Archived: Abbey Care Home

Updated 19 February 2022

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.

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

The inspection was carried out by two inspectors.

Service and service type

Abbey Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 two managers registered with the Care Quality Commission, one of whom is the sole owner and director of the registered provider. 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

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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.

We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service and four members of staff including the director and registered manager.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We attended safeguarding strategy meetings with other system stakeholders.

Updated 19 February 2022

About the service

Abbey Care Home is a residential care home providing personal care to people aged from 18 to 65 years and over who may have mental health, learning disability, physical disability or dementia. The service can support up to 20 people in one adapted building, over three floors. The service is centrally located providing easy access to local community facilities and transport. At the time of the inspection there were 12 people accommodated.

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

The service was not well-led. There continued to be a failure to recognise and identify significant failings impacting on the quality and safety of service provision and a continued lack of consistency in how well the service was managed and led. Lessons had not been learned to minimise risk and drive improvement. Management and staff roles and responsibilities were not clear or understood. Concerns continued to be raised by whistleblowers, professional visitors and others.

People were not protected from abuse or avoidable harm. Management did not recognise or appropriately respond to abuse; they failed to properly apply safeguarding policies and procedures when circumstances needed it. People were not valued and treated with dignity and respect, especially people living with dementia or mental health needs. The provider failed to ensure there were enough suitably competent and skilled staff deployed to meet people’s needs safely and effectively.

There continued to be significant shortfalls with how the provider and registered manager were responding to the COVID-19 pandemic. They were failing to do all that was possible to keep people safe from the transmission of COVID-19 infection. Management and staff were not following Government guidance and best practice infection prevention and control (IPC) guidance. Measures to limit the risk of cross infection continued to be neglected, compromising people’s safety and welfare. Areas of the home were still not clean, and the provider was failing to have effective and additional cleaning schedules in place for frequently touched areas and deep cleaning.

Immediately following this inspection, we made safeguarding alerts to the local authority. The local authority safeguarding, and quality improvement teams continue to monitor the service through management support and regular visits to ensure the safety of people living at the service.

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 11 November 2021) and there were multiple breaches of regulation. We took immediate enforcement action to force improvement. We shared our concerns with the local authority and fire safety authority. In response, the local authority monitored people’s care experience and offered to support the provider through the improvement process. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected: We received information of concern about infection prevention and control measures at this service during an outbreak of COVID-19 and the way people were being treated by some staff. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. As part of CQC’s response to care homes with outbreaks of COVID-19, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice is safe and that services are compliant with IPC measures.

At this inspection enough improvement had not been made and the provider was still in breach of regulations. This report only covers our findings in relation to the key questions Safe and Well Led. Ratings from previous inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service remains inadequate. This is based on the findings of this inspection.

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 Abbey Care Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified continued breaches in relation to infection prevention and control practices, safeguarding, staffing, managerial oversight and leadership at this inspection. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. We will monitor and review information received about this service and inspect sooner if we need to.

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.