This inspection took place on 23 November 2017 and was unannounced. A second day of inspection took place on 28 November 2017 which was announced. This is the first rated inspection of Abbey Court with the provider Malhotra Care Homes Limited.

Abbey Court 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.

Abbey Court is registered to accommodate 45 people in one adapted building over two floors. At the time of the inspection there were 37 people accommodated at Abbey Court.

The current manager had been in post for eight months at the time of the inspection and had made an application to register with the Commission. Since the dates of the inspection site visits their application has progressed and they became the registered manager on 11 December 2017.

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 completed an initial walk around of the home with the deputy manager and carried out a further walk around with the registered manager to look at how safe the premises were. We found goods were stored in the under stairs areas on two fire escapes however this did not compromise the evacuation route. Clinical and general waste bins were open and the waste storage area was unsecured. Action was taken immediately to rectify these concerns and we have received assurances from the provider that all concerns have been resolved.

We also found during lunch time that a hot-lock trolley used for keeping food hot presented a trip hazard for people. This had been identified by the compliance manager and a permanent solution sought however the immediate risk had not been mitigated.

We found some concerns in relation to record keeping which had not been identified through the providers quality assurance systems. These related to some care records and two peoples medicine records.

We have made a recommendation about the maintenance and upkeep of records.

Safeguarding concerns, accidents and incidents and complaints had been logged. Lessons learnt in relation to safeguarding’s and complaints were recorded and had been used to improve practice.

Medicines were managed safely and a pharmacy auditor confirmed they had no concerns with regards to medicines management at Abbey Court.

End of life care was provided sensitively and with compassion. The deputy manager was very aware of the need to ensure family members, as well as the person, were supported at this difficult time.

Staff were able to spend time with people chatting and supporting them in a relaxed and friendly manner. Caring relationships were observed and people and relatives were complimentary about the approach of the staff.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

Care documentation included information about people’s personal history, their likes and dislikes, past jobs and significant people and events. This information was used to get to know people, to plan activities and to develop support strategies. Care plans were detailed and specific to the person.

Risks were assessed and managed effectively. We found one person did not have a risk assessment in place for choking and the deputy manager was proactive in ensuring this was completed.

People were supported with their nutritional and hydration needs. Staff were offered praise during the handover in relation to the support they offered people to maintain a healthy fluid intake. Whe