About the service:

Abbeywell Court is a care home that provides personal and nursing care to up to 45 people in one adapted building. 38 people were living at the home at the time of the inspection.

People’s experience of using this service:

People were supported by a sufficient number of safely recruited staff who knew how to keep people safe. Systems were in place to protect people from abuse and staff understood them. Risk was managed and reviewed to ensure people were kept safe. Medication was stored and administered safely.

People’s needs and choices were assessed and promoted effectively. People were supported with eating and drinking in line with their dietary needs to ensure they maintained a balanced diet. Staff were skilled and had the knowledge to deliver effective care. People had access to healthcare services and staff worked well together and with healthcare professionals to effectively meet people’s needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported by kind and caring staff who display empathy and compassion. People and their relatives were encouraged to be involved in making decisions about their care. People were supported by staff who respected their privacy and dignity and promoted their independence.

People were supported to engage in hobbies and interests important to them. Staff understood people’s preferences and individual communication needs. People’s end of life wishes were considered and plans were in place to ensure people received personalised care at that time of their life.

Audits were in place that effectively checked the quality of the service and action plans were implemented and followed where necessary. Relatives and staff told us they found the management team approachable. There was an open culture in the service and the management team made themselves available. The management team continually sought ways to improve the quality of the service.

The service met the characteristics of Good in all areas; more information is available in the full report below.

Rating at last inspection:

Requires Improvement (published 5 January 2018)

Why we inspected:

This was a planned inspection based on the rating at the last inspection. At the last inspection in November 2017, the service was rated as Requires Improvement overall with ratings of Requires Improvement in the key questions of Safe, Effective, Responsive and Well-Led. At the last inspection, we asked the provider to take action to make improvements.

At this inspection, the required improvements had been made and the service had met the characteristics of Good in all areas. The overall rating is Good.

Follow up:

We will continue to monitor the service through the information we receive.

We completed an unannounced inspection at Abbeywell Court on 23 and 24 November 2017. At the last inspection on 24 March 2015 the provider was meeting the Regulations and we rated the service as ‘Good’.

Abbeywell Court 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.

Abbeywell Court accommodates up to 45 people in one adapted building. Abbeywell Court provides support for people who predominately have a physical disability and/or a mental health condition such as dementia.

There was a registered manager at the service. 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 found that some medicines were not always administered as prescribed.

Some improvements were needed to ensure that unexplained bruises were investigated and reported to the local safeguarding authority when required.

People enjoyed the food provided. However, some improvements were needed to promote people’s choice and mealtime experiences.

Improvements were needed to ensure that people’s past lives, cultural and diverse needs were assessed and considered to enable individualised care that met all aspects of people’s needs.

Some improvements were needed to ensure people were involved in the advance planning of their end of life wishes.

The provider had systems in place to assess, monitor and improve the quality of care. However, some of the systems were not always effective and improvements were needed to ensure areas of concern were identified and rectified.

Risks to people’s health and wellbeing were managed and followed by staff who knew people well, which ensured people were supported safely.

The environment had been adapted in a way that promoted people’s safety, independence and orientation.

There were enough suitability recruited and skilled staff to provide support to people. Staff had received training to ensure they had sufficient knowledge to carry out their role effectively.

People were protected from the risk of infection because the provider had policies and systems in place to control infection risks at the service.

Systems were in place to ensure that people received the least restrictive care and treatment to keep them safe and staff understood and followed the Mental Capacity Act 2005.

People were supported with their nutritional needs and action was taken to ensure people at high risk of malnutrition were supported effectively.

Advice was sought from health and social care professionals when people were unwell, which was followed by staff.

There were systems in place to ensure people received consistent care from staff within the service and also from staff from external agencies.

People received support from staff that were kind and compassionate. People’s dignity was respected and their right to privacy upheld.

People were supported with their communication needs and information was provided in a format people understood which meant that people were supported to make informed choices.

People and their relatives knew how to complain. Complaints received had been investigated and responded to in line with the provider’s policy.

People, relatives and staff felt able to approach the registered manager and the feedback gained from people about their care had been acted on.

The registered manager understood their responsibilities of their registration and worked in partnership with other agencies to make improvement to the way people received their care.

The inspection took place on 24 March 2015 and was unannounced.

Abbeywell Court provides accommodation and personal or nursing care to up to 45 people who were living with dementia or have a mental health diagnosis. The service was divided into two units and there were 42 people in residence at the time of the inspection.

The service didn’t have 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. The provider had recruited a manager who had submitted an application to register with us, the application was being processed.

The Mental Capacity Act 2005 (MCA) is designed to protect people who cannot make decisions for themselves or lack the mental capacity to do so. The Deprivation of Liberty Safeguards (DoLS) are part of the MCA. They ensure that people assessed as not having capacity in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. The provider ensured that people’s mental capacity had been assessed and any restrictions necessary to ensure their safety had been agreed in their best interest, if they did not have the capacity to make decisions for themselves.

People’s needs were not always met safely because of inappropriate moving and manual techniques which placed them at risk of injury. People’s needs were met in a timely way because there were sufficient staff deployed throughout the service. Staff told us they felt supported by the management and had opportunities to access the training they needed to enable them to meet people’s needs. People’s medicines were managed safely.

Risks to people’s health and wellbeing were assessed, managed and regularly reviewed, but manual handling risks had not always been addressed or managed as stated in individual plans of care. Where people needed to receive health care support, the provider took prompt action to involve the necessary health services.

People were treated with dignity, respect, kindness and compassion. There were opportunities for people to be involved in hobbies and other activities of their choices. People and their relatives knew how to complain and any complaints were looked into and responded to.

Systems to monitor the quality of the service were in place and changes made to ensure people received improved experiences.