The inspection took place on 9 August 2018 and was unannounced. The last inspection took place on 7 April 2016 when the home was rated Good. At this inspection we found a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014.

Abafields is a privately owned residential ‘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.

Abafields Care Home is situated close to Bolton town centre. There is parking to the front of the building for visitors.

The care home accommodates 35 people in one adapted building, over two floors. Bedrooms and bathrooms were located on the ground and first floor. The dining room and lounge areas were situated on the ground floor. On the day of the inspection there were 31 people living at the home.

The home had a registered manager in place who had been at the home since January 2018. 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 registered manager was also the nominated individual.

The service used Bolton local authority safeguarding procedures to report any safeguarding concerns. Staff had been trained in safeguarding topics and were aware of their roles and responsibilities.

There were a number of policies and procedures in place. We discussed with the registered manager that the policies needed to be reviewed, updated and made specific to the service.

Staff recruitment was satisfactory. However, there was a lack of information about a new member of staff, including no Disclosure and Barring Service (DBS) check. We were told by the registered manager that the DBS had now been applied for.

We looked at the staffing rotas which showed staffing levels were consistent. However, the general manager was not included on the rotas, On the day of the inspection there were sufficient numbers of staff on duty including a number of volunteers.

The ordering of medicine was not consistently safe as an individual had been left without their medicine for a period of three days. Training records showed that staff had been trained in administration of medicines.

Staff had received training in infection control. However, the last inspection from the Community Infection and Prevention Control team in July 2018 indicated a drop in standards. In one room we noted there was a malodour. We discussed this with the registered manager for actions to be taken to address this.

The environment both inside and outside required attention. The first floor required some refurbishment. We found some safety issues in a number of bedrooms where wardrobes were not secured to the walls. The outside garden areas were unkempt and required attention. The home did not have a maintenance person to keep on top of jobs that staff cannot deal with.

Electrical and gas supplies were serviced regularly. Each person had a personal emergency evacuation plan (PEEP). A PEEP informs the fire service what room people live in and what assistance they require to evacuate them safely from the building. The home’s fire risk assessment was out of date and needed to be reviewed.

People were offered a well-balanced and nutritional diet with a wide range of choices available.

Staff had been trained in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The registered manager was aware of her responsibilities of how to apply for any best interest decisions under the Mental Capacity Act 2005 and followed the correct procedures.

New staff received induction training to provide them with the

Abafields Residential Care Home is a large converted property with bedrooms on the ground and first floor. The home is situated on the outskirts of Bolton town centre and is close to bus, rail and motorway links. The home is registered to provide personal care and support for up to 35 people.

This inspection was an unannounced and took place on 07 April 2016. There were 33 people using the service at the time of the inspection. We last inspected the home on 07 August 2013. At this inspection we found that the service was meeting all the regulations were reviewed.

The home had a manager registered with the Care Quality Commission (CQC) who was present on the day of the 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 and associated Regulations about how the service is run.

People who used the service told us they felt safe and that the staff had the skills and experience to meet their needs. People were happy with the care and support they received and spoke positively about the kindness and caring attitude of the registered manager and staff.

We found that people were cared for by sufficient numbers of suitably skilled and experienced staff who were safely recruited. We saw that staff received the essential training and support to enable them to do their job effectively and care for people safely.

We found the system for managing medicines was safe and we saw how the staff worked in cooperation with other health and social professionals to ensure that people received appropriate care and treatment.

We saw risk assessments were in place for the safety of the premises. All areas of the home were clean and well maintained. Procedures were in place to help prevent and control the spread of infection.

Systems were in place to deal with any emergencies that could affect the provision of care, such as failure of the electricity or gas supply.

People’s care records contained enough information to guide staff on the care and support people required. Care records showed that risks to people’s health had been identified and plans were in place to help reduce or eliminate the risk. People and their relatives were involved and consulted about the development of the care plans. This helped to ensure the wishes of people who used the service were considered and planned for.

The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff demonstrated an understanding of both MCA and DoLS.

The meals provided were varied and nutritionally balanced. People told us they enjoyed the meals.

Systems were in place to monitor the quality of the service provided. Regular checks were undertaken on all aspects of running the home.

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We visited Abafields on 7 August 2013 and found the home to be warm, clean and bright. At the time of our visit the manager was on annual leave. We conducted this inspection with two senior staff on duty.

We saw people who used the service were well presented and we observed staff interacting with them in a friendly, polite manner and respecting their dignity and privacy.

We looked at a selection of care records and other information that ensured the home was properly managed.

We spoke with three people who used the service, one told us, “Nothing changed since you were last here everything is still fine “. Another told us,

“The girls are lovely”. We spoke with a visitor who told us, “I have no complaints; the staff are very good and understanding”.

We saw staff had access to relevant policies and procedures including safeguarding procedures and contact details. Staff we spoke with demonstrated an understanding of safeguarding and whistleblowing and said if they had any concerns these would be reported to senior staff.

We saw a number of compliment cards from relatives, some comments included: ‘Thanks for the wonderful care given’. Another said, ’Thanks to all the girls for the love, care and attention given, you are a credit to your profession’.

The people using the service were complimentary about the staff and the care provided. They told us; I am happy with the care and support”. “The meals are good and we are offered a varied menu”. “I am very happy with my care “.

We spoke with a relative who told us, “My mother is well looked after, the staff are amazing with her. If I have any concerns I can discuss them with the manager who is brilliant”.

Another relative told us, “The care is wonderful. I have nothing but praise for the manager and staff. They also give care and support to us as a family when times are difficult.

Staff spoken with told us that the manager is ‘very hands on’ and that they felt supported by her.

One person said, “We get excellent support from the manager”.

Comments from a recent residents and relatives survey included, “The manager and the staff are excellent” and “Very pleased with all the services provided”. People told us that a lot of activities were arranged at the home, and some people went on holiday to Southport in October 2011. We were told that there were plenty of staff around, and there was always someone available to help when required. One person said they missed being able to watch football matches on Sky TV, and the manager told us that installation of Sky TV was currently being arranged to make this possible.