Abbeywell Court

Abbeywell Court is a care home providing personal and nursing care to up to 45 people. The service provides support to older people, including people living with dementia, people with mental health concerns and younger adults. At the time of our inspection there were 38 people using the service. Care was provided in one adapted building across two floors. There were communal rooms available on each floor and an enclosed garden for people to enjoy.

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

During the last inspection, quality assurance processes were identified as requiring improvement. During this inspection we found improvements were still required to ensure risks were effectively monitored and care plans were kept in line with people’s changing needs.

Risks to people were not always managed or monitored safely. There were gaps in people’s repositioning charts and some medicines were not always effectively monitored or stored safely.

Staff received a detailed induction and on-going training. However, staff did not receive epilepsy training despite people with a diagnosis of epilepsy living in the home.

People were not always treated with dignity and respect. There was an occasion where staff did not respond to a person displaying distressed behaviour and on another occasion a person was not supported in a dignified way during lunch.

The provider acted quickly to the concerns identified. All care documentation was updated or amended accordingly. New systems were implemented to improve quality processes and medicine monitoring. The concerns regarding dignity and respect were addressed with the staff team and all staff were put on an epilepsy awareness course.

Staff were recruited safely. The provider used a dependency tool to ensure there were enough staff on duty to meet people's needs.

People told us they felt safe living in the home. Staff understood what was meant by abuse and told us how they would report their concerns.

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.

People’s preferences and cultural beliefs were respected. People and relatives praised the meaningful activities which took place in the home.

Relatives and staff had confidence in the manager's ability to lead the service. A visiting professional confirmed how the provider worked in partnership to achieve positive outcomes for people.

People, relatives and staff felt involved in the home and felt able to offer suggestions and raise concerns openly.

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 requires improvement (published 01 July 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last 2 consecutive inspections.

Why we inspected

We received concerns in relation to staff training, the management of medicines care and risk monitoring. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only. We inspected and found there was a concern relating to the dignified care and treatment of people, so we widened the scope of the inspection which included the key question of Caring.

The provider acted quickly on all concerns and put in systems and processes to address each area. We will review these in our next inspection.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained Requires Improvement. This is based on the findings at this inspection.

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

Enforcement and Recommendations

We have identified breaches in relation to risk monitoring and recording, safe managing of medicines and governance systems 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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

Abbeywell Court is a care home providing personal and nursing care to up to 45 people. The service provides support to people with physical and mental health needs in one adapted building across two floors. At the time of our inspection there were 34 people using the service.

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

The monitoring of people’s risks required improvement as whilst staff were aware of people’s needs some people’s care records showed conflicting or out of date information. People’s medicines were not always managed effectively. The provider’s systems to monitor and review the service required improvement.

Staff were trained to recognise and report on any harm or abuse. People were supported by enough staff and the managers were working to recruit permanent staff. The provider had effective infection, prevention and control systems in place. Lessons were learnt when things went wrong.

Managers and staff were clear about their roles. The manager was working to instil a positive culture among staff and staff were encouraged to be open and honest. People, their relatives and staff were involved in the service. The provider was working with health and social care professionals.

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 19 February 2019).

Why we inspected

The inspection was prompted in part due to concerns received about people’s safety, medicines, staffing and risks associated with people’s care. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

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

Since our inspection the manager had taken action to make improvements and mitigate any 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 COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Abbeywell Court 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.

Abbeywell Court is a care home that provides personal and nursing care to up to 45 people in one adapted building. 38 people were living at the home at the time of the inspection.

People’s experience of using this service:

People were supported by a sufficient number of safely recruited staff who knew how to keep people safe. Systems were in place to protect people from abuse and staff understood them. Risk was managed and reviewed to ensure people were kept safe. Medication was stored and administered safely.

People’s needs and choices were assessed and promoted effectively. People were supported with eating and drinking in line with their dietary needs to ensure they maintained a balanced diet. Staff were skilled and had the knowledge to deliver effective care. People had access to healthcare services and staff worked well together and with healthcare professionals to effectively meet people’s needs. 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 supported by kind and caring staff who display empathy and compassion. People and their relatives were encouraged to be involved in making decisions about their care. People were supported by staff who respected their privacy and dignity and promoted their independence.

People were supported to engage in hobbies and interests important to them. Staff understood people’s preferences and individual communication needs. People’s end of life wishes were considered and plans were in place to ensure people received personalised care at that time of their life.

Audits were in place that effectively checked the quality of the service and action plans were implemented and followed where necessary. Relatives and staff told us they found the management team approachable. There was an open culture in the service and the management team made themselves available. The management team continually sought ways to improve the quality of the service.

The service met the characteristics of Good in all areas; more information is available in the full report below.

Rating at last inspection:

Requires Improvement (published 5 January 2018)

Why we inspected:

This was a planned inspection based on the rating at the last inspection. At the last inspection in November 2017, the service was rated as Requires Improvement overall with ratings of Requires Improvement in the key questions of Safe, Effective, Responsive and Well-Led. At the last inspection, we asked the provider to take action to make improvements.

At this inspection, the required improvements had been made and the service had met the characteristics of Good in all areas. The overall rating is Good.

Follow up:

We will continue to monitor the service through the information we receive.

Abbeywell Court 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.

Abbeywell Court accommodates up to 45 people in one adapted building. Abbeywell Court provides support for people who predominately have a physical disability and/or a mental health condition such as dementia.

There was a registered manager at the service. 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.

We found that some medicines were not always administered as prescribed.

Some improvements were needed to ensure that unexplained bruises were investigated and reported to the local safeguarding authority when required.

People enjoyed the food provided. However, some improvements were needed to promote people’s choice and mealtime experiences.

Improvements were needed to ensure that people’s past lives, cultural and diverse needs were assessed and considered to enable individualised care that met all aspects of people’s needs.

Some improvements were needed to ensure people were involved in the advance planning of their end of life wishes.

The provider had systems in place to assess, monitor and improve the quality of care. However, some of the systems were not always effective and improvements were needed to ensure areas of concern were identified and rectified.

Risks to people’s health and wellbeing were managed and followed by staff who knew people well, which ensured people were supported safely.

The environment had been adapted in a way that promoted people’s safety, independence and orientation.

There were enough suitability recruited and skilled staff to provide support to people. Staff had received training to ensure they had sufficient knowledge to carry out their role effectively.

People were protected from the risk of infection because the provider had policies and systems in place to control infection risks at the service.

Systems were in place to ensure that people received the least restrictive care and treatment to keep them safe and staff understood and followed the Mental Capacity Act 2005.

People were supported with their nutritional needs and action was taken to ensure people at high risk of malnutrition were supported effectively.

Advice was sought from health and social care professionals when people were unwell, which was followed by staff.

There were systems in place to ensure people received consistent care from staff within the service and also from staff from external agencies.

People received support from staff that were kind and compassionate. People’s dignity was respected and their right to privacy upheld.

People were supported with their communication needs and information was provided in a format people understood which meant that people were supported to make informed choices.

People and their relatives knew how to complain. Complaints received had been investigated and responded to in line with the provider’s policy.

People, relatives and staff felt able to approach the registered manager and the feedback gained from people about their care had been acted on.

The registered manager understood their responsibilities of their registration and worked in partnership with other agencies to make improvement to the way people received their care.