residential care home providing personal and nursing care to older people, people with physical disabilities and or sensory impairments and people living with dementia. At the time of the inspection, 15 people were receiving regulated activities at the home. The service can support up to 39 people.

At the time of the inspection visit the home was separated into two separate units. One unit had been registered as a designated site, supporting people who were recovering from COVID-19. One person was living within this scheme on the first day of inspection. The remaining people were living on the residential unit. On the second day of inspection, we were informed no one was being supported within the designated site and this was no longer open for admissions. People living on the residential unit had access to two lounges and a secure garden area.

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

People within the residential and nursing unit were not safe. Risk was not always appropriately identified, assessed and managed in a timely manner. Safeguarding procedures aimed to keep people safe were not consistently implemented and when people had been exposed to risk of harm, incidents were not always reported to the local authority safeguarding team for review. Infection control processes on the residential and nursing unit were not robust and we could not be assured good practice guidance was consistently implemented. The registered provider was working hard to make improvements to medicines management, however some concerns remained, and we could not be fully assured medicines were always managed safely. We have made a recommendation about recruitment processes.

Governance systems within the home were not always sufficient and had sometimes failed to identify all the key concerns we picked up at inspection. For example, infection control processes, medicines and safeguarding procedures had not been fully implemented and embedded within the service. Auditing systems were missing and when audits had taken place, they were not always effective. Auditing systems to keep people safe had not been implemented on the first day of inspection. Paperwork was not always in place, accurate and complete.

Consent to care and treatment was not routinely sought for people, so we could not be assured people had consented to all care and support. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. We have made a recommendation about the review of systems to ensure consistent and effective care and staff training.

Care and support were sometimes person-centred. We observed some positive interactions between staff and people who lived at the home. Staff had time to sit and spend time with people. However, we were not fully assured that person-centred care was consistently provided. People told us they were happy with the food and we were assured that people’s dietary needs were met.

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

Rating at last inspection

This service was registered with us on 10 October 2018 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about medicines, infection control, staff practices, leadership and governance. A decision was made for us to inspect and examine those risks.

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 coronavirus and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the full report.

You can see what action we have asked the provider to take at the end of this full report.

The registered provider has been responsive to concerns noted during the inspection and has started to take action to make improvements and promote safety within the home.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to management of risk, medicines, infection control, safeguarding, consent, and governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We found the following examples of good practice:

• Staff were wearing the required levels of personal protective equipment (PPE) and they disposed of used PPE safely and in line with the relevant guidance.

• The home had a COVID-19 testing programme in place ensuring that all residents and staff were tested regularly.

• Staff supported relatives to safely visit their loved ones in exceptional circumstances in line with the relevant guidance, such when people were receiving end of life care.

• Staff and people living at the home were supported to isolate when necessary.

• The layout of communal areas in the home had been adjusted to ensure social distancing could be maintained. For example, chairs in the lounge areas had been moved further apart.

• The premises were clean and hygienic. Frequent cleaning was carried out throughout the day.

We found the following examples of good practice

• A safe visiting procedure was in place and followed. Visitors to the service had their temperature taken and completed a health screening questionnaire. Hand sanitiser was available, and a PPE station and changing facilities were located near to the main reception. A temporary record of all visits was kept to support NHS Test and Trace.

• The service was registered for regular testing to ensure people and staff were tested frequently. Staff were aware of the need to self-isolate if they developed any symptoms.

• The service had a self-contained unit with a designated staff team to support people with COVID-19. Accommodation for people consisted of single rooms with washing and toileting facilities. Outdoor space was also utilised with social distancing measures in place.

• The service followed good infection prevention control standards. Training, policies, procedures and equipment were in place to maintain infection control and support the needs of the people using the service. The registered manager acted as the lead for infection prevention and control.

Further information is in the detailed findings below.