Archived: Abbas Combe Nursing Home

Updated 15 February 2017

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.

The inspection took place on 10 and 11January 2017 and was unannounced. The inspection was carried out by an inspector and a Specialist advisor in nursing care.

We reviewed information we held about the service, including previous inspection reports and notifications of significant events the provider sent to us. A notification is information about important events which the provider is required to tell the Care Quality Commission about by law.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We reviewed information we held about the service, including previous inspection reports and notifications of significant events the provider sent to us. A notification is information about important events which the provider is required to tell the Care Quality Commission about by law.

We spent time observing the care and support people received in communal areas of the home. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experiences of people who could not talk with us.

During the inspection we spoke with five people and to three relatives. We spoke with the manager and five staff, which included the chef, a housekeeper, care staff and a registered nurse. We also spoke to the provider and the provider’s regional manager. We obtained the views of the local authority who commissioned services from the home and carried out their own audit visits. These professionals gave permission for their comments to be included in this report.

We looked at the care records for 11people and the medicines administration records (MARs) for people accommodated on the ground floor. Staff training, induction and supervision records were looked at. We also looked at records such as complaints and quality assurance checks.

Updated 15 February 2017

The inspection took place on 10 and 11 January 2017 and was unannounced.

Abbas Combe Nursing Home is registered to provide accommodation and nursing care for up to 25 people with a variety of needs including those living with dementia. At the time of our inspection, there were 18 people living at the home all of whom were over 65 years of age and had varying needs such as those associated with old age, frailty and dementia. Abbas Combe Nursing Home is a detached property close to the A27 on the outskirts of Chichester. Communal areas include an entrance hall, lounge with a conservatory and a dining room. Approximately half the rooms have en-suite facilities. The property has gardens at the rear, with seating areas.

The service did not have a registered manager in post as the previous registered manager had left the service. There was a new manager in post who has applied to be registered with the Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The last inspection took place on 27 and 28 October 2015. At that inspection we made legal requirements for two breaches of our regulations; these were regarding the lack of adequate maintenance of the premises and inconsistency in records for needs such diet and management of pressure areas on people’s skin. The provider sent us an action plan to say how these legal requirements would be met. The action plan, however, did not include a date to say when these would be completed but said the action plan was ‘ongoing.’ At this inspection we found improvements and redecoration to the premises had been made and this regulation was now met. We also found care records were generally accurate and consistent; this regulation is also now met.

Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People said they felt safe at the home.

Care records showed any risks to people were assessed and there was guidance of how those risks should be managed.

Medicines were safely managed although we have made a recommendation regarding ‘as required’ medicines to ensure there is clear guidance for their use.

There were sufficient numbers of staff to meet people’s needs. Staff recruitment procedures ensured suitable staff were employed.

Staff were trained and supervised so they provided effective care to people. This included induction training for newly appointed staff and access to nationally recognised training such as the Diploma in Health and Social Care.

People were consulted about their care. Records showed people’s consent was obtained regarding the care and support they needed.

The CQC monitors the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Staff were trained in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). People’s capacity to consent to their care and treatment was assessed and applications made to the local authority where people’s liberty needed to be restricted for their own safety.

People were looked after by kind and caring staff who knew them well. People and their relatives said people were treated with respect and dignity. Staff were observed to support people well and to respond to their emotional needs.

People’s needs were assessed before they were admitted. Care plans gave staff guidance on how to support people. A range of activities were provided and the provider was planning to extend these.

The service had a complaints procedure and people knew what to do if they were not satisfied with the service they received. Records were kept of any complaints which showed they were looked into and responded to.

There were a range of systems to measure the quality of care provided. People, their relatives, staff and other professionals were asked for their feedback on the service; these were mainly positive. Residents’ meetings were held where people were able to express their views on the service.