Background to this inspection
Updated
9 August 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This inspection was conducted by one inspector on the first day and one inspector and an Expert by Experience on the second day. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Abbeyfield - Richard Cusden is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
The inspection was unannounced on the first day. The provider knew we would be returning on the second day.
What we did before the inspection
We reviewed information we had received about the service since the last inspection.
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.
During the inspection
We spoke with 10 people who used the service about their experience of the care provided and three relatives. We spoke with nine members of staff including the registered manager, the head of care, activities co-ordinator, the lead for training and development, the chef and care workers.
We reviewed a range of records. This included three people’s care records and medicines records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including complaints, incident forms, policies and procedures were reviewed.
After the inspection
We requested additional evidence to be sent to us after our inspection. This was received and the information was used as part of our inspection.
Updated
9 August 2019
About the service
Abbeyfield - Richard Cusden is a care home providing residential care without nursing for up to 22 older people, including those who may have dementia. At the time of the inspection there were 20 people using the service.
People’s experience of using this service and what we found
People and their relatives were happy with the care they received from staff and felt their needs were being met.
However, we found that the service was not always safe. This was because records relating to the management of risk were not always up to date. This was identified as an area of improvement at the last inspection and we were not assured that the provider had taken sufficient action to fix these concerns.
People and their relatives told us they felt safe and well cared for. Recruitment procedures were robust and there were enough staff employed to meet people’s needs safely. The provider monitored any incidents and accidents to try and identify any underlying themes. People were protected from the risk of poor infection control as appropriate measures had been taken in this area.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Appropriate referrals were made to healthcare professionals and the provider worked collaboratively with other services to ensure people’s needs were met. People’s nutritional needs were met by the provider.
People and their relatives told us that the staff were caring and friendly. There was a homely environment at the service and we observed examples of care that demonstrated empathy towards people. People’s independence and dignity were respected.
Care plans were reviewed on a monthly basis which helped to ensure their needs were being met. Discussions around end of life care needs were held and referrals made to the palliative care team where required. No formal complaints had been received which was reflected in the feedback that we received from people and relatives.
The registered manager was due to leave and a new manager had been recruited. People and their relatives were satisfied with the leadership of the service. The provider took steps to engage with people, relatives and staff through regular meetings and surveys. There was a culture of learning and improvement, this was seen through a service improvement plan that was based on quality assurance visits that had been completed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 11 April 2017).
Enforcement
At this inspection we identified breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around safe care and treatment. Details of action we have asked the provider to take can be found at the end of this report.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.