Abbeywood Tottington Limited

Abbeywood Residential Care Home is a large extended detached property which provides accommodation for up to 40 older people who require support with personal care. Accommodation is provided over several floors, accessible by two passenger lifts. The home is situated on a main road close to the centre of Tottington. There is easy access to local amenities and shops as well as public transport. At the time of the inspection there were 33 people living at the home.

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

The deputy manager had recently been appointed as the manager. The management team completed regular audits and checks. Information gathered had helped to inform the homes business improvement plan identifying areas of development for the forthcoming year. The monitoring of staffing levels and the development of activities were to be explored further by the manager.

Safe systems were in place with regards to safeguarding procedures, staff recruitment, the management and administration of people’s medicines and infection control procedures.

Individual and environmental risk were assessed and monitored. Individual care plans were in place providing information about people’s individual needs and wishes. Information was being transferred to an electronic system to help monitor and review the information recorded. Records showed relevant referrals were made to help maintain people’s health and well-being.

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.

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

Rating at last inspection

The last rating for this service was good (published 25 April 2022)

Why we inspected

We received concerns in relation to people’s care, staffing levels and falls management. As a result, we undertook a focused inspection to review the key questions of safe and well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Abbeywood Tottington Limited on our website at www.cqc.org.uk.

Follow up

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

Abbeywood Residential Care Home is a large extended detached property which provides accommodation for up to 40 older people who require support with personal care. Accommodation is provided over several floors, accessible by two passenger lifts. At the time of the inspection there were 35 people living at the home.

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

Action had been taken to address the shortfalls identified at the last inspection.

Recruitment processes had been improved ensuring all information and checks were in place prior to new staff commencing work. Relevant health and safety checks had been carried out to ensure the safety and suitability of the premises and equipment. Systems were in place to monitor and review the service. Care records were kept under review and updated to reflect people’s changing needs.

Adequate numbers of staff were available. Managers were actively recruiting for staff so that enough staff were available as occupancy increased.

People’s prescribed medicines were managed safely. Records for the application of topical creams had been improved. Arrangements were made to replace the medication fridge so that items were stored at the correct temperature. Where people received their medicines covertly, decisions had been made in their ‘best interest’. 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.

Systems and process were in place to help ensure people were safe. Accidents and incidents were recorded and reported to relevant agencies, where necessary. The provider was exploring how the service could be improved further.

The service continued to maintain good hygiene standards. Relevant COVID-19 guidance was followed in relation to staff and resident testing and the use of personal protective equipment (PPE). People continued to be supported to meet with family and friends.

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 22 April 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.

Why we inspected

We carried out an announced focused inspection of this service on 25 February 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 safe care and treatment, fit and proper persons employed and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led, which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive and focused inspections, by selecting the ‘all reports’ link for Abbeywood Tottington Ltd on our website at www.cqc.org.uk.

Follow up

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

Abbeywood Residential Care Home is a large extended detached property which provides accommodation for up to 40 older people who require support with personal care. Accommodation is provided over several floors, accessible by two passenger lifts. The home is situated on a main road close to the centre of Tottington. There is easy access to local amenities and shops as well as public transport. At the time of the inspection there were 29 people living at the home.

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

Concerns had been raised with CQC about the safe care and treatment of people living at Abbeywood. Managers were assisting the local authority with their investigations.

Management systems were not sufficiently robust ensuring regulation notifications were forwarded to CQC when required. Nor had they identified the shortfalls found at this inspection. Records in relation to staff rotas and training had not been accurately maintained to reflect current arrangements.

Servicing and maintenance checks were not up to date. The fire risk assessment had not been updated to reflect changes to the property and evacuation procedures needed to be expanded upon.

Areas of risk were assessed and planned for. However, we found information in the care plans and risk assessments did not always provide sufficient detail or accurately reflect people’s current and changing needs. People’s records did show additional advice and support had been sought from health professionals where people’s needs had changed.

Recruitment checks were not sufficiently robust. Criminal records checks had not been received prior to commencing work, a risk assessment had not been undertaken where a disclosure had been made and gaps in employment had not been explored.

The management of people’s prescribed medicines, including controlled drugs, were being managed safely. We have made a recommendation about records to confirm the application of prescribed topical creams, which should be signed by those staff completing the task.

Good infection control procedures were in place with additional checks and cleaning due to COVID-19. The service was also involved in the testing and vaccination programme and appropriate personal protective equipment (PPE) was available and worn by staff. Monitoring records were completed where people had been supported to isolate.

People told us they were happy living at home, liked the staff and said they were well cared for. People had enjoyed being able to maintain contact with family members and have visits using the new ‘lodge’. People’s relatives were also happy with the care and support their family member received. Communication was said to be good and relatives felt their views were listened to.

Staff said they felt supported in their role, there was good teamwork and people’s changing needs were communicated. Opportunities for learning and development were also provided.

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

Rating at last inspection: The last rating for this service was Good (published 10 March 2018).

Why we inspected

We received concerns in relation to risk management where people had sustained injury, locked bedroom doors and delays in seeking medical advice and support. As a result, we undertook a focused inspection to review the key questions of safe and well-led.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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

We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

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

Enforcement

We have identified breaches in relation to health and safety checks, recruitment procedures, record keeping and systems to evidence clear management and oversight of the service at this inspection.

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

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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 confidently demonstrated the use of personal protective equipment (PPE), including correct means of disposal.

Handwashing facilities were accessible throughout the building. Hand sanitizer was also provided. Relevant guidance was displayed.

The home was well ventilated and visibly clean; regular cleaning procedures were in place to minimise the risk of infection.

The service engaged with a regular testing programme and staff were positive in their approach to supporting people with this process.

The service was rated requires improvement in effective and overall as Good. At this inspection we found the breaches had been met and the service remained overall Good in all areas.

Abbeywood 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.

Abbeywood Residential Care Home is a large extended detached property which provides accommodation for up to 40 older people who require support with personal care. There were 36 people living at the home during our inspection.

The service had a manager who was registered with us. 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 registered manager and the nominated individual, the person nominated by the registered provider were present during this inspection. The nominated individual worked at the home on a day-to-day basis.

Staff had received training in safeguarding adults. They were able to tell us of the action they would take to protect people who used the service from the risk of abuse.

Recruitment checks were carried out to ensure suitable people were employed to work at the home. Our observations and discussions with staff and people who lived at the home confirmed sufficient staff were on duty.

Risk assessments had been put in place and were individual to the person assessed. This was to minimise potential risk of harm to people during the delivery of their care and support.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storing.

We had a walk around most parts of the building and found the home was well decorated and maintained and infection control measures were in place.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

We observed regular snacks and drinks were provided throughout the day between meals to make sure people received adequate nutrition and hydration.

We found people had access to healthcare professionals and their healthcare needs were met.

During the inspection we observed frequent and friendly interactions between staff and people who used the service. The atmosphere at the home was calm and relaxed.

Enabling people to die with dignity and remembering those who had lived at the home was very important at the home.

People who lived at the home were encouraged to participate in a range of activities that had been organised.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available.

The registered provider used a variety of methods to assess and monitor the quality of care at Abbeywood. These included regular audits of the service, quality assurance surveys, resident meetings and staff meetings to seek the views of people about the quality of care at the home.

There were effective systems in place to reduce the risk and spread of infection. We looked around most parts of the home. We found that the home was clean and tidy and no malodours were detected.

People who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.

There were recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

Prior to our visit we contacted the local commissioning and safeguarding teams. They confirmed with us that they were not aware of any concerns about Abbeywood at this time.