Archived: Adbolton Hall

Updated 16 November 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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Adbolton Hall is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Adbolton Hall is a care home with nursing care. However, Adbolton hall had stopped providing nursing care at the time of our inspection. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

The registered manager resigned from their position after the first day of our inspection.

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 (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with 15 people who used the service about their experience of the care provided and two relatives. We spoke with 12 members of staff including the registered manager, deputy manager, operations manager, senior care workers, kitchen staff, care workers and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with two professionals about their experience of the care provided at the home. We reviewed a range of records. This included six people's care records and multiple medicine records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including training records, policies and procedures were reviewed.

Updated 16 November 2022

About the service

Adbolton Hall is a residential care home providing personal care to 24 people some of whom were living with dementia at the time of our inspection. Adbolton Hall can support up to 53 people across two floors, due to the number of people using the service and the state of disrepair of the first floor only the ground floor was in use.

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

Infection prevention control measures were not in place and did not protect people from risk of harm. Staff were not recruited safely which left people at risk of receiving care from unsuitable people. Lessons were not learnt.

Medicines were not managed safely, and people were at risk of not receiving their prescribed medicines. People were not protected from the risk of harm or abuse. Staff did not recognise or report safeguarding incidents. Known risks had not always been assessed and risk reduction measures were either not in place or not followed.

People did not have their needs fully assessed and care was not delivered in line with best practice guidance and the law. This left people at risk of receiving unsafe care. People were not always offered choice in what they wanted to eat, or drink.

Although staff completed training in areas such as safeguarding and moving and handling, training was not effective, and people were not always supported safely. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People did not receive personalised care and support. People were not offered choices in how they wished to spend their time, there were no activities on offer and staff did not engage in meaningful conversations with people. End of life care plans were not in place for people admitted to the home for end of life care and support.

People were not provided with consistently kind and caring support, they were not given choices or

consulted about their care. Staff did not always support people in a dignified way, and they did not always acknowledge people who required support.

Governance systems in place did not identify the serious concerns we found. There was ineffective partnership working between the registered manager and provider which meant known issues had not been acted on. This meant people were at risk of receiving care which placed them at risk of harm in an unsafe environment.

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 requires improvement (published 24 December 2020).

Why we inspected

The inspection was prompted due to concerns received about staffing, training, management of risk and overall management of the service. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from requires improvement to inadequate.

We have found evidence that the provider needs to make improvements. Please see all sections of this full report.

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 Adbolton Hall on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, safeguarding service users

from abuse and improper treatment, staffing, fit and proper persons employed, person-centred care, dignity and respect and good governance.

We took urgent enforcement action to ensure people were kept safe from harm and placed conditions on the providers registration which meant they were not permitted to admit or readmit any new people to the service without the consent of CQC.

Follow up

We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore 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.

The provider closed the service following after our inspection.