At the last inspection of Abbey Lea Care Home in October 2015 the service met all of the regulations we assessed under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At that inspection the service was rated ‘Good’.

This inspection of Abbey Lea Care Home took place on 27 September 2017 and was unannounced. At this inspection we found the service remained ‘Good’.

Abbey Lea Care Home provides care and support to a maximum of 23 older people who may be living with dementia. The building is an old farmhouse with facilities on two floors, accessed by a passenger lift, and a single-storey extension to the rear. Some people had en-suite bedrooms and there was plenty of communal space in the form of two large lounges (one with dining space), a separate dining room, an entrance sitting-hall and other smaller seating areas. Two rooms were shared rooms, but the rest were single occupancy. The service had patio doors onto an enclosed courtyard with patio pavers, flower beds with a variety of well-kept plants for people to enjoy and seating areas.

The registered provider was required to have a registered manager in post. There was a registered manager that had been in post for six and a half years. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People were protected from the risk of harm, as there were systems in place to manage safeguarding concerns. Staff were trained in safeguarding adults from abuse and understood their responsibilities with regards to safeguarding concerns. Risks were managed so that people avoided injury or harm. The premises were safely maintained and there was documentary evidence to show this. Staffing numbers were sufficient to meet people’s need and we saw that rosters cross referenced with the staff that were on duty. Recruitment systems were followed to ensure staff were suitable to support people. The management of medicines was safe.

Qualified and competent staff were employed and supervised by seniors or the registered manager. Their personal performance was checked at an annual appraisal. People’s mental capacity was appropriately assessed and their rights were protected. 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 supported this practice. People were supported with nutrition and hydration to maintain their levels of health and wellbeing. The premises were suitably designed and furnished for providing care and support to older people and those living with dementia.

People received compassionate care from kind staff that knew about people’s needs and preferences. People were provided with information that helped them make choices, involved in their care and asked for their consent before staff undertook any support tasks. People’s wellbeing, privacy, dignity and independence were respected. This ensured people felt satisfied and were enabled to maintain control of their lives.

People were supported according to their person-centred care plans, which reflected their needs well and were regularly reviewed. Everyone we spoke with felt Abbey Lea Care Home provided support that was very responsive to people's needs. People engaged in an abundance of pastimes, activities and occupation if they wished to and were encouraged to maintain many of their daily living skills and abilities. The focus of the service was on activity and occupation at an appropriate level for people to achieve. There was an array of interesting visual displays around the premises, which promoted discussion and reminiscence, while daily activities and conver

This inspection took place on 2 October 2015 and was unannounced.

The last inspection took place on 4 July 2013, the service was meeting all of regulations we looked at.

Abbey Lea Care Home provides residential care for up to 23 older people living with dementia. The building is an old farmhouse with an extension. People had ensuite rooms and there was plenty of communal space. Two rooms were shared rooms. The service had patio doors onto an enclosed courtyard with a variety of well-kept plants for people to enjoy.

The service had a registered manager. 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.

Staff knew how to protect people from avoidable harm. Staff had attended safeguarding training and the service had an up to date safeguarding policy which provided staff with clear instruction about the action they would need to take. The service had a whistleblowing policy which meant staff knew how to raise any concerns and who to contact. Staff told us they were confident the registered manager would deal with any concerns appropriately and quickly.

People had risk assessments and risk management plans which staff followed to keep people safe. These were well developed and people, their families and the relevant health and social care professionals had been consulted. They provided staff with step by step guidance about how to keep people safe. They balanced the need to keep safe with the right to freedom which meant people were not unnecessarily restricted.

The service had sufficient staff to meet people’s needs. People who used the service, their relatives and staff members confirmed this.

Medicines were managed safely. Staff had received the appropriate training and we saw staff offered people explanation and reassurance when their medication was being administered. People who needed medication to be administered as required, due to agitation or distress, had detailed plans staff should follow and medication was administered as a last resort.

The service had emergency evacuation plans and the fire alarm was tested in line with the fire safety policy.

Staff were supported and trained to help them deliver effective care. They had access to mandatory training, and staff told us they were supported to attend other courses which would be of benefit to their personal development and people who used the service.

The principles of the Mental Capacity Act (2005) were consistently followed by staff. Consent to care and treatment was sought. When people were unable to make informed decisions we saw a record of best interest decisions. There was a record of the person’s views and other relevant people in their life. The registered manager had a clear understanding of the Deprivation of Liberty Safeguards.

People told us the food was good. We saw people had access to regular drinks, snacks and a varied and nutritional diet. If people were at risk of losing weight we saw plans were in place to manage this and the appropriate healthcare professionals had been consulted.

Staff were kind, caring and spoke with warmth and compassion about the people they supported. People’s dignity and privacy was respected. Life stories had been completed with people and their families and these enabled staff to get a real sense of the person and what was important to them.

A visiting health professional told us staff were caring and knew people well. People and their families confirmed this.

Staff we spoke with told us they would be happy for their relative to live at the service, if they needed this kind of care.

Care was planned and delivered in a person centred way. People and their families were involved and we saw regular reviews took place. Care plans provided staff with information about how the person wanted to be supported.

People and their relatives told us they knew how to make a complaint but had never needed to. The service had received a variety of compliments. Feedback was sought from people as part of the review of their care.

People had access to a range of activities. They were supported to maintain their relationships with families. People had their religious needs met.

The service was well-led. Everyone we spoke with was full of praise for the registered manager. Staff morale was high and there was a strong sense of staff being committed to providing person centred care.

The registered manager was committed to ongoing professional development and spoke passionately about the service. They had a strong understanding of the importance of supporting the person and their family to live well.

We used a number of different methods to help us understand the experiences of people using the service, because some of the people who used the service had complex needs which meant they were not able to tell us their experiences. During our visit we spent time observing how people were being cared for. We observed staff supporting people in an appropriate manner providing reassurance and support to those who needed it. One person told us "They (the staff) are so kind."

We saw that people were encouraged to make decisions for themselves or were supported by the staff to make decisions about how they wanted to spend their time. We observed staff treating people kindly and with dignity.

People had care plans and risk assessments in place which helped staff to understand and meet their needs.

People's dietary needs were assessed and these continued to be monitored. The food provided looked appetising and snacks and drinks were made available at any time. People said "The food is good." and "The food is always tasty."

Medicines were prescribed and given to people appropriately; we saw people were given the right medicine, in the right way and at the right time on the day of our inspection.

We saw staff received training and support which helped provide them with the skills they needed to be able to look after people safely.

We used a number of different methods to help us understand the experiences of people using the service. We spoke with three people who live there, but were not able to communicate with them in a meaningful way, because of their complex needs.

We observed the way staff communicated and generally interacted with people living there. We spoke with a relative who visited the home regularly and looked at some of the records kept by the home. We also checked to see if the service had received any complaints in recent months.

We found that there were enough care staff and they were seen regularly checking on people’s well-being. We saw many examples of positive interactions, where staff helped people in a courteous and respectful manner to make small choices about how they wanted to spend their time. We saw people weren’t rushed to make these decisions. The visitor told us. “People here get fantastic care. It’s second to none. Staff are always very respectful. Bev (the registered manager) doesn’t miss a thing.”