Archived: Abbotsfield Residential Care Home

Our last comprehensive inspection of this service was in November 2016. At that inspection we assessed that the provider was meeting legal requirements. However, we found, although people were safe, improvements were needed to the assessment and recording of risks and to the use and auditing of medicines used in the home. We also found that people gave consent to any support they received but the processes to obtain and record consent needed to be improved. Although the provider had systems to assess the quality of the service these had not identified areas where the service required further improvement. We made recommendations that the provider took advice to improve these areas. We checked these areas at this inspection in May 2018 and found that the provider had taken action to address these issues.

Abbotsfield Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home provides accommodation and personal care for up to 26 older people and people who have dementia. At the time of our inspection there were 22 people living in the home.

The home is a large period property, set in its own grounds, that has been adapted for its present use. There is a main stair lift and two smaller chair lifts linking the accommodation on the ground and first floor of the property. The home has a range of equipment to assist people who live there.

There was a registered manager employed. 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 told us this was a good service and said they would recommend it. The staff knew people well and treated people with kindness and respect. People were asked for their views and action was taken in response to their comments.

People received the support they required to maintain their mental and physical health. The registered manager worked with appropriate services to ensure people continued to receive the support they required if their needs changed and when they were approaching the end of life.

People were safe and protected from abuse. The staff knew how to identify and report abuse and were confident to do so.

There were enough staff to provide the support people required. Safe systems were used when new staff were employed to check they were suitable to work in the service. The staff completed a range of training to give them the skills and knowledge to provide people’s support.

People’s rights were respected. 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 provided with meals and drinks they enjoyed. They had been asked for their views about the meals provided and menus had been changed in response to their feedback.

Care was planned and delivered to meet people’s needs.

Visitors were made welcome in the home and people could see their friends and families as they wished.

The registered manager had a procedure for receiving and responding to complaints about the service. Information about how people could complain and agencies independent of the service that people could contact were displayed in the home.

There were arrangements in place to ensure the effective management of the home. People knew the registered manager and members of the management team and were confident approaching them as they needed. The registered manager and members of the management team carried out checks on the service to ensure people received a good quality of service.

The registered manager had informed us of significant incidents that had occurred in the home. This meant we could check appropriate actions had been taken.

We last inspected this service in February 2015. At that inspection we found breaches of legal requirements. We found that people were not always safe because action had not been taken to protect them from foreseeable risks, people had not always been supported in a way that maintained their dignity, care had not been planned to meet people’s needs and the systems for assessing the safety and quality of the service had not been robust.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. At our inspection in November 2016 we looked at the actions the provider had taken and found that legal requirements had been met.

Abbotsfield Residential Care Home provides accommodation and personal care for up to 30 older people and people living with dementia. The home is a large period property, set in its own grounds, which has been adapted for its present use. Accommodation is provided on the ground and first floor of the building. There is a main stair lift and two smaller chair lifts linking the accommodation on the ground and upper floor. There were 22 people living in the home at the time of our inspection.

There was a registered manager employed at the home. 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.

Everyone we spoke with told us that people were safe living in the home. There were enough staff to provide support as people required. The staff were trained and knowledgeable about how to protect people from abuse.

The staff treated people with kindness and respect. People were asked for their views and included in decisions around their care.

People’s privacy and dignity were respected and they were supported to maintain their independence. They were included in agreeing to the care they received and support was planned and provided to meet people’s needs.

People received a choice of meals, snacks and drinks and were supported to eat and drink enough to maintain their health. They could see their visitors as they wished and were provided with a range of activities that took account of their interests and preferences.

Risks to people’s safety had been identified and there was information for staff about how to protect people from risks such as falls and fire. Some risk assessments had not been completed properly and one emergency evacuation plan was out of date. However, the staff we spoke with understood how to protect people from harm.

We have made a recommendation about the assessment and recording of risks.

People were supported to access appropriate health care services. They received their medicines as they needed and in a discreet way that protected their dignity. Some information for staff about the use of “as required” medicines required more detail to guide staff on their use. We also saw that the systems used to check medicines required more detail of the checks that had been completed.

We have made a recommendation about the use and auditing of medicines held in the home.

People received support from staff who knew them well and who had completed training to give them the skills and knowledge to provide their care. The staff felt well supported and were given opportunities to discuss their practice with members of the home’s management team.

People gave consent to the care they received and their rights were respected. Records around consent had not always been signed by people with the appropriate valid and legal authority.

We have made a recommendation about the processes used to obtain consent.

People knew the registered manager and the members of the home’s management team. They said they would be happy to speak with one of the managers if they had any concerns about the service provided.

The managers in the service had taken action to make and sustain improvements in the areas we identified at our inspection in February 2015. They had carried out checks on the service but these had not identified areas where the service needed to improve further.

People made many positive comments about the care staff and told us they provided a good quality of care. They said the routines in the home were flexible, fitting around the wishes and preferences of the people who lived there.

People told us:

'The staff are wonderful, they are all very caring and kind,'

'We have a choice of meals, but if you don't like either of the options they'll always make you something else.'

And said, 'The girls know I like things a certain way and it's never too much trouble for them to do things how I ask.'

Many of the people who lived in the home were not easily able to express their views about the service or the care they needed. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

From our observations we saw that people received the care they needed in a way which respected their rights and protected their safety and independence.