Abiden Care Home

Updated 17 March 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

One inspector, 1 medicines inspector visited the service on day 1. One inspector visited the service on day 2 and 1 Expert by Experience undertook telephone calls to relatives. 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

Abiden Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Abiden Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. There was an acting manager in post. The nominated individual told us they had recently recruited a new manager who was planning to commence the registered manager application process once in post.

Notice of inspection

Day 1 of this inspection was unannounced, day 2 was announced. The inspection activity started on 7 February 2023 and ended on 23 February 2023. We visited the service on 7 and 8 February 2023.

What we did before the inspection

Prior to the inspection, we looked at the information we held about the service. This included feedback and notifications which the provider is required to send to us. We asked for feedback from professionals who had knowledge of the service. We checked whether Healthwatch had undertaken an inspection. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people who used the service and 2 relatives on the days we visited. We also spoke with 5 relatives or friends over the telephone. We received feedback from 4 professionals. We undertook a tour of the building and completed observations in the communal areas. We spoke with 9 staff members. These included, 2 care staff, 1 senior carer, the care lead, the cook, the housekeeper, the acting manager, the operations manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We looked at a range of records. These included 3 care records, 5 medicine administration records and medicines related documentation. We checked medicines storage. We also checked 3 staff files, training records and records relating to the operation and management of the service.

Updated 17 March 2023

About the service

Abiden Care home is a residential care home providing personal care for up to 22 people in 1 adapted building. The service provided support to older people, people living with a dementia, mental health, and people with a physical disability. At the time of the inspection 12 people were living at the service.

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

Accident and incident records did not contain all the information about actions taken following an incident, as a result the audits undertaken did not reflect the accidents in the service. There was enough staff to meet people’s needs. Staff files were mostly complete however, we made a recommendation to ensure proof of identity checks were in place for staff. People and relatives told us they felt safe in the service and staff had undertaken safegaurding training. Individual and environmental risk assessments were in place. Lessons learned were considered.

People were positive about the food and drinks they received and we observed a positive meal time experience. However, one person’s weight loss had not been followed up and acted upon. People had been consulted about their care and consent forms had been signed. People were mostly 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. Some deprivation of liberty (DoLS) applications had been undertaken. However, one person’s authorisation had not been reapplied for and another did not confirm conditions had been considered in their care records. We made a recommendation about this. We found medicines were managed safely across the service. We made a recommendation in relation to undertaking regular planned medicines audits.

Improvements had been made in the environment and ongoing work was being undertaken. An improvement plan was in place. Staff training was refreshed at regular intervals. We saw some evidence of limited supervisions taking place however, these had not been done recently. We made a recommendation about this. There was evidence of the involvement of professionals and assessments had been undertaken.

People received good care, where some concerns were raised about people’s care this was followed up by the management team who confirmed all care had been provided. People were treated with dignity and respect. Where one person told us about the privacy in their room the nominated individual took immediate action to address their concerns.

Records had been completed to show some activities were taking place. However, most people told us no activities were offered and some people said they were bored. The nominated individual told us they were in the process of developing detailed life history records to support tailored activities for people. Care plans had all been reviewed and contained information to meet the needs of people. The nominated individual told us they had taken action to record do not attempt cardio pulmonary resuscitation status for people. People’s individual communication needs were considered. A system had been developed to record complaints. The provider took action to investigate a concern they had not previously been aware of.

The nominated individual confirmed they would ensure an outstanding notification was submitted to the Care Quality Commission without delay. Satisfaction surveys were carried out and regular feedback was sought from people and staff . However, not all relatives could confirm they were engaged and involved in the service. There was evidence of partnership working and improving care. Very positive feedback was received from professionals working with the service. Audits were being undertaken but there were still gaps in some of the audits and a lack of detail about the actions taken. There was inconsistent management arrangements for the service . The nominated individual confirmed a manager had recently been recruited to post and would be commencing the application for registered manager.

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 inadequate (published 07 September 2022). At the last inspection, we issued the provider with warning notices for Regulation 12 and Regulation 17. The provider completed an action plan after the last inspection to show what they would do and by when to improve. The provider worked closely with the Care Quality Commission and Local Authority commissioners.

At this inspection, we found improvements had been made however, the provider was still in breach of regulation.

At our last inspection we made recommendations in relation to staffing, staff recruitment, supervision and competency checks for staff, supporting people's dignity and appropriate care and meaningful activities. At this inspection, we found some improvements. However, we made further recommendations in relation to the provider seeking guidance to ensure proof of identity checks were obtained and recorded and the provider ensuring DoLS applications are followed up and conditions are acted upon. We also recommended the provider ensures all staff received regular and timely supervisions and they undertake regular planned medicines audits to ensure all documentation is current and complete.

This service has been in Special Measures since 7 September 2022. During this inspection, the provider demonstrated improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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.

You can see what action we have asked the provider to take at the end of this full report. The nominated individual has provided assurance of their commitment to continue to make improvements in the service.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make further improvements. 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 Abiden care home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to the safe management of incidents and accidents and ensuring systems were effective in ensuring people received food according to their needs and any changes in people’s conditions were acted upon as well as ensure the oversight, monitoring and good 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

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