Archived: Abbeyfield - St Martins

Updated 9 June 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 09 April and 14 April 2015 and was unannounced.

The inspection team consisted of two adult social care inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for older family members.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the home, what the home does well and improvements they plan to make. We reviewed previous inspection reports and notifications before the inspection. A notification is information about important events which the home is required to send us by law.

We spent time speaking with seven people and three relatives. We interviewed eight staff and we spoke with the registered manager. Some people were not able to verbally express their experiences of living in the home. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We observed staff interactions with people and observed care and support in communal areas.

We contacted health and social care professionals to obtain feedback about their experience of the service.

We looked at records held by the provider and care records held in the home. These included six people’s care records, risk assessments, four weeks of staff rotas, six staff recruitment records, meeting minutes, policies and procedures.

We asked the registered manager to send additional information after the inspection visit, including some policies and training records. The information we requested was sent to us in a timely manner.

We last inspected the service on the 10 June 2013 and there were no concerns.

Updated 9 June 2015

The inspection was carried out on 09 April and 14 April 2015. Our inspection was unannounced.

Abbeyfield St Martins is a care home providing accommodation and personal care for up to 41 older people. The home is close to shops, a library, and a doctor’s surgery. There are three lounges, a large dining room and a spacious activities lounge within the home. At the time of our inspection 37 older people were living at the home, many of whom were living with dementia. Some people had sensory impairments and some people had limited mobility.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Effective recruitment procedures were not in place to ensure that potential staff employed were of good character and had the skills and experience needed to carry out their roles.

Medicines were stored, administered and disposed of safely. Medicines were not always recorded safely. We made a recommendation about this.

People gave us positive feedback about the home. People felt safe and well supported. They told us that staff were good at communicating and the food was good. People told us, “The staff are very kind and thoughtful”; “They are all very pleasant, caring and thoughtful”. There were plenty of activities to keep people active and engaged.

Staff knew and understood how to protect people from abuse and harm and keep them as safe as possible. The home had a safeguarding policy in place which listed staff’s roles and responsibilities.

People’s safety had been appropriately assessed and monitored. Each person’s care plan contained individual risk assessments in which risks to their safety were identified, such as falls, mobility and skin integrity.

The home was suitably decorated. The home was adequately heated and was clean. There was a relaxed atmosphere.

There were enough staff on duty to meet people’s needs. Staff had undertaken training relevant to their roles and said that they received good levels of hands on support from the management team.

There were procedures in place and guidance was clear in relation to Mental Capacity Act 2005 (MCA) that included steps that staff should take to comply with legal requirements. Staff had a good understanding of the MCA 2005.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Best interests meetings had taken place with relevant people. The registered manager understood when an application should be made and how to submit one when required.

People had choices of food at each meal time. People were offered more food if they wanted it and people that did not want to eat what had been cooked were offered alternatives. People with specialist diets had been catered for. The cook had a good understanding of how to fortify foods with extra calories for people at risk of malnutrition.

People received medical assistance from healthcare professionals when they needed it. They attended hospital appointments when needed.

People told us they found the staff caring, and said they liked living at the home. Relatives gave us positive feedback about the care and support their family members received. Staff were kind, caring and patient in their approach and had a good rapport with people.

People had been involved in planning their own care. All the records we viewed had consent to care and treatment forms that had been signed by the person or their relative. Relatives told us that they were involved with reviewing their family members care on a quarterly basis.

Staff were careful to protect people’s privacy and dignity and people told us they were treated with dignity and respect, for example staff made sure that doors were closed when personal care was given.

People and their relatives and visitors had access to a number of shared areas which meant that they could spend private time together. People’s information was treated confidentially. Personal records were stored securely.

People told us that the home was responsive and when they asked for something this was provided.

People were engaged with activities when they wanted to be. The activities plan for the home showed that activities took place every day of the week. People participated in their local community such as using local library services and attending church services.

The complaints policy was displayed on the wall of the home. The policy detailed the arrangements for raising complaints, responding to complaints and the expected timescales for a response.

People had provided feedback about the service they received and people’s comments had been acted on. Relatives told us that they were kept well informed by the home.

Staff were well supported by the management team. They told us that communication was good and staff meetings had taken place. Staff were confident that the management team and provider would deal with any concerns relating to bad practice or safeguarding issues appropriately. The registered manager and senior staff were visible throughout the home.

There were effective quality assurance systems and the registered manager carried out regular checks on the home to make sure people received a good service.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of this report.