Abbey House Nursing Home

Updated 3 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 was an unannounced inspection which took place over two days on 5 and 8 January 2018. On the first day of our visit, the inspection team consisted of two inspectors, a specialist nurse advisor and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who has used this type of service. On the second day, the team consisted of two inspectors.

Before the inspection, we reviewed all the information we held about the service including previous inspection reports and notifications received by the Care Quality Commission. A notification tells us about important issues and events which have happened at the service. The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, such as what the service does well and improvements they plan to make. We used this information to help us decide what areas to focus on during our inspection.

During the inspection we spoke with 17 people who used the service and the relatives of a further six people. We spoke with the registered manager, the operations manager, training manager two registered nurses and four care workers. We reviewed the care records of four people in detail and aspects of another five people’s care plans. We also looked at the records for four staff and other records relating to the management of the service such as audits, incidents, policies and staff rotas.

During and following the inspection we sought feedback from five health and social care professionals about the care provided at Abbey House Nursing Home.

The last inspection of Abbey House Nursing Home was in September 2016 when the service was rated as requires improvement. This was because we found that some of the legal requirements were not being met as people had not always received safe care, staff had not been received effective supervision, some of the records relating to people’s care were not always fit for purpose and the governance arrangements were not being effective at ensuring the safety and quality of the service. Overall, this inspection found there had been improvements and the legal requirements were now being met, although in some cases, further work was needed to ensure that the improvements were consistent, embedded and sustained throughout the service.

Updated 3 February 2018

Abbey House Nursing Home is a care home. People in care homes receive accommodation and their care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection. Abbey House Nursing home provides accommodation for up to 48 older people who require nursing care. A small number of people using the service were living with dementia or other mental health problems. The home provides a rehabilitation service for up to nine people under contract with the NHS. These people were accommodated temporarily at the service for between two and six weeks and were being supported to regain their independence following their discharge from hospital. At the time of the inspection there were 48 people using the service.

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 and associated Regulations about how the service is run.

Improvements were needed to ensure that all aspects of medicines were managed safely.

Overall there were a range of systems and processes in place to identify and manage risks to people’s wellbeing and environmental risks, but we have made some recommendations about the frequency with which people cared for in their room are checked and identified that many of the tools and charts used to monitor people’s needs and risks were not being completed consistently.

Overall, the home was clean but we did identify some infection control concerns that could present risks to people.

Staff had received training in safeguarding adults, and had a good understanding of the signs of abuse and neglect.

There were suitable numbers of staff deployed to meet people’s needs. Appropriate checks had been made to ensure that new staff were suitable to work in the home.

Accidents and incidents were investigated and action taken to reduce the risk of further harm.

Improvements had been made to ensure that staff were provided with opportunities to develop their skills and knowledge and performed their role effectively.

Staff sought people’s consent before providing care and people were encouraged and supported to make decisions about their care and support. Staff worked in accordance with the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards were applied appropriately.

People were supported to have enough to eat and drink. People were able to choose the meals they wish to eat and alternatives were provided.

Abbey House was not a purpose built nursing home and we did find that some aspects of the premises and of the equipment within it were in need of attention. We have made a recommendation about this.

Where necessary a range of healthcare professionals including GP’s, community mental health nurses, dentists and speech and language therapists, had been involved in planning peoples support to ensure their health care needs were met.

People were cared for by kind and compassionate staff. Staff were very motivated and spoke with enthusiasm about providing person centred care. People were treated with dignity and respect.

Improvements had been made to people’s care plans which contained a more detailed record of people’s individual needs. This enabled staff to have a good knowledge and understanding of the people they were supporting and helped to ensure people received care and support which was responsive to their needs.

There was evidence that staff provided compassionate care to people reaching the end of their life.

The service was well led. Staff were positive about the leadership of the service and felt well supported in their roles. Staff morale was good and staff worked well as a team to meet people’s needs.

The registered manager and provider had been proactive in making improvements to the governance arrangements within the service to improve the quality and safety of care for people. The provider sought feedback from people, their relatives and from staff and used this to continually improve the service.

The registered manager demonstrated knowledge, passion and enthusiasm for their role and to the people in their care and the staff team.