Abbey Ravenscroft Park Nursing Home is a 'care home'. The accommodation is purpose-adapted with passenger lift access to all three residential floors, each of which have separate adapted facilities. People in this care home receive accommodation along with nursing and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service has a registered manager, which 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 is registered to provide accommodation for up to 67 people, although records informed us the maximum practical occupancy was 64. There were 52 people using the service at the start of this inspection. The service specialises in dementia care and is operated by a regional care provider.
This was an unannounced comprehensive inspection, to make sure the service was providing care that is safe, caring, effective, responsive to people's needs, and well-led.
At our last inspection of this service, in September 2017, we found two breaches of legal requirements. These were in respect of safe care and treatment, and safeguarding people using the service from abuse. The service was rated 'Requires Improvement.' The provider completed an action plan to show what they would do and by when to improve the rating of key questions of 'Is it Safe?' and 'Is it Well-Led?' to at least ‘Good.’
At this inspection, we found the necessary improvements had been made. Systems, processes and practices were now safeguarding people from abuse. The service was also now ensuring people received medicines as prescribed. The service’s overall rating from this current inspection has therefore improved to ‘Good.’ However, the rating for ‘Is it Safe?’ remains ‘Requires Improvement.’ This is because we identified some concerns about staff recruitment processes, maintaining sufficient staffing levels in practice, and upholding infection control standards. Whilst the provider sent us a comprehensive written response to address these matters shortly after our visits, we could not be assured that these matters would have been identified without our involvement. We have recommended the provider seek and implement best practice guidance on staff recruitment checks.
People using the service spoke positively about it, describing it as ‘very nice’ and ‘excellent’ for example. Everyone said they would recommend it to friends and family. People’s relatives and representatives provided similarly positive feedback. There was particular praise about supporting people with health-related matters.
We found the whole service worked in co-operation with other organisations to deliver effective care and support. This helped ensure that people’s health care needs were well attended to, for example, for skin integrity, swallowing concerns, and with helping people to reduce aggressive behaviours. People were supported to eat and drink enough and maintain a balanced diet.
The service made sure staff had the skills, knowledge and experience to deliver effective care and support. Staff were committed to people’s care, and treated people with kindness, respect and compassion.
The service supported people to maintain relationships that mattered to them. People’s visitors, relatives and representatives were welcomed into the service, and kept updated where appropriate.
People were supported to express their views and make decisions about their care and support. Their independence was promoted, and their privacy and dignity was respected including for end-of-life care.
People's needs were holistically assessed to help ensure the service could meet their specific needs. These were kept under review, to help ensure people received a responsive service.
The service provided a range of activities that aimed to reflect people’s preferences.
Attention was paid to providing a safe service, both in terms of the premises and equipment, and in respect of people’s individual abilities and needs. Accident and incidents were kept under review, to aim to minimise risks of reoccurrence.
The service listened and responded to people’s concerns and complaints, and used this to improve the quality of care. Systems at the service generally enabled sustainability and supported continuous learning and improvement.
The feedback of some staff indicated weaknesses in the service’s working culture. The provider sent us an action plan shortly after our visits, that aimed to address this. Nonetheless, the provider, management team and staff upheld a clear vision and credible strategy to deliver the good quality care and support that people and their representatives told us of and which we found.