Archived: Abingdon Court Care Home

This unannounced inspection took place on 24 August 2016.

We last inspected this service on 30 June 2015 and we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. On this inspection we found some improvements had been made.

Abingdon Court care home is registered to provide accommodation for up to 64 older people some of whom were living with dementia and require personal or nursing care. At the time of the inspection there were 61 people living at the service.

There was a manager in post who was in the process of registering with the Care Quality Commission (CQC). 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. The manager worked closely with the deputy manager.

People who were supported by the service felt safe. Staff had a clear understanding on how to safeguard people and protect their health and well-being. There were systems in place to manage safe administration and storage of medicines.

People had a range of individualised risk assessments in place to keep them safe and to help them maintain their independence. Where required, staff involved a range of other professionals in people’s care.

The service had enough suitably qualified and experienced staff to meet people's needs. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.

The manager and staff had a good understanding of the Mental Capacity Act 2005. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Where people were thought to lack capacity to make certain decisions, assessments had been completed in line with the principles of MCA. The manager and staff understood their responsibilities under the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be deprived of their liberty for their own safety.

Staff received adequate training and support to carry out their roles effectively. People felt supported by competent staff who benefitted from regular supervision (one to one meetings with their line manager) and team meetings to help them meet the needs of the people they cared for.

People’s nutritional needs were met and people benefited from a good dining experience. People were given choices and received their meals in a timely manner. People were supported with meals in line with their care plans.

Staff knew the people they cared for and what was important to them. Staff appreciated people’s unique life histories and understood how these could influence the way people wanted to be cared for. People's choices and wishes were respected and recorded in their care records.

People had access to activities and stimulation opportunities, however, these could be improved. People received limited one to one activities. The service structured group activities to people's interests.

Where people had received end of life care, staff had taken actions to ensure people would have as dignified and comfortable death as possible. End of life care was provided in a compassionate way.

Leadership within the service was open and transparent at all levels. The provider had quality assurance systems in place. The provider had systems to enable people to provide feedback on the care they received.

The manager informed us of all notifiable incidents. The manager had a clear plan to develop and further improve the home. Staff spoke positively about the management support and leadership they received from the manager.

We spoke with ten people and two people’s relatives about how they were involved in their care. We also spoke with three care workers and two nurses. At the time of our visit 60 people lived at the home.

Everyone we spoke with told us they were involved in their care. One person told us, “I get what I want when I want it. I ask for tea and biscuits a lot and I always get it”. One relative told us, “I live some distance away and you have no idea how happy I am to be able to drive away knowing that my aunt will be well cared for and happy”.

People were treated with dignity and respect. During our SOFI we observed a care worker assisting a person with a cup of tea. The care worker was attentive to the person’s needs. The care worker worked at the person’s pace to maintain the person’s independence. The person benefitted from this interaction, and appeared alert and happy throughout.

People we spoke with informed us that they felt safe living in the home. One person told us "I feel safe, I have no complaints".

Care workers and nurses told us that they had completed safeguarding training and knew how to recognise and report abuse.

People living at the home told us that they were happy living there and staff were very kind and friendly. Relatives said they were very happy with the home and pleased with the care provided to their family members. We observed some good interaction between staff and people living at the home and saw that some people were offered choices.

Some people who use the service however were not fully involved in day to day decisions. We observed staff not respecting the dignity of people with advanced dementia. Some people were not engaged in any activities for the time we observed them.

We saw that the home had made significant improvements since our last visit to ensure that the environment was free from malodours and all waste was managed appropriately.

We found that the home had suitable arrangements in place to protect people from the risk of abuse. Nurses however did not always know how to implement the safeguarding procedure to ensure any identified or suspected abuse was addressed appropriately.

Systems were in place to enable the manager to monitor the quality of the service provided and identify and respond to risks. We saw that complaints had been investigated and concerns addressed. The manager was taking action to ensure staff complete tasks to a high quality to ensure good care was consistently provided during the day and night time.