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Abraham House, Ashton-on-Ribble, Preston.

Abraham House in Ashton-on-Ribble, Preston is a Residential home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, caring for adults over 65 yrs and dementia. The last inspection date here was 2nd May 2018

Abraham House is managed by Europe Care Holdings Limited who are also responsible for 1 other location

Contact Details:

Ratings:

For a guide to the ratings, click here.

Safe: Good
Effective: Good
Caring: Good
Responsive: Good
Well-Led: Good
Overall: Good

Further Details:

Important Dates:

    Last Inspection 2018-05-02
    Last Published 2018-05-02

Local Authority:

    Lancashire

Link to this page:

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Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

12th March 2018 - During a routine inspection pdf icon

Abraham House is a residential care home providing personal care for a maximum of 30 older people living with dementia. The accommodation is over two floors with a passenger lift to both floors. There are 26 single rooms and two double rooms. Communal areas comprise of two lounge areas, a conservatory and a dining room. There is an enclosed garden and a car park.

We carried out an inspection in January 2017, at which two breaches of Regulation 12 (Safe care and treatment) were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches of regulations. We carried out this unannounced focused inspection in August 2017 to check they had followed their plan and to confirm they now met legal requirements, which they had. At this inspection we saw that improvements had been sustained and the rating overall had improved to Good.

At this inspection we found the registered provider continued to provide a good standard of care to people who lived at the home.

People who lived at Abraham House had care plans that reflected their complex needs and these had been regularly reviewed to ensure they were up to date. The care plans had information related to all areas of a person’s care needs. Staff were knowledgeable of people’s needs and we observed them helping people as directed within their care plans.

Relatives told us staff treated their family members as individuals and delivered personalised care that was centred on them as an individual. Care plans seen and observations during our visit confirmed this.

Staff delivered end of life care that promoted people’s preferred priorities of care.

The registered provider had researched good practice guidance and refurbished the home to ensure people living with dementia were living in an environment that promoted their safety, independence and positive wellbeing.

We saw staff were responsive to each person’s changing needs. They worked together to ensure people who became agitated were offered a selection of person centred interventions to meet their needs and soothe their agitation.

The service had systems to record safeguarding concerns, accidents and incidents and took action as required. The service carefully monitored and analysed such events to learn from them and improve the service. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices. The registered provider had reported incidents as required.

People told us staff were caring and respectful towards them. Staff we spoke with understood the importance of providing high standards of care and enabled people to lead meaningful lives.

We found there were sufficient numbers of staff during our inspection visit. They were effectively deployed, trained and able to deliver care in a compassionate and patient manner.

Staff we spoke with confirmed they did not commence in post until the management team completed relevant checks. We checked staff records and noted employees received induction and ongoing training appropriate to their roles

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. Care records showed they were reviewed and any changes had been recorded.

We looked around the building and found it had been refurbished, maintained, was clean and a safe place for people to live. We found equipment had been serviced and maintained as required.

Medication care plans and risk assessments provided staff with a good understanding about specific requirements of each person who lived at Abraham House.

Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection. We found supplies were available for staff to use when required, such as hand gels.

People were supported to have maximum choice and control of their lives and staff supported them in the least restr

3rd August 2017 - During an inspection to make sure that the improvements required had been made pdf icon

We carried out an unannounced comprehensive inspection of this service on 31 January 2017, at which two breaches of Regulation 12 (Safe care and treatment) were found. This was because the provider did not have adequate medicine management and administration systems in place at the service and systems for assessing and managing risks were not robust.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches of regulations. We carried out this unannounced focused inspection on the 03 August 2017 to check they had followed their plan and to confirm they now met legal requirements. This report only covers our findings in relation to these topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Abraham House' on our website at www.cqc.org.uk.

Abraham House is a residential care home providing personal care for a maximum of 30 older people living with dementia. The accommodation is over two floors with a passenger lift to both floors. There are 26 single rooms and two double rooms. Communal areas comprise of two lounge areas, a conservatory and a dining room. There is an enclosed garden and a car park.

The service had a registered manager in place. 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.

At our focused inspection on the 03 August 2017, we found improvements had been made. We found the registered provider had employed a business manager to work alongside the registered manager in the day-to-day running of the home. New processes had been introduced to monitor, assess and minimise risks to people. For example, incidents and accidents were discussed at daily staff handover meetings.

Medicine management policies and procedures had been reviewed. New systems had been introduced to manage medicines safely.

Recruitment procedures the service had were robust and safe The procedures were audited regularly to ensure good practice standards were maintained.

We could not improve the rating for safe from requires improvement because to do so requires consistent good practice over time. We will check this during our next planned comprehensive inspection.

31st January 2017 - During a routine inspection pdf icon

We carried out an unannounced inspection at Abraham House on 31 January 2017.

We last inspected Abraham House in July 2015. At the last inspection on 21 July 2015 we found the provider was in breach of regulations relating to risk assessments, person centred care, safe care and treatment and meeting nutritional and hydration needs.

During this inspection we reviewed actions the provider told us they had taken to improve the service. We saw that significant work had taken place since our last inspection to improve the safety, effectiveness and quality of the service. However, some further improvements were required in respect of person centred care planning and risks assessments to ensure a consistent delivery of safe care and treatment that could be evidenced in the longer term.

Abraham House is a residential care home providing personal care for a maximum of 30 older people with dementia. The accommodation is over two floors with a passenger lift to both floors. There are 26 single rooms and two double rooms. Communal areas comprise of two lounge areas, a conservatory and a dining room. There is an enclosed garden and a car park. There were 29 people living there at the time of our inspection.

We found the service continued to be in breach of one regulation under the Health and Social Care Act, 2008 (Regulated Activities) Regulations 2014. The breach was in respect of Regulation 12, safe care and treatment. This included shortfalls in the review of risks after accidents and incidents and a failure to manage people’s medicines effectively. You can see what action we have told the provider to take at the back of the full version of the report. We also made recommendations in relation to staff recruitment, staff training and person centred care planning.

The registered manager was present throughout the inspection. 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.

Before this inspection, we had received some concerning information in relation to poor personal care, dignity and respect, moving and handling of people and skin care management and lack of pressure care relief. We looked into these areas during the inspection.

Feedback from people and their relatives regarding the care quality was overwhelmingly positive. Views from professionals were mixed.

People who lived at Abraham House told us that they felt safe and there was sufficient staff available to help them when they needed this. Visitors and people who lived at the home spoke highly of the registered manager and told us they were happy with the care and treatment.

Since the last inspection in July 2015, a new laundry machine and a new sluice room had been introduced into the home and this had led to an improvement in the management of the people’s laundry, management of the risks of cross contamination and infection control. Staff had also received infection control training. A new contractor had been hired to carry out monthly health and safety inspections.

There were up to date policies and procedures in use by staff.

We saw copies of satisfaction surveys that had been completed by people who lived at the home. These surveys demonstrated people thought their care and the staff who supported them were excellent.

We looked at how the service protected people against bullying, harassment, avoidable harm and abuse. We found there were policies and procedures on safeguarding people. Although some staff had not received up to date training in safeguarding adults; they showed awareness of signs of abuse and what actions to take if they witnessed someone being ill-treated.

Safeguarding incidents had been reported to the relevant safeguarding authority. Staff had documented the sup

21st July 2015 - During a routine inspection pdf icon

Abraham House is a residential care home providing personal care for a maximum of 30 older people with dementia. The accommodation is over two floors with a passenger lift to both floors. There are 26 single rooms and two double rooms. Communal areas comprise of two lounge areas, a conservatory and a dining room. There is an enclosed garden and a car park.

The last inspection of the service was carried out on 23 May 2013. During that inspection the service was found to be fully compliant with all the areas we assessed.

This inspection took place on 21 July 2015 and was unannounced.

The registered manager was present throughout the inspection.

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.

People who lived at the service told us that they felt safe.

Relatives told us that their loved ones were safe, however two relatives told us that they had found people who lived at the service to be in soiled clothing when they visited and staff were not always available to respond in a timely manner.

We have made a recommendation for the provider to consider improved ways of working around maintaining people's dignity.

We looked at how the service provided care that was tailored to people's individual needs.  We found that a person centred ethos was not fully embraced at the service. 

We were concerned about poor organisation at meal times. We observed people to wait 45 minutes for their meal and this caused them to become restless. We observed two people to become distressed and staff did not respond to their way of communicating.

We asked staff about people's dietary needs and found that not all staff were aware of individuals needs. We looked at diet and fluid intake records for two people and found that their intake had been substantially low, staff were not able to explain why this was or tell us about how they had responded. 

We looked at care records and found that risk assessments and care plans were undertaken and reviewed. However we found that identified risk was not always included in the associated care plans and some risk assessments had not been completed in full.

We found that some care plans had been written in a negative way and did not always represent people's strengths.

We found that the service had put in place some design aspects and activities that were dementia friendly but that these did not seem to be understood or actioned by all staff.

We looked at the way medicines were managed and found that the service had robust systems in place for the safe administration of medicines.

We looked at infection control standards and found that the provider did not have suitable systems in place for the management of soiled waste. The provider made immediate plans to improve waste management and was responsive to our concerns.

We found that the environment was clean. However, we found that the main lounge area had a significant malodour. The registered manager told us that this issue was being addressed and replacement flooring had been considered.

We found that the service did not always record decisions made when people are deprived of their liberty and care planning did not reflect how the person's mental capacity had been assessed prior to such decisions being made.

We observed staff interaction with people who lived at the service and found them to be caring and respectful. However there were significant delays in time for people's immediate care needs to be addressed. For example, we saw people walked around the service in unclean clothing and we had to request that staff attended to their needs.

We identified four breaches in fire safety, fire doors had been wedged with furniture

that included large lounge chairs and bedroom cabinets

. This placed people at risk of harm.

We looked at staff training records and found that training was provided as outlined in the providers policies and procedures.

The service issued customer surveys on an annual basis. We looked at survey results from 2014 and 2015 and found people were substantially pleased with the service being provided. Both 'Residents' and 'Relatives' scores came out as 'very good' for overall rating of the service in 2014 and 'excellent' in 2015.

We looked at recruitment processes and found that the provider did not always ensure that robust checks were undertaken prior to staff being appointed.

People told us that the manager is approachable and listens to their concerns.  We looked at systems in place to monitor care standards at the service and found that the manager undertook audits on a regular basis.

We found the provider was in breach of a number of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to person centred care, safety and meeting people's nutrition and hydration needs.

You can see what action we have asked the provider to take at the end of this report.

23rd May 2013 - During a routine inspection pdf icon

Relatives and people who lived at the home told us their care preferences and choices had been discussed with them and their agreement to their care plan had been sought. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

People who lived at the home told us they were happy with the care and support they received. One person said, “The care is great. I can have help when I need it or do my own thing”.

We found that up to date care assessments and care plans were in place and these were followed in practice. A visiting district nurse told us the staff were co-operative and always implemented their care instructions fully and to a high standard. A visiting GP told us the manager always made timely and appropriate healthcare referrals for people living at the home.

The premises were well maintained and suitable for the needs of the people living there.

People were cared for by suitably qualified, skilled and experienced staff. Effective recruitment and selection processes were in place.

There was an effective system to regularly assess and monitor the quality of service that people receive and to ensure the provision of safe and appropriate care at all times.

There was an effective complaints system available. One person said, “I’ve never had a complaint but I would go to the manager if I had a problem”.

13th August 2012 - During a routine inspection pdf icon

People told us they could express their views and were involved in decision making about their relatives care. They told us they felt listened to when discussing the care needs of their relative. They said routines were relaxed and they could visit whenever they wished. They said the standard of food was very good and the activities organised kept people entertained.

"We feel mum is living in a very friendly and homely environment. The manager and her staff are always welcoming whenever we visit. They have a settled staff team which means mum is receiving continuity with her care. We can always find someone who has been dealing with her and knows what they are talking about”.

"No issues with the care. Mum is happy and settled. She is always clean and well presented whenever we visit. She looks really well".

"They cater to my mum’s needs excellently. I have no issues or concerns”.

"I was fully involved in mum's assessment before she moved into the home. I attend meetings when we review her care and I am consulted about any changes they feel need to be made".

"Highly satisfied with the care provided. They cater to my mum’s needs excellently. I have no issues or concerns about her care".

“I visit my mum most days and I am fully involved in her care. I am always updated about her care whenever I visit. They contact me immediately if they have any worries about her”.

 

 

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