Abbey Lodge - Coulsdon

Abbey Lodge - Coulsdon is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Abbey Lodge - Coulsdon does not provide nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service can support up to 9 people with mental health needs. 9 people were using the service at the time of our inspection.

People’s experience of using this service and what we found

People were supported safely. The provider ensured that people’s risks were assessed and managed. The care home environment was bright, clean and in good repair. Staff followed infection prevention and control guidance to keep people safe. The provider carried out robust checks to ensure staff were suitable to deliver care and support. People received their medicines as prescribed.

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.

The registered manager worked in partnership with health and social care professionals to ensure people received good quality care. The care and support provided to people was monitored and audited to drive improvements. People were supported to achieve positive outcomes which included moving on to independent living and to services where they required less support. The provider sought the views of people, relatives, staff and professionals to plan and improve the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 12 August 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Abbey Lodge - Coulsdon on our website at www.cqc.org.uk

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Abbey Lodge - Coulsdon is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Abbey Lodge - Coulsdon does not provide nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service supports up to nine people with mental health issues, learning disability and autism. There were eight people using the service at the time of our inspection.

People’s experience of using this service and what we found

Health and safety checks were carried out regularly however, we found that some environmental issues had not been identified during these audits. The house was tidy but there were several areas of the service which required repair or replacement furniture. There was a cleaning schedule in place which included additional cleaning of regular touch points to minimise the spread of infection specifically COVID-19.

Recruitment procedures were not robust enough and we found some staff had been working without providing full employment history and had an expired disclosure barring service (DBS). Since the inspection, the provider assured us that a new process would be introduced to ensure safe recruitment practices. People were safe and supported well by staff. Staff had received training in safeguarding people from abuse and knew when and how to report concerns if this was necessary.

There was a registered manager in place who was responsible for three residential homes for the provider. Within each service was a deputy manager who supported with the management oversight daily. At the time of inspection, Abbey Lodge did not have a deputy manager however, they were actively recruiting.

During the inspection it was identified that the provider did not have the correct service user banding in place. This banding is used to clarify the type of service and the support that could be provided. This information is used to regulate services appropriately. The provider has since rectified this.

Due to the issues found, it was clear that the governance and oversight arrangements were insufficient.

Individual risk assessments were detailed, personalised and included people’s voice and opinions clearly. Staff understood the risks to people and knew how to mitigate these. During the inspection, one person was in pain and was very upset. Staff demonstrated how to support this person during this period to ensure they received regular pain relief and appropriate medical treatment.

People were supported to take their medication as prescribed.

The provider had arrangements in place to make sure any accidents and incidents were investigated, and people kept involved and informed of the outcome.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting how they were meeting the underpinning principles of Right support, right care, right culture. The model of care maximises people’s choice, control and independence as far as possible. This is done in a way that maintains people’s safety but also takes risks positively. Care is person-centred and promotes people’s dignity, privacy and human rights.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

Rating at last inspection was Good (published 2nd August 2018)

Why we inspected

We received concerns in relation to the support people received, particularly regarding the interaction between staff and people, their diet and Nutrition, also the safety of the environment and recruitment practices. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led and a targeted in Effective only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the Safe, Effective and Well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Abbey Lodge - Coulsdon on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, staffing, and governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

There was a registered manager in post at the time of our inspection. 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 provider managed risks relating to people’s care, including their mental health needs, through suitable risk assessment processes.

People were protected from abuse and improper treatment as the provider trained staff to understand how to safeguard people and staff were aware of their responsibilities. People’s risk of discrimination was reduced in relation to gender reassignment and sexual orientation and the provider trained staff to understand equality and diversity.

The provider checked staff were suitable to work with people and there were sufficient numbers of staff deployed to work with people.

People’s medicines were managed safely and processes were in place to check people received their medicines as prescribed.

The premises were maintained safely with a range of health and safety checks and the premises and met people’s support needs.

The provider trained staff to understand people’s needs and staff were supported with suitable induction and supervision.

People’s care needs were assessed though consultation with people and the professionals involved in people’s care. The provider created care plans to meet people’s assessed needs and preferences. People’s care plans reflected their physical, mental, emotional and social needs, their personal history, individual preferences and interests.

The registered manager and staff understood the Mental Capacity Act 2005 and people received care in line with the Act. The provider applied to deprive some people of their liberty as part of keeping them safe.

People were positive about the food they received and food was provided according to people’s choices. People were supported with their day to day health needs and to access professionals they needed to maintain their mental and physical health.

Staff knew people well and developed positive relationships with them. Staff treated people with dignity and respected their right to privacy. People were involved in decisions about their care.

People were supported to maintain and build their independent daily living skills and the provider encouraged people to do voluntary or paid work where possible.

People were provided with activities they were interested in and told us they had enough to occupy themselves. People were supported to maintain and develop relationships to reduce social isolation.

The provider had a process in place to respond to concerns and complaints. Records relating to people and the management of the service were accurate and well maintained.

The service was well-led by a competent and experienced registered manager and leadership was visible across the service. The provider had good governance systems in place to check the quality of the service and to gather feedback from people, staff and professionals. Staff understood their roles and responsibilities.