Archived: Mellifont Abbey

Updated 10 December 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.

The inspection was brought forward due to cumulative concerns raising potential risks to people at the home. The second day on site was carried out due to further concerns being received.

Inspection team

This inspection was carried out by two inspectors on the first day and one inspector on the second day.

Service and service type

Mellifont Abbey 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 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. The registered manager was also one of the directors and owner of the care home.

Notice of inspection

We gave a short period of notice of the first day of inspection because of the current COVID-19 pandemic to ensure everyone’s safety. Due to new concerns the second day was carried out unannounced.

What we did before the inspection

Due to the current pandemic the provider did not complete the required Provider Information Return. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and other professionals. We used all of this information to plan our inspection.

During the inspection-

We spoke to five people informally during the inspection. To keep them safe we did not spend long with them. We spoke with the registered manager, deputy manager and assistant manager plus five other care staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at four staff files in relation to recruitment.

After the inspection

Due to the pandemic we reviewed a variety of records offsite relating to the management of the service including one care plan, incident and accident records, policies and procedures and rotas. We spoke to two staff and four health and social care professionals on the telephone.

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We also requested a variety of records within specific time frames. These time frames were not always met.

Updated 10 December 2020

About the service

Mellifont Abbey is a residential care home providing personal care of up to 23 people with mental health conditions including dementia. At the time of the inspection there were 20 people living at the home on the first day and 19 people on the second day. One person was in hospital at the time of the inspection.

The home is a large converted building where each person has their own bedroom. There are communal areas on the ground floor including a dining room and lounges. There are extensive gardens and a patio area which is more secure.

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

People were not being kept safe when they had a specific health or care need. People’s care plans had not been updated when their risks changed. When actions had been identified to mitigate risks, they had not always been actioned. Infection control systems to reduce the risk of infection spreading were not always being followed. Following the inspection we were informed actions were taken to rectify this.

Staff levels were not adequate to keep people safe and meet their needs. Training for staff did not always meet the needs of people and keep them safe. Staff used specialist equipment to support people with limited mobility without suitable training to keep people safe.

Staff had a mixed understanding around safeguarding systems. The provider had not alerted relevant authorities when someone was at risk of potential abuse. People were placed at risk in the event of a fire because fire drills and alarms were not carried out in line with the provider’s policies.

Systems to ensure enough staff could safely administer medicines were not in place. Although we did see medicine administration which was in line with a person’s preferences. Medicine was stored safely.

The home was not well led. Systems to manage the home were chaotic and documents which should be readily available were not always. Policies were not being followed by staff and the management. Quality assurance systems had failed to identify concerns identified during the inspection.

Throughout the inspection we saw that staff interactions with people were positive and caring.

The provider had strong links with the local community which helped in the early stages of the COVID-19 pandemic.

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

Rating at last inspection

The last rating for this service was good (published 25 October 2019)

Why we inspected

The inspection was prompted in part due to concerns received about a cumulative range of concerns including staff levels, staff understanding of people’s needs and management of the home. As a result, we undertook a focused inspection to review safe and well-led only. A decision was made for us to inspect and examine those risks.

We reviewed the information we held about the service. Due to the current COVID-19 pandemic we felt it was not necessary to inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see the safe and well led sections of this full report.

Following this inspection, we started the process to slowly close the home. The home is now closed.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mellifont Abbey 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 breaches in relation to safe care and treatment including managing risks, staff training in relation to people’s needs and inadequate staff trained to administer medicines. We also found concerns around staff levels, protecting people from potential abuse and how effective the management is at the home.