CQC report explained · a nursing home
What the CQC found at Abbey House Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2018
Abbey House Nursing Home was rated Good overall; inspectors found kind, person-centred care, but medicines safety required improvement.
This was an unannounced inspection over two days. Inspectors spoke with people living in the home, relatives, staff and health professionals. They reviewed care plans, medicines records, staff records, rotas, incidents, audits and other documents.
The home was rated Requires Improvement for Safe. Inspectors found problems with medicines storage, expiry dates, opening dates and records for creams. Some care charts and risk assessments were not completed consistently. There were also infection control concerns and some equipment and building issues.
The other four areas were rated Good. People were supported by kind staff, received food and healthcare support, and had more detailed care plans than at the previous inspection. The home had improved since September 2016, when it was rated Requires Improvement overall, but inspectors said some improvements still needed to become consistent and lasting.
Kind and respectful care
People and relatives described staff as caring and friendly. Inspectors saw warm interactions and care that protected people's privacy and dignity.
“People were cared for by kind and compassionate staff.” from the report
Staffing and recruitment
Inspectors found suitable numbers of staff during the visit. The home completed identity, reference, employment history and Disclosure and Barring Service checks before staff worked unsupervised.
“There were suitable numbers of staff deployed to meet people's needs.” from the report
Improved care planning
Care plans contained more information about individual needs, preferences and choices. Staff had a good understanding of the people they supported.
“Improvements had been made to people's care plans which contained a more detailed record of people's individual needs.” from the report
Improved staff development
Staff were receiving regular supervision and appraisals. Training and induction had been strengthened, including support for new and inexperienced staff.
“Improvements had been made to ensure that staff were provided with opportunities to develop their skills and knowledge and performed their role effectively.” from the report
Leadership and quality checks
The home had introduced more effective audits, action plans and quality meetings. Staff were positive about leadership and worked well together.
“The service was well led. Staff were positive about the leadership of the service and felt well supported in their roles.” from the report
Medicines management
seriousA medicines trolley was left unattended with tablets on top, some liquid medicines had no opening date, and medicines past their expiry date were found. Cream administration records were incomplete.
“Improvements were needed to ensure that all aspects of medicines were managed safely.” from the report
Incomplete monitoring records
needs fixingFluid, food and repositioning charts were not always completed in enough detail. Some risk assessments had not been reviewed regularly, and one person with repeated falls did not initially have a falls care plan.
“Many of the tools and charts used to monitor people's needs and risks were not being completed consistently.” from the report
Infection control issues
needs fixingSome bed rail bumpers and a mattress were unsuitable or stained. A stand aid surface was flaking, and clothing stored beside a toilet created a possible cross-infection risk. The home replaced the mattress and bumpers during the inspection.
“Overall, the home was clean but we did identify some infection control concerns that could present risks to people.” from the report
Building and equipment
needs fixingSome floors were sloping, some shared rooms were difficult to use with hoists, and parts of the premises and equipment needed attention. Inspectors recommended reviewing whether shared rooms were large enough for people's needs.
“Abbey House was not a purpose built nursing home and we did find that some aspects of the premises and of the equipment within it were in need of attention.” from the report
- 01What has been done since the inspection to make sure all medicines are locked away, in date and marked with their opening dates?
- 02How do you check that topical creams are given and recorded every time?
- 03How often will people who stay in their rooms be checked, and how is this based on their individual needs?
- 04How do you make sure fluid, food, repositioning and other monitoring charts are completed accurately and reviewed?
- 05What improvements have been made to shared rooms, sloping floors and equipment used with hoists?
This was an unannounced inspection over two days that assessed all five key questions and reviewed progress since the September 2016 inspection. This explanation was written from the published report of 3 February 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2016
Abbey House Nursing Home was rated Requires Improvement; inspectors found safe and caring support, but important gaps in treatment, records, staff supervision and management.
This was an unannounced inspection over three days in September 2016. Inspectors spoke with people, relatives, staff and health professionals. They observed care and reviewed care records, medicines records, staff rotas, training, supervision and quality checks.
The home was rated Good for Safe and Caring. Staffing levels were considered adequate, medicines were generally managed safely, and people described kind and respectful care. The home provided activities and people could raise complaints and give feedback.
The home was rated Requires Improvement for Effective, Responsive and Well-led. Inspectors found a delay in getting treatment for one person's possible urine infection. They also found gaps and inaccuracies in care records, inconsistent use of the Mental Capacity Act, overdue staff supervision and quality checks that had not led to enough improvement.
The overall rating Requires Improvement means the home was not consistently meeting the required standards at the time of this inspection. The provider was told to send a report explaining what action it would take, and the CQC said it would check that action.
Safe staffing and medicines
Inspectors found staffing levels adequate for people's safety. Medicines records were complete and medicines were administered by trained staff.
“Staff levels were adequate to ensure people's needs were met safely.” from the report
Kind and respectful care
People and relatives spoke positively about the staff. Inspectors saw staff offering reassurance, supporting independence and respecting privacy in most situations.
“People told us they were cared for by kind and caring staff and were treated with dignity and respect.” from the report
Activities and feedback
The home offered group and one-to-one activities, including music, gardening and visits. People and relatives had opportunities to share their views and make complaints.
“A range of activities were provided and people were given opportunities to express their views and to give feedback about the service.” from the report
Improved risk controls
The home had improved some arrangements since the previous inspection. Examples included safer storage of thickening products and separate hoisting slings.
“Products used to thicken drinks for people who had swallowing problems were now stored securely.” from the report
Delayed healthcare treatment
seriousOne person had signs of a urine infection and a positive urine test, but treatment had not started by the date inspectors reviewed the case. Inspectors were concerned about an avoidable delay in accessing appropriate treatment.
“The care and treatment of one person had not been provided in a manner that effectively met their healthcare needs.” from the report
Incomplete care records
needs fixingWound records, fluid and food charts, repositioning records and care plans were not always complete or current. This could leave staff without clear guidance about people's needs.
“Records relating to the care and treatment provided were not always fit for purpose or accurate.” from the report
Staff supervision
needs fixingMany care workers and all registered nurses reviewed had not received recent supervision. The provider's earlier breach on supervision had therefore not been fully resolved.
“Staff were still not receiving ongoing supervision in their role to make sure their competence was being maintained.” from the report
Consent decisions
needs fixingSome consent records were inconsistent or signed by people without evidence that they had legal authority. Records about bed rails and people's capacity did not always agree.
“Some other records showed a lack of understanding of the legal framework regarding consent.” from the report
Weak quality checks
seriousAudits did not identify or resolve all the problems found by inspectors. Some actions had been carried forward, and training and supervision records were not reliable.
“There was a failure to ensure there were effective governance, quality assurance and auditing systems in place.” from the report
- 01How do you now identify and escalate possible infections, and how do you make sure treatment is not delayed?
- 02How often does each member of staff receive supervision, and how do you check that this is happening?
- 03How are wound care, fluid intake, repositioning and pain records checked for completeness and accuracy?
- 04How do you assess a person's capacity for each decision, and how do you record who can lawfully give consent?
- 05What changes have been made to your audits so that repeated problems are identified and resolved?
This was an unannounced inspection of all five key questions over three days, including observations, discussions and reviews of care, medicines, staffing and management records. This explanation was written from the published report of 18 October 2016 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Abbey House Nursing Home
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- February 2018Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- May 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 13 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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