The Abbey Residential Home is situated next to the church in Old Malton. Accommodation can be provided for up to 24 people who require help with personal care; some people may be living with dementia. The service has 20 bedrooms; some can be used for shared occupancy but only one of them is currently used in this way. All of the bedrooms have en-suite facilities; 18 have an added bath and one has a shower. There are several communal rooms and seated areas for people to use.The service had a registered manager in post as required by a condition of registration. 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.
We undertook this unannounced inspection on 6 and 7 July 2016. At the time of the inspection there were a total of 21 people living in The Abbey Residential Home. At the last inspection on 16 January 2014, the registered provider was compliant with all areas assessed.
We found people were provided with a safe environment. Staff knew how to safeguard people from the risk of harm and abuse and how to deal with any information of concern. Risk assessments were completed to help guide staff in how to minimise issues of concern such as falls.
Staff were recruited safely and deployed in sufficient numbers to meet people’s current level of need. There was an issue raised about the tea time period, four days a week when staff felt stretched. This was mentioned to the assistant manager and they told us they would address this by ensuring one of two managers was available to help the staff team during this busy time.
We found people received their medicines as prescribed. Medicines were obtained, stored and returned to the pharmacy when no longer required. Staff recorded when medicines were received into the service and when they were administered to people. There were some minor recording issues and the need for protocols for medicines prescribed ‘when required’. This was mentioned to the registered manager to address.
People’s health and nutritional needs were met. We saw health professionals were involved and provided advice and treatment when required. People had their weight monitored and input from dieticians was sought when required.
People’s needs were assessed and care plans formulated. These helped to guide staff in how to support people in ways they preferred. We found staff supported people to make their own decisions and choices. The registered manager was aware of the action to take and who to consult if they felt someone lacked capacity and a decision was needed about their care and treatment.
We observed staff approach was kind, patient and caring; there were very positive comments about the staff from people who used the service and their relatives. We saw staff respected people’s right to privacy and treated them with dignity. The staff provided information to people so they could make choices, for example about their meals and what activities to take part in. Some people were very independent and could access the community independently; staff encouraged this and supported people to maintain the independent skills they had.
There was an activity co-ordinator who helped to plan meaningful activities; they made a record of who participated in them.
We saw staff had access to training considered essential by the registered provider and other courses which were more specific to the needs of people who used the service. The registered manager was currently completing a training analysis to see if there were any shortfalls which needed to be planned for in the coming year.
Staff told us they felt supported and we saw they received supervision and observation of their practice. This enabled staff to be developed in their role.
We found the environment was safe, warm and clean. Checks were carried out on equipment to make sure it was safe to use.
There was a quality monitoring system in place although we found this could be more structured and recording of shortfalls and actions taken to address issues could be improved. We have made a recommendation about this. The culture of the service was open which meant people felt able to raise concerns and complaints in the belief they would be addressed.