Abbeyfield Silverdale & District Society Limited

We found the following examples of good practice.

¿ The registered manager had ensured staff could access comprehensive and informative training in various aspects of infection control. Staff confirmed they felt confident in the training and this helped them deliver

care based on best practice.

¿ The environment and equipment had been arranged to minimise the risk of infection and was clean and clutter free.

¿ Information was gathered from visitors to help minimise the risk and spread of infection.

¿ Risk assessments were carried out to minimise the risk and spread of infection.

¿ Processes to minimise the risk of infection were carried out by staff. For example, temperature checks, safe waste disposal and increased cleaning of the home took place.

¿ COVID-19 policies and risk assessments were available and known by staff.

¿ Checks and audits were carried out on the cleanliness of the home and action taken if this was needed.

¿ Adequate handwashing facilities, infection control gel and personal protective equipment (PPE) was available to support best practice.

¿ Staff supported people to use electronic tablets and telephones to maintain contact with loved ones. An internal visitors room was being introduced and an external visitors pod was available to support face to face visits.

¿ People were supported to access health professional advice and maintain their well-being. People told us they received good care.

¿ Staff and people were tested regularly for COVID-19. A member of staff had undergone training and competency assessment to support the safe and competent administration of tests.

¿ People and staff were taking part in the vaccination programme. People at the home were supported to decide if they wanted to participate. Processes were in place to ensure if people were unable to make this decision for themselves, best interest discussions were held with relatives and documented.

Abbeyfield Silverdale & District Society Limited 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 is situated in the village of Silverdale. It is a large detached property in its own grounds in a residential area overlooking the sea. The home is set on two floors with a lift to the first floor. There are large gardens surrounding the home which are accessible to people who live at the home.

At our last inspection in April 2016 the service was rated ‘Good.’ At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The registered manager completed a series of checks and investigations to identify where improvements were required in the quality of the service provided. Staff told us they were informed of the outcomes of these. We noted some of the checks were not documented, therefore action plans were not developed. We have made a recommendation regarding improving the audit and investigation recording process.

The home was introducing an electronic care record system. We found that the system was in use and information from paper based records was being transferred to the electronic system. Care records contained information regarding risks and guidance for staff on how risks were to be managed. We found one care record required updating as information was not consistent with the person’s needs. Prior to the inspection concluding we were informed this had been done. We have made a recommendation regarding the documenting of people’s needs and wishes.

Staff we spoke with knew the needs and wishes of people who lived at the home. Staff spoke fondly of the people they supported and said they wanted to enable people to live happy lives. Staff were gentle and patient with people who lived at the home and people told us they felt respected and valued.

Relatives told us they were consulted and involved in their family members care. People we spoke with confirmed they were involved in their care planning if they wished to be and spoke highly of the level of involvement they were offered.

Staff we spoke with were able to describe the help and support people required to maintain their safety and people who lived at the home told us they felt safe.

People told us they were happy with the way their medicines were managed. We observed medicines being administered and saw this was carried out in a safe way. Access to medicines was restricted to staff who had received training to ensure medicines were administered and managed safely.

People told us they had access to healthcare professionals and their healthcare needs were met. Documentation we viewed showed people were supported to access further healthcare advice if this was appropriate. People and relatives told us they were happy with the care at support provided at Abbeyfield Silverdale & District Society Limited.

People told us they could raise their views on the service provided and they felt involved in the running of the home. We saw minutes of meetings where people at the home were informed of changes and were asked their opinion on the service provided.

People told us they had a choice of meals to choose from and they enjoyed the meals provided. People also told us they were offered more if they wanted this. We observed the lunchtime meal. We saw people were given the meal of their choice and were offered more if they finished their meal. Staff were available to help people if they needed support.

We found the environment was clean and we observed staff wearing protective clothing when required. This minimised the risk and spread of infection.

Staff told us they were committed to protecting people at the home from abuse and would raise any concerns with the registered manager or the Lancashire Safeguarding Authorities so people were protected.

There was a complaints procedure which was displayed in people’s rooms. People we spoke with told us they had no complaints, but they if they did these would be raised to the registered manager or staff.

Recruitment checks were carried out to ensure suitable people were employed to work at the service and staff told us they were supported to attend training to maintain and increase their skills.

People and relatives we spoke with told us they were happy with the staffing arrangements at the home. We observed staff spending time with people and the atmosphere was relaxed and unhurried. Staff we spoke with raised no concerns with the staffing arrangements at the home.

People told us there were a range of activities provided to take part in if they wished to do so. We found an activities schedule was displayed at the service and staff told us they reminded people of the activities available.

The registered manager demonstrated their understanding of the Mental Capacity Act 2005. People told us they were enabled to make decisions and staff told us they would help people with decision making if this was required. People are supported to have maximum choice and control in their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Further information is in the detailed findings below.

Abbeyfield Silverdale & District Society Limited is a registered society and an exempt charity for tax purposes. The society owns a home in the village of Silverdale. The home is a large detached property in its own grounds in a residential area overlooking the sea. The home is set on two floors and accommodates up to 22 older people. There are large gardens surrounding the home which are accessible and used by people living there. There are a range of aids and adaptations suitable to meet the needs of people living there. Parking is available in the grounds of the home.

The home is managed by a registered manager. A registered manager has 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 they were happy living at Abbeyfield Silverdale and the care met their individual needs. People described staff as ‘very pleasant’ and told us they trusted staff.

There were systems in place to protect people at risk of harm and abuse. Staff were able to define abuse and the actions to take if they suspected people were being abused.

We found individual risk assessments were carried out and care plans were developed to document the measures required to reduce risk. Staff were knowledgeable of the measures in place and we observed these were followed these to ensure people’s safety was maintained.

We found medicines were managed safely. We saw people were supported to take their medicines in a dignified manner. There were systems in place to ensure medicines were stored securely.

We saw appropriate recruitment checks were carried out to ensure suitable people were employed to work at the home and there were sufficient staff to meet people’s needs. We saw staff could undertake tasks supporting people without feeling rushed. People told us they were supported promptly.

Staff received support from the management team to ensure training needs were identified. We found staff received appropriate training to enable them to meet people’s needs.

Processes were in place to ensure people’s freedom was not inappropriately restricted and staff told us they would report any concerns to the registered manager.

We saw people were offered a variety of foods and people told us, “It’s fine.” And, “It’s alright.” We saw people were offered a choice of meals and snacks throughout the day.

People were referred to other health professionals for further advice and support when assessed needs indicated this was appropriate.

We saw staff treated people with respect and kindness and relatives told us they were involved in their family member’s care planning.

Staff knew the likes and dislikes of people who lived at the home and delivered care and support in accordance with people’s expressed wishes. During the inspection we saw people were supported to carry out activities which were meaningful to them.

There was a complaints policy in place, which was understood by staff. People told us they would speak with staff if they had any concerns.

We saw systems were in place to identify if improvements were required. People who lived at the home were offered the opportunity to participate in annual questionnaires and the registered manager completed audits to identify if improvements were required. In addition the registered provider also monitored the quality of service by carrying out quality assurance checks.

This helped to answer our five questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found.

Is the service safe?

People were treated with respect and dignity by the staff team. People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

Systems were in place to make sure that the management and staff team learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and how to submit one.

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk.

Is the service effective?

There was an advocacy service available if people needed it. This meant that when required, people could access additional support.

People told us that they were pleased with the level of care that was being delivered to them and that their assessed needs were being met. From our observations and through speaking with staff it was clear that there was a good understanding of each person's assessed needs and that personal preferences were accommodated. One person told us, 'This is a jolly good place to live'. Another person said, 'I am quite happy here. You get every attention they cannot do enough for us'.

Health and care needs had been assessed and people had been involved, as far as they wished, or were able, in writing their plans of care. Although some people spoken with were unsure about their current care plan, they were unconcerned by this. On the care plans we looked at, each had been signed by the person or a close relative, to confirm their understanding and agreement to the content.

The relatives we spoke with confirmed that that were able to see people in private and at a time of their choice. These people were also very positive in their comments regarding the care provided at Cove House and confirmed that they had good communication with the staff team.

Is the service caring?

People were supported by kind, caring and attentive staff. We saw that care staff showed humour, patience and gave encouragement when supporting people. One relative, when asked what the service did well, commented, 'The overall care, compassion and kindness shown to people'. Another relative said, 'They (the staff) always go the extra mile'. A person living at the home said, 'It is a very nice place to be. They (the staff) do quite a lot really and they are all very, very kind'. A member of staff added, 'Cove House is homely. We try to make it home from home, do activities and outings. The care we give is I think, very good. It is good enough for my family, for my dad.

People using the service and their relatives and friends had been given opportunity to complete satisfaction questionnaires. This, along with the regular resident meetings and open general meetings, helped people to formally have their say and influence change.

Health and care needs had been assessed and people had been involved, as far as they wished, or were able, in writing their plans of care. Although some people spoken with were unsure about their current care plan, they were unconcerned by this. On the care plans we looked at, each had been signed by the person or a close relative, to confirm their understanding and agreement to the content.

Is the service responsive?

The people we spoke with said they were very satisfied with the arrangements in place to support social activities and social interactions. Social care needs had been given high priority. However it was also acknowledged that some people preferred spending time alone in their bedroom and this was respected.

People said that they knew how to make a complaint if they were unhappy about anything. Although formal complaints were infrequent, documents were available to record the complaint, the name of the person making the complaint, the process of investigation and the outcome. We saw that there was an 'open door' policy with people expressing their views, or queries as they arose. This meant that any concern or query could be dealt with immediately. People living at the home and the relatives we spoke with confirmed this to be the case.

Is the service well led?

The service worked well with a range of health professionals to make sure that people received their care in a joined up way. Records were kept of all health professionals visits in respect of each person, which included the reason for the visit and the outcome.

Staff told us that they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and the quality assurance processes in place. This helped to ensure that people received a consistent service at all times.

Staff also told us that they felt very well supported by the registered manager, general manager and the wider Abbeyfield Silverdale and District Society organisation. We were also told that the staff team worked well together for the benefit of the people living at the home. We saw that the staff team was stable meaning that people living at the home were cared for and supported by staff who knew them well.

A wide range of routine audits and internal quality control measures were in place including structured overall monitoring of the service by the Trustees. This helped to ensure that a consistent service was maintained that helped to protect people and keep them safe.

People told us that they were happy at Abbeyfield Silverdale. They said that they received care and support when they wanted it. We saw that staff assisted people with personal care discretely and sensitively, in a timely manner. We heard staff talking with people in a kindly way.

We briefly observed people having their meal. The mealtime was relaxed and unhurried, with people able to take their time over their meal. We saw that staff were aware of the dietary needs of people living in the home. People said that the food was good and plentiful.

People told us that they had the aids and adaptations they needed. Equipment was maintained and regularly serviced.

We saw satisfactory numbers of staff on the inspection to respond to people's needs. People told us that staff assisted them in the way they wanted and when they wanted them to.

Systems were in place for monitoring the quality of the service people received. People living in the home and relatives told us that they were well supported by the senior staff team.

People we spoke with told us they could express their views and were involved in decision making about their care. They told us they felt listened to when discussing their care needs. Staff confirmed with us they also involved relatives, where possible to ensure people received the right care and support. This was confirmed when we looked at two records, which included evidence of involvement in care planning and review. One person told us, 'I think staff involve me in planning what I need here.' Another told us, 'Staff are always asking what I need.'

When asked about routines in the home people we spoke with told us it was relaxed and, "Staff are always around when you need them."

We spent time in various parts of the home throughout the inspection where we saw staff talking with people in a respectful manner. We saw staff spent time with people on an individual basis. One staff member told us, 'It's nice to be able to spend time with residents. They like it as well.'