Abbeyfield House is a sheltered housing complex made up of 21 en-suite studio flats. People who live at Abbeyfield House are tenants of a private landlord. Abbeyfield House - York provides a domiciliary care service to some of the people who live at Abbeyfield House. At the time of our inspection, the service supported 10 people who lived at Abbeyfield House. The care and support provided consisted of prearranged visits at agreed times throughout the day. Abbeyfield House – York was not responsible for the upkeep or the maintenance of the building or people’s own flats and, as such, the accommodation provided was not within the Care Quality Commission’s remit to inspect.

We inspected this service on 16 March 2017. The inspection was announced. The registered provider was given 24 hours’ notice of our visit, because the location provides a domiciliary care service and we needed to be sure that someone would be in the location’s office when we visited.

Abbeyfield House was last inspected in March 2016 when we rated the service ‘Requires improvement’. We identified that records were not well maintained. Risk assessments were not consistently implemented, contained limited information and were not always updated as people’s needs changed. Alongside this we identified concerns around supervision records, recruitment records, medication administration records and accident and incident records. This was a breach of Regulation 17 of the Health and Social care Act 2008 (Regulated Activities) Regulations 2014.

At this inspection, we found that the registered provider had addressed our concerns and they were now meeting this regulation. We found that the registered provider had introduced new care plans and risk assessments which contained more comprehensive and details person-centred information about people’s needs. The registered manager completed audits of medication administration records and this had resulted in a significant reduction in recording issues. Accident and incident records were reviewed and signed off by the registered manager to ensure that appropriate action had been taken to minimise any identified risks. Recruitment records included appropriate references. However, we noted that one person had started shadowing before their DBS check had been returned.

The registered provider is required to have a registered manager as a condition of registration. 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. On the day of our inspection, there was a registered manager in post and as such the registered provider was meeting this condition of their registration.

People who used the service told us they felt safe with the care and support staff provided. Staff we spoke with knew how to identify and respond to safeguarding concerns. Sufficient staff were employed to meet people’s needs and people told us that staff responded promptly to their calls for assistance. People received support to take their prescribed medicines. Staff completed training on medicine management and the registered manager observed staff to ensure they were providing safe support with medicines.

Staff received on-going training and people who used the service provided positive feedback about staff’s knowledge and skills. Staff told us they felt supported in their role and said they were regularly observed and advice and guidance was given on their practice. The registered manager maintained a diary of meetings with staff and observations of their practice, although we spoke with them about developing a more robust and accountable record to evidence staff’s competencies in these areas.

People who used the service provided positive feedback about the support provided with

We inspected this service on 31 March and 4 April 2016. The inspection was announced. The registered provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in the location’s office when we visited.

Abbeyfield House is a sheltered housing complex comprising of 21 en-suite studio flats. At the time of our inspection Abbeyfield House - York provided a domiciliary care service to 13 people who lived at Abbeyfield House. This care and support consisted of prearranged visits at agreed times throughout the day. Abbeyfield House – York is registered to provide personal care to people living as tenants in their own studio flats. Abbeyfield House – York was not responsible for the upkeep or the maintenance of the building or people’s own flats and, as such, the accommodation provided was not within the Care Quality Commission's remit to inspect.

Abbeyfield House was last inspected in April 2014 at which time it was compliant with the regulations we inspected.

The registered provider is required to have a registered manager as a condition of registration. 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. On the day of our inspection, there was a registered manager in post and as such the registered provider was meeting this condition of their registration.

During this inspection we found that people using the service were consistently positive about the care and support provided. However, we identified that records were not well maintained. Risk assessments were not consistently implemented, contained limited information and were not always updated as people’s needs changed. We were concerned that important information about people’s needs was not immediately available to new staff. Alongside this we identified concerns around supervision records, recruitment records, medication administration records and accident and incident records.

This was a breach of Regulation 17 (1) (2) (a) (b) (c) (d) of the Health and Social care Act 2008 (Regulated Activities) Regulations 2014.

Staff received on-going training to equip them with the skills they needed to carry out their roles effectively. We received positive feedback about the support provided to staff by the registered manager.

Staff sought consent before providing any care and support, however, we have made a recommendation about developing staff knowledge and confidence around completing mental capacity assessments and best interest decisions.

There were systems in place to support staff to identify and respond to signs of abuse. There were enough staff to meet people’s needs and staff received on-going training.

People were supported to eat and drink enough and access healthcare services when necessary.

We received consistently positive feedback about the kind and caring nature of staff. People told us they were supported to be in control of the care and support provided and to make decisions. People told us staff respected their privacy and dignity.

People told us they were able to make complaints or raise concerns if needed and felt that the registered manager was approachable and open to feedback.

We received consistently positive feedback about the registered manager and the service provided.

Abbeyfield House provides sheltered housing for older people in Dringhouses, a suburb to the west of York city centre. It is owned by Abbeyfield York Society Limited. The service registered with the Care Quality Commission in order to provide personal care, when necessary, to people living as tenants at Abbeyfield House. This enables those people to continue to live independent lives and receive care and support from the established staff team working at Abbeyfield House.We visited the service and looked for evidence to help us answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe. They trusted the staff team that supported them and thought they were kind, friendly and skilled.

People told us their rights and choices were respected and they were involved in decisions about their care.

The service carried out assessments of risk so that when necessary systems could be put in place to promote people’s safety.

People received appropriate support in managing their medication. This ensured people received their medicines safely and at the times they needed them.

Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

The manager was available and approachable. She talked with people using the service and with staff on most days, so that people could easily raise concerns with her if necessary.

Is the service effective?

People’s health and care needs were assessed with them, and individuals were involved in writing their plans of care.

The service held both informal and more formal discussions with people about the care they were receiving so people had the opportunity to say whether they were receiving the right care and support.

Support workers attended training so they had the skills to provide safe, appropriate care. This ensured people received consistent care.

Is the service caring?

We spoke with three people who used the service. They told us they were getting the care they wanted, from staff who were kind and attentive. They commented “The staff are lovely. They definitely know what they’re doing.” Another person said “The staff are very, very good. They are very competent.”

Support workers told us they enjoyed their work and felt valued by the provider. It was clear from talking with them that they took pride in providing good care.

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with their wishes.

Is the service responsive?

People told us they knew how to complain about the service. They added that they had confidence in the provider to look into any concerns properly.

The service held regular resident’s meetings where people could comment about any aspect of the service. The minutes were made available for people to read following the meetings, so that all the people using the service were kept informed about any proposed changes.

Is the service well led?

People told us the manager was approachable and available so that people living at the service and staff could discuss their work or make suggestions about how care could be delivered.

Some quality monitoring systems were in place, but these needed to be built on and then sustained.

The support workers were aware of their roles and responsibilities as care providers. Staff communicated well with each other, so that important information about people’s care needs could be promptly shared.

People we spoke with said that they were informed about the service they could receive and were able to ask questions before they gave their consent to receive a service. We saw evidence of this during our visit to this service.

People told us they received the care and support they wanted to receive. One person said “I trust the staff I know very well, if I want help they are there.” Another person said “The staff respect my wishes and treat me with dignity.” We saw that people looked well cared for and that they received support from staff in a timely way. This helped to ensure that people’s needs were being met.

During our visit we saw that there was enough skilled and experienced staff to meet people’s needs. This was confirmed by people we spoke with. One person said “There are enough staff. I get help when I want it." Staff we spoke with confirmed that training occurred to help keep their skills up to date.

The quality of the service being provided was being monitored by the manager. Any issues found were acted upon. We saw that there were systems in place to deal with any complaints. This helped to ensure that people remained happy with the service that they received.

People who use the service told us that they had consented to receive their service. One person said “I signed to say I agreed with the help that was going to be provided for me”. Another person said “Care plans and risk assessments are updated regularly. I sign to say that I agree with these. The staff are very professional and they respect my privacy and dignity”.

People receiving care and support said they received the help they needed. One person said “Staff know what help I need, they know me well. They look after me”. Another person said “The staff are pleasant they help me with the things I cannot do for myself”.

People we spoke with told us that they could and would raise any issues and felt issues would be looked into. One person said “I always tell the manager what I feel and think”.

People said they felt the staff were recruited using thorough methods and were trained to deliver care and support safely. One person said “Staff have been recruited properly so they are suited to do care work”. One person’s representative said “There is not a big turnover of staff”.

People told us that their views about the service they were receiving were asked for. One person said “Every so often residents meetings are held. I always go to air my views. We are listened to”.