We carried out an inspection of Abiden Care on 5 and 6 April 2017. The first day of the inspection was unannounced.

Abiden Care provides accommodation and personal care for up to 22 older people. The home provides accommodation in 18 single rooms and two shared rooms on two floors. Ten of the bedrooms have an ensuite facility which includes a toilet and hand wash basin. There are two stair lifts which facilitate access between the floors. At the time of the inspection there were 22 people accommodated in the home.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers ('the provider'), 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.

At our last inspection on 2 and 3 June 2015, we asked the provider to ensure people received safe care and treatment and ensure records were made of observations following an accident. We also asked the provider to make improvements to the maintenance of care records. Following the inspection, the provider sent us an action plan which set out what action they intended to take to improve the service. During this inspection, we found improvements had been made in order to meet the regulations.

People living in the home said they felt safe and staff treated them well. There were sufficient staff deployed in the home to meet people's care and support needs. Appropriate recruitment procedures were followed to ensure prospective staff were suitable to work in the home. Safeguarding adults’ procedures were in place and staff understood their responsibilities to safeguard people from abuse. Risks associated with people’s care were identified and assessed. People's medicines were managed appropriately and according to the records seen people received their medicines as prescribed by health care professionals.

Staff had completed an induction programme when they started work and they were up to date with the provider's mandatory training. The registered manager and staff understood the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and acted according to this legislation. There were appropriate arrangements in place to support people to have a varied and healthy diet. People had access to a GP and other health care professionals when they needed them.

Staff treated people in a respectful and dignified manner and people's privacy was respected. People living in the home had been consulted about their care needs and had been involved in the care planning process. We observed people were happy, comfortable and relaxed with staff. Care plans and risk assessments were person centred and provided guidance for staff on how to meet people’s needs and preferences. There were established arrangements in place to ensure the care plans were reviewed and updated regularly. People were encouraged to remain as independent as possible and were supported to participate in a variety of daily activities. People were also offered the opportunity to go on regular trips in the community.

The registered manager was well respected and provided strong, supportive leadership to her team. Systems were in place to monitor the quality of the service provided and ensure people received safe and effective care. These included seeking and responding to feedback from people in relation to the standard of care.

We carried out this inspection because we received information of concern about the recruitment procedures operated in the home. During the inspection we found all care staff had been recruited appropriately and in line with the current regulations.

We looked at four staff files in detail and noted the necessary checks and documentation had been obtained prior to staff commencing work in the home. This ensured staff were suitably qualified and skilled to carry out their role safely and effectively.

At our last inspection we found the provider had not made suitable arrangements to assess the needs of a former resident of the home. The provider has also failed to carry out appropriate risk assessments. We found none of these shortfalls on this inspection and the provider was compliant with the outcome assessed.

People’s care was planned and delivered in accordance with their needs. People had individual care plans which were supported by a series of risk assessments and daily care records. We looked at three people’s care plans during the visit and noted they were comprehensive and covered all aspects of need.

People were satisfied with the service provided, one person told us, “I’m happy here and have no complaints” and another person said the home was “very nice”. People told us their rights to privacy, dignity and independence were upheld and respected.

However, we found significant shortfalls in the planning and delivery of one former resident’s care, including the failure to carry out an assessment of the person’s needs when their status changed in the home and the failure to assess the risks associated with using equipment in the home. This meant the provider had not taken proper steps to ensure the person’s welfare and safety.

At the time of the inspection, people’s care was planned and delivered in accordance with their needs. Additional risk assessments had also been carried out and placed on people’s personal files in order to provide guidance for staff on managing risks.

People were provided with suitable equipment which had been maintained and serviced on a regular basis.

People spoken with said there was a sufficient number of staff on duty and made positive comments about the approach taken by staff. Staff were provided with appropriate training and were supported by the management team.

There were systems in place to monitor the quality of the service, which included seeking the views of people living in the home.

People were satisfied with the service provided, one person told us, “It is a lovely place and the staff are very good”. People told us their rights to privacy, dignity and independence were upheld and respected.

People’s care was planned and delivered in accordance with their needs. People had individual care plans which were supported by a series of risk assessments and daily care records. This meant people’s care could be readily monitored and evaluated.

Staff had an understanding of safeguarding procedures and knew who to contact in the event of a concern.

The recruitment and selection processes for new staff had been revised and we found all checks had been carried out on new employees in line with legal requirements.

We found there were appropriate systems to monitor the quality and operation of the service, which included annual customer satisfaction questionnaires.

People told us they were happy living in the home and they were able to express their views and opinions about the care they were provided. One person said “It’s a lovely place to live and it’s always spotlessly clean”. People spoken with felt they were well cared for and the staff respected their rights to privacy and dignity.

People made complimentary comments about the food and confirmed they were offered a choice each mealtime in line with their preferences.

People liked their bedrooms and said they were able to furnish them with their own belongings and possessions.

Visitors were welcome in the home at any time and people said they were supported to maintain good contact with their family and friends. Relatives spoken with were very satisfied with the quality of care provided and felt that their family members were looked after in a caring and sensitive manner.

People made positive comments about the staff team and felt they could talk to the any of the staff or the manager if they had a problem or query.

We carried out an inspection of Abiden Care on 2 and 3 June 2015. The first day of the inspection was unannounced.

Abiden Care provides accommodation and personal care for up to 22 older people. The home provides accommodation in 18 single rooms and two shared rooms on two floors. Ten of the bedrooms have an ensuite facility which includes a toilet and hand wash basin. There are two stair lifts which facilitate access between the floors. At the time of the inspection there were 19 people accommodated in the home.

The service had a registered manager 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.

At the last inspection on 1 and 2 October 2014, we asked the provider to take action to ensure staff assisted people to move in a safe way, ensure environmental risks were identified and addressed, ensure people’s capacity to make decisions and potential restrictions of liberty were assessed and addressed, ensure people’s rights to dignity were respected at all time, ensure people were involved and were enabled to contribute to the care planning process and ensure a system was put in place to consult people about the service they receive. Following the inspection the provider sent us an action plan which stated they would take action to address these issues by 30 March 2015. On this inspection we found the action had been completed and the necessary improvements had been made.

Whilst the registered manager sent us an updated falls policy and procedure following our visit we found during this inspection that the provider had not always ensured people had received safe care and treatment. We also noted the provider had not consistently maintained complete and accurate records. You can see what action we told the provider to take at the back of the full version of the report.

People told us they felt safe and were well cared for in the home. Staff knew about safeguarding and we saw concerns had been dealt with appropriately, which helped to keep people safe.

We noted there were adequate numbers of staff on duty to support people safely and ensure that people’s needs were met appropriately.

Systems and processes in place ensured that the administration, storage, disposal and handling of medicines were safe.

We found relevant checks had been completed before a member of staff started to work in the home. From the records seen and discussions with staff we also noted staff had completed relevant training for their role and they were well supported by the registered manager.

As Abiden Care is registered as a care home, CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found appropriate mental capacity assessments had been carried out and applications had been made to the local authority for a DoLS. Staff had completed training and had a working knowledge of the Mental Capacity Act 2005.

We noted people had a good choice of meals and were provided with snacks and drinks throughout the day.

People had opportunities to participate in a variety of activities and we observed staff actively interacting with people throughout our visit. All people spoken with told us the staff were caring, compassionate and kind. We saw that staff were respectful and made sure people’s privacy and dignity were maintained. People and their relatives spoke positively about the home and the care they or their relatives received.

From looking at people’s care files we could see all people had a detailed care plan which covered their needs and any personal preferences. We saw the plans had been reviewed and updated at regular intervals. This meant staff had up to date information about people’s needs and wishes.

People and their relatives told us they knew who to speak to if they wanted to raise a concern. There were systems in place for responding to complaints.

We saw there was a system of audits in place to monitor the quality of the service and people and staff were given opportunities to express their views and provide feedback on the service.