We inspected Abbeydale on 2 February 2015. The inspection was unannounced which means that we did not tell the provider before that we were coming to inspect the service. Abbeydale provides accommodation for persons who require nursing or personal care, treatment of disease, disorder or injury to people and diagnostic and screening services.
At our last inspection on 17 March 2014 the service was meeting the regulations we inspected with regard to consent to treatment and record-keeping.
On this inspection we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 with regard to peoples’ care and welfare. You can see what action we have told the provider to take at the back of the full version of this report.
A registered manager was in place. 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.
Staff had received training on how to protect people who used the service from abuse or harm. They demonstrated they were aware of their role and responsibilities in keeping people as safe as possible.
We found people largely received their prescribed medication in a safe way by staff trained in medication administration.
Detailed risk assessments had not always been undertaken to inform staff of how to manage and minimise risks to people's health from happening.
Improvements in some aspects of caring for people with dementia were needed in terms of providing more stimulating activities and improving the environment.
The provider supported staff by an induction and some ongoing support, training and development. However, comprehensive training had not been provided to all staff.
The Mental Capacity Act (MCA) is legislation that protects people who may lack capacity to consent to their care and treatment. We found examples where the registered manager was following this legislation which informed us that people’s capacity to consent to specific decisions had been assessed appropriately.
People who used the service had their dietary and nutritional needs assessed and planned for. People received a choice of what to eat and drink and staff supported them to maintain their health.
People who used the service and relatives told us they found staff to be caring, compassionate and respectful. Our observations largely found staff to be kind and attentive to people’s individual needs.
People who used the service were, as far as possible, able to participate in discussions and decisions about the care and treatment provided.
People who used the service and their relatives had been to share information that was important to them about how they wished to have their needs met, though this process had not been fully completed.
The provider had internal quality and monitoring procedures in place. These needed to be strengthened to prove that necessary actions had been implemented.
The managers enabled staff to share their views about how the service was provided by way of staff meetings and supervision, although these opportunities had been infrequent.