09 April and 14 April 2015
During a routine inspection
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.