Archived: Abbeyfield - Woodgate

Updated 3 August 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 3 July 2015 and was unannounced. The inspection team consisted of three inspectors and an expert by experience. An expert by experience is a person who has personal experience of using, or caring for someone who uses, this type of care service.

We gathered and reviewed information about the service before the inspection, including information from the local authority and previous reports. We spoke with the safeguarding team and the commissioners of the service to gather their views of the care and service. We looked at notifications we had received from the provider. This is information the provider is required by law to tell us about.

During our inspection we spoke with nine people, five people’s relatives and seven staff. We used the Short Observational Framework for Inspection (SOFI) because most people were living with dementia and many could not tell us about their experiences of using the service. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We looked at care records and associated risk assessments for five people. We observed medicines being administered. We looked at various records the registered manager kept for the running of the service.

Updated 3 August 2015

This inspection was carried out on 3 July 2015 and was unannounced. We last inspected Abbeyfield Woodgate on 5 and 13 March 2015. We found that the service was meeting the requirements of the regulations, but we made recommendations that they further improve in the areas of medicines, staffing and activities. We carried out this focused inspection to follow up on these areas. We also had concerns about another service provided by the same organisation. Because we are taking enforcement action at that service we needed to gather evidence to ensure people at this service were not experiencing the same inadequate care. We found that although minor improvements were required people were safe and receiving effective care. You can read the report from our last comprehensive inspection (5 and 13 March 2015), by selecting the 'all reports' link for Abbeyfield – Woodgate on our website at www.cqc.org.uk

Abbeyfield Woodgate provides accommodation for up to 48 people who need personal care and support. The service provides care for older people and people living with dementia. Accommodation is provided on two floors arranged into separate units. The service has single bedrooms, but has the facility to provide accommodation to couples wishing to share a room. There were 43 people living at the service at the time of our inspection.

The registered manager of the service had been in post since February 2015 and had been registered with the commission since 25 June 2015. A registered manager is a person who has registered with the Care Quality Commission to manage the care and has the legal responsibility for meeting the requirements of the law. 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.

At this inspection we found that improvements had been made to staffing, medicines and social activities.

There were enough staff to provide safe and effective care for people. Staff were skilled in meeting the needs of people living with dementia. People told us, “Staff know what they are doing” and “They are skilled in what they do.” Staff understood the specific needs of people living with dementia and how to respond when people were distressed, agitated or confused. We saw that they provided compassionate support that met people’s needs.

People’s medicines were managed in a way that kept them safe. People received the medicines they needed when they needed them.

People were supported to take part in a range of activities to meet their social needs. People had been asked what was important to them and how they liked to spend their time. Staff used this information to plan the activities provided. This meant that people were able to spend their time in the way they preferred.

We found a breach of regulation in relation to consent. People were not always asked for their consent to care and treatment. Some decisions had been made on people’s behalf; for example in relation to life saving treatments and the use of bed rails. Where this had happened an assessment of the person’s capacity to make their own decision had not been completed. This meant that people may not have been given the opportunity to make their own decisions.

Staff followed good practice regarding hand washing to reduce the risk of infections and the service was kept clean. However the laundry room was not well organised to ensure that the risk of infection was reduced. We have made a recommendation about the management of the risk of infection.

The premises were not designed to meet the needs of people living with dementia. The registered provider had identified this and had started building a new home on the site that would provide more suitable accommodation. This was to be completed in 2016. The current premises were clean and comfortable, but there were areas where improvements could be made. Some people’s bedrooms were sparse and not very personalised. The upper floor did not provide people living with dementia with an interesting space to move around in. We have made a recommendation about the suitability of the premises for people living with dementia.

Some care records were not up to date. This meant that staff may use out of date information to provide people’s care. We have made a recommendation about record keeping.

The risks to people’s safety and well-being had been assessed and minimised. Staff knew what action they needed to take to keep people safe. Staff followed risk assessments and promoted people’s safety. This meant that people were protected from risks to their welfare whilst being supported to be as independent as possible.

Staff told us they felt supported in their roles and the registered manager provided staff with clear guidance and leadership. Staff had completed the training and qualifications they needed and we saw they used this knowledge to provide people with safe and effective care.

People had their health needs assessed and care plans were put in place to meet their needs. For example a person who was at risk of losing weight had a plan for a supplemented diet and increased snacks. Detailed plans were in place to guide staff in meeting people’s specific needs to avoid unnecessary hospital admissions. This meant that people were supported to remain as healthy as possible.

Staff were caring, compassionate and attentive in their approach to meeting people’s needs. Everyone we spoke with praised the approach of the care staff. Comments included, “Most everyone is very, very caring” and “They are simply wonderful.” Staff knew people well and took time to chat with them and provide assurance. Staff were friendly and helpful and showed warmth and affection towards people. Staff showed examples of excellent person centred care for people living with dementia.

Staff knew people well and used the information they had about people’s interests to tailor their support. This meant that people received personalised care that reflected their preferences and met their needs.

The registered manager had made improvements in the service to provide personalised care. Staff were clear about their roles and were confident they could raise concerns with the registered manager. The registered provider had shown how they had learned from incidents in the service and in their other registered services and had used the information to improve care. This showed that the service was well-led.

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