The Four Seasons Trust Limited - 33 Abbotswood

Updated 14 February 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

33 Abbotswood 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection as the service is small. We therefore wanted to be sure there would be people at home to speak with us.

What we did

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection we spoke with the three people who used the service about their experience of the care provided. We spoke with five members of staff including the registered manager, a senior care worker and three care workers

We reviewed a range of records. This included two people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. We also reviewed variety of records relating to the management of the service, including accidents and incidents, audits and complaints policies.

Following the inspection, we continued to seek clarification from the provider to validate evidence found. We reviewed information sent by the registered manager. We spoke with one professional who had visited the service three times in 2019 to support them with systems and processes. We contacted six health and social care professionals after the inspection by email. These included care managers, an advocate, a Mental Capacity Act Assessor and three medical professionals, including a GP. We also contacted the four members of the Trust Board which runs the service and relatives of all the people living at 33 Abbotswood. We spoke with one trustee. We also received one response from professionals and three responses from relatives.

Updated 14 February 2020

About the service

33 Abbotswood is a 'care home' registered to provide accommodation and personal care support for up to four people living with a learning disability and/or autistic spectrum disorder. At the time of this inspection three people were living there.

People’s experience of using this service:

Care plans were not fully up to date and did not always reflect people’s risks needs and preferences. Work was in progress to review and update care plans, so they more accurately described how each person should be supported. However, aspects of the older care plans, which were still in use, were not up to date. This meant staff did not have accurate information about how to support people with specific needs. Renewal of one person’s Deprivation of Liberty Safeguards authorisation had not been actioned before the expiry date, which meant the service was not adhering to the requirements of the Mental Capacity Act 2010.

The registered manager had worked with local authority and Skills for Care quality improvement staff to improve the systems and processes to run the service effectively. This included developing audits and checks to ensure the safety and quality of the service. However, these checks had not identified all the issues found at this inspection.

Medicine storage was in the kitchen where it was possible the temperature would be above recommended levels. Medicines were administered and recorded by staff who were trained and competent. Where an error occurred, actions were taken to report the problem and find ways to reduce risks of reoccurrence. People living at the service were protected from abuse because staff had received training and were confident in raising concerns about people’s wellbeing.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a domestic sized house, which was in keeping with other homes in this quiet residential area. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff did not wear a uniform or anything that suggested they were care staff when coming and going with people.

People and relatives were very positive about the service, with comments about how much staff and the registered manager cared and often went above and beyond duty. There was a happy relaxed atmosphere in the service with people planning what they were going to do. Activities included opportunities to make and meet friends, follow hobbies and interests and keep active.

People were supported to develop life skills such as cooking, shopping and housework. People were supported to have choice and control of their lives by staff who supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were involved in choices about food and said they enjoyed the meals they had at the service. People’s health was monitored, and staff involved health and social care professionals appropriately.

Rating at last inspection

The last rating for this service was Good (Report published on 17 June 2017)

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvement. Please see the Safe, Responsive 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.

We found no evidence during this inspection that people were at risk of harm from the concerns regarding care plans and the storage of medicines. The provider was acting to mitigate the risks working with the local authority and this had been effective. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Four Seasons Trust Limited – 33 Abbotswood on our website at www.cqc.org.uk.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk