Abbegale Lodge

Updated 22 September 2018

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.

This inspection took place on 16 August 2018 and was unannounced.

The inspection team consisted of an adult social care inspector and an expert by experience with particular expertise in care for older people living with dementia.

Before our inspection visit, we reviewed the information we held about Abbegale Lodge. This included notifications we had received from the provider about incidents that affect the health, safety and welfare of people who used the service. We also emailed some social care professionals to see if that had any information they wished to share with us. We received no feedback. We also accessed the Provider Information Record (PIR) we received prior to our inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This provided us with information and numerical data about the operation of the service. We saw there had been a high number of falls in the home over the course of 12 months. We used this information to populate our 'planning tool' which helps us plan how the inspection needs to be conducted and what we would need to discuss at this inspection.

During our inspection we spoke with nine people who lived at the home and one relative. We also spoke with the registered manager, senior carer, the chef and four care staff. We looked at three people’s care plans and associated documentation, four staff recruitment folders, and other documents relating to the safe running of the home.

Updated 22 September 2018

This unannounced inspection of Abbegale Lodge took place on 16 August 2018.

Abbegale Lodge is a residential home which can accommodate up to 41 people. The home is split into three sections, residential, referred to as ‘The Lodge’ residential EMI referred to as ‘The Unit’ and younger adults with mental health needs, referred to as ‘The Villa.’ At the time of our inspection there were 27 people living across the three separate areas of the home.

A registered manager was in post. 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.

We last inspected this service in May 2017. During this inspection we found a breach of regulation in relation to safe care and treatment. This was because some of the environmental checks on the building were not always completed, and we could not be sure if suitable action had been taken to protect people against the risk associated with this. After our inspection the registered provider sent us an action plan detailing what steps they were going to take to rectify these concerns, we checked this during this inspection and found that improvements had been made and the provider was no longer in breach of this regulation.

We found at our last inspection in May 2017, the governance systems required improving. This was because they had not highlighted the concerns we found in relation to the environmental checks. We checked these had been improved during this inspection and found that they had.

We made a recommendation at our last inspection in relation to the Mental Capacity Act 2005. This was because there were some records which contained conflicting information. We saw during this inspection that most information regarding people's capacity needs was clear and concise.

Training was recorded for each staff member in the training matrix. Training was a mixture of classroom based courses and E-learning sets. All new staff completed a twelve week induction process. We discussed specific training needs for staff who supported people with complex mental health problems. We saw that staff engaged in a basic programme of training, however, there was no specific training centred around people with enduring mental health needs. We have made a recommendation about this.

All of the staff we spoke with said that the service had improved since the new registered manager took up post 12 months ago.

Everyone we spoke with said that the food was of good quality, and there was clear improvement in the choices of food. The ordering processes for the food had changed since the last inspection and the chef told us this was a lot better.

There was a process in place to ensure staff were suitably recruited to enable them to work with vulnerable people. This included a police check, (referred to as a DBS) which standards for disclosing and baring service. Two verified references for staff, and proof of identification.

Staff were able to describe the course of action they would take if they felt someone was being harmed or abused, and all staff had been trained in safeguarding and discussed the action they would take to alert the appropriate professionals.

Risk assessments were reviewed every month, and written in way which explained what the risk was to the person and how the staff should reduce or manage the risk.

Medications were well managed and stored safely. Regular stock balance audits took place on medication by the registered manager and supporting pharmacist. Trolleys were kept locked when not in use and the temperature of the room was taken twice daily.

People had regular input from district nurses when they needed it as well as other medical professionals. The home was a member of the Care Home Innovation Programme (CHIP) and made use of this facility. The service worked in conjunction with physiotherapists, health nurses (RMN)s and psychiatrists to ensure people had effective care and treatment.

We observed kind and caring interactions between staff and people who lived at the home. Staff spoke kindly and fondly about people, and demonstrated a good knowledge about them, their likes and their needs. People told us they liked the staff and felt that they were kind to them.

People were supported to eat and drink in accordance with their needs. People, who were assessed as at risk of weight loss, had appropriate documentation in place to monitor their food and fluid intake. Where specialist diets were needed for some people, the chef had knowledge of this.

Most areas of the home and some people's bedrooms had been refurbished to a high standard. The registered provider had clearly made some improvements to the fixtures and fittings of the home since our last inspection. There was, however, still some further improvements which were needed and were planned in for completion.

There were positive examples of person centred information in people’s care plans. Since our last inspection the registered manager had introduced new documentation which was more in depth and provided more information about people, their likes, dislikes and how they wanted their support to be delivered.

There was a procedure in place to document and address complaints. Everyone we spoke with said they knew how to complain. The complaints procedure was displayed in the communal areas of the home.

Feedback was regularly gathered from people who lived at the home and their relatives and used to improve their experience of living at Abbegale Lodge. The registered manager had attempted to arrange meetings with relatives at certain points in the day, over a series of days, however most people did not attend.