This inspection took place on 11 September 2018 and was unannounced.

Abbey Grange Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal 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 Grange Nursing Home can accommodate up to 74 people who require accommodation and nursing or personal care. The home consists of one adapted building across three floors. At the time of our inspection there were 71 people living in the home.

Our last inspection of Abbey Grange Nursing Home took place on 14 August 2017. We rated the service good overall, but requires improvement in the key question of safe. We found there were two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There was a breach of Regulation 17: Good governance because the service did not always follow its policy and procedure regarding the management of people’s money which was kept by the home for safe keeping. There was a breach of Regulation 19: Fit and proper persons employed. This was because necessary recruitment checks were not always completed when new staff were employed by the home.

Following the last inspection, we asked the registered provider to complete an action plan to show what they would do, and by when, to improve the key question of safe to at least good. At this inspection we found sufficient improvements had been made to meet the requirements of Regulation 17 and Regulation 19.

At this inspection we found the evidence continued to support the overall rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager employed at Abbey Grange Nursing Home. A registered manager is a person who has registered with the 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 2008 and associated Regulations about how the service is run.

People told us they felt safe. There were enough staff available to meet people's needs in a timely way and to keep people safe. Staff had completed safeguarding vulnerable adults training and they had a good understanding of their responsibility to protect people from harm.

There were effective procedures in place for the safe management and administration of medicines. People received their medicines as prescribed.

People's needs were assessed before they moved into Abbey Grange Nursing Home to check the service was suitable for them. Their care plans were regularly reviewed to make sure they always received the correct level of care and support.

People told us the staff were kind and caring. During this inspection we observed staff treat people with kindness, dignity and respect. People’s relatives told us staff were caring and supportive towards them as well. Relatives and friends were welcomed into the home.

Staff received a range of training which the registered provider considered to be mandatory. Staff told us they were happy with the training they received and felt it supported them in their roles.

People were asked for consent before care was provided to them. Where people lacked capacity to make certain decisions for themselves, their care records showed decisions had been made in their best interests. People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible. The policies and systems in the service support this practice.

The service worked closely with community health professionals to support people with their heal

Abbey Grange is a care home which is registered to provide accommodation and personal care for up to 74 older people who may have nursing needs may be living with dementia. The home is purpose built and was registered in 2013. On the day of our inspection there were 68 people living in the home.

This inspection took place on 14 August 2017 and was unannounced. This meant no-one was aware we were inspecting the service on that day.

There was a registered manager in post. 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.

At the last inspection on 15 August 2016 we asked the registered provider to take action to make improvements with medicines and staffing levels. At this inspection we found this action had been completed.

There were sufficient numbers of staff that were suitably trained to keep people safe and meet their needs.

People’s medicines were managed in a safe way.

Discussions with people living at the home, their relatives and health professionals told us people’s human rights were upheld and they were safe. Improvements were required with the system in place to manage people’s money held by the service in a safe way.

Improvements were also required with the information obtained about staff during their recruitment to evidence they were fit and proper persons to be employed.

People living at the home, their relatives and health professionals told us the staff were caring and supportive.

There was a programme of training in place to provide staff with the skills and knowledge they needed to do their jobs. Staff understood their roles and what was expected of them. Staff said they were happy in their work and wanted the best for people who used the service.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. Policies and systems in the service ensured the service complied with the Mental Capacity Act.

Relatives told us they were contacted when their family member was ill and that they were kept updated about their family member.

People’s personal preferences and interests were recorded in care plans and support was being provided in accordance with people’s wishes.

People told us social activities were on offer to enhance their wellbeing and improve their quality of life. At the time of this inspection there were two vacancies for activity staff that were being recruited to.

People living at the home, their relatives and staff were confident in reporting concerns to the registered manager and registered provider and felt they would be listened to.

People living at the home, their relatives and staff were able to share their views about the service.

There were systems in place to assess and monitor the quality of service provided, so improvements continued to be made.

We found two breaches in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in Regulation 17: Good governance and Regulation 19: Fit and proper persons employed.

You can see what action we told the provider to take at the back of the full version of the report.

Abbey Grange is a care home which is registered to provide accommodation and personal care for up to 74 older people who may have nursing and dementia care needs. The home is purpose built and was registered in 2013. On the day of our inspection there were 72 people living in the home.

This inspection took place on 15 August 2016 and was unannounced. This meant prior to the inspection people were not aware we were inspecting the service on that day.

There was a new manager at the service who had recently been employed and was in the process of registering with CQC. 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 last inspected Abbey Grange on 2 December 2013 and found that the service was meeting the requirements of the regulations we reviewed at that time.

People who used the service, their relatives and staff told us staffing numbers were not always sufficient in order for people’s needs to be met in a timely manner. Their comments included, “It’s not the girls [staff] fault, they try but there’s just not enough of them sometimes” and “I sometimes feel like I’m waiting a long time for help.”

On the day of our inspection we observed one unsafe practice during medicine administration. This was because the medicine trolley was left unlocked and unattended in the dining room, which left people at risk of harm.

People who used the service and their relatives told us they had no concerns about their safety at the home.

People told us the staff were caring and supportive. They said they enjoyed the company of the staff and felt that staff knew them well.

Two healthcare professionals spoken with said, “This is a really good service which has very caring staff. Staff report things to us straight away so we can provide treatment quickly. We have a really good working relationship and mutual respect for each other.”

The service followed the requirements of the Mental Capacity Act 2005 Code of practice and Deprivation of Liberty Safeguards (DoLS). This helped to protect the rights of people who were not able to make important decisions themselves.

Staff said the programme of training they were required to complete provided them with the skills and knowledge they needed to do their jobs. Care staff said they understood their role and what was expected of them. Staff said they were happy in their work and wanted the best for people who used the service.

Relatives told us they were contacted when their family member was ill and they needed to call the GP. Relatives told us the staff phoned them and kept them updated about how their family member was and what the GP had said. One relative said this was, “Good, especially if I cannot get down to the home.”

People’s personal preferences and interests were recorded in care plans and support was being provided in accordance with people’s wishes.

People told us they wanted to do more social activities. Some people told us they were “Bored.” We saw people falling asleep during the day, due to lack of stimulus. One person told us, “I’m not used to sitting down all day watching TV, I would prefer to be outside going for a walk.” Another person said, “There is nothing to do here.” One relative said, “[Name] often tells me they are bored and have got nothing to do,”

The service had a complaints policy and procedure. We saw the policy was on display in the foyer area of the home. Five people who used the service spoken with said they would either speak to a staff member or manager if they had a problem or complaint. People and relatives told us they were confident staff would sort out their concern.

We found two breaches in the regulations of the Health and Social Care Act 2008 (Regulated Activi

We visited the service on 2 December 2013 as part of our scheduled inspection programme. We spoke with nine people who used the service, five relatives of people who used the service, seven staff and the registered manager.

We found that people were asked for their consent to care and treatment and the staff acted in accordance with their wishes.

People who used the service told us they were happy living at the home. Their comments included, “I think it's very good here. Everyone is caring,” “I wish I was at home but that's not possible, so I'm OK here" and “The staff are angels."

We found that care and support was offered appropriately to people and that staff were skilled, in recognising the diversity, values and human rights of people who used the service.

During our inspection we conducted a tour of the premises and found it was tidy and free of any unpleasant odours. People were cared for and supported in a clean, safe and well maintained environment.

Staff that we spoke with said they were very well supported by the registered manager to carry out their role.

We saw that the service had provided people with information about how to complain. People who used the service told us their comments and complaints were listened to and acted upon.

People who we were able to communicate with told us that they were happy living at the

home and that they were satisfied with the care they received. People said, "The staff are great and so very helpful.", "It's a wonderful place to live.", "I am very settled and contented." and "The staff are well trained and there are no restrictions on what I can do."

We spoke with five relatives. They all spoke very highly about the home and the care that was provided. They told us "I have no worries or concerns about the home and think its good in every aspect.", "Mum has only been here for a short while and she is quickly settling in, whenever we visit we're offered a drink and the staff make us feel so welcome." and "Everyone is so welcoming and kind, I really couldn't find fault with anything."

People living in the home, relatives and staff were all very proud of the home as it had recently had a refurbishment. The refurbishment had been carried out to a very high standard. New communal areas were spacious, bright and welcoming. A number of newly refurbished bedrooms offered high quality and homely furnishings and fittings. People told us that the refurbishment had made the home feel like being in "A five star hotel."

We spoke with two health professionals that visited the home on a regular basis. They both said they felt the care offered at the home was good. They also said that communication between themselves and the staff at the home was much improved since the new manager had been in post. They said they had no worries or concerns about the way people were being supported and cared for in the home.

Sheffield Local Authority Contracting and Commissioning had carried out a full monitoring visit on 11 November 2011. Their report showed that they believed that the service met all aspects of quality and safety that they reviewed.

People that were able told us that overall they were happy living at the home and satisfied with the care and support they were receiving. Their comments included:

“I am very happy here, things are OK”.

“It’s just like home”.

“I have a nice room, I’m comfortable”.

“The meals are good and I can decide how I spend my day”.

“It’s not as god as it was when I first came here, several years ago, but things are starting to improve again”.

In the entrance hall there was a comments book, where people visiting could record their view of the home. The book had been introduced by the new manager, so there were only a few comments entered. The comments that relatives and friends had written were all positive. People said they were pleased with the new manager, the staff and the care provided at the home.

One visiting professional told us, they were always made to feel welcome at the home. Staff were always available to assist them when necessary and they saw that staff treated people well and had patience and empathy when dealing with people.

Sheffield Local Authority, Contracting and Commissioning told us they had recently carried out a full moitoring visit. They said “there have been improvements, both under the new ownership and the management”. They sent us a copy of their report which showed that the majority of outcomes checked were met. There was evidence that the manager was aware of any areas that weren’t met and was working towards fully meeting these.