About the service: The Abbey Residential Home is a care home providing personal care for up to 24 older people. At the time of the inspection, 21 people were using the service.

People’s experience of using this service: People told us they were happy, and staff understood their care and support needs. There was enough staff to provide support to people when needed. This was delivered by a consistent team who had the skills, knowledge and relevant training to support people.

People were treated with dignity and respect and their independence was promoted. Staff spent time getting to know people and their life histories. They understood the importance of this which stimulated meaningful conversations. Impromptu activities took place as staff recognised this had a positive impact on the number of people who chose to join in.

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. Choices people made were respected.

Systems in place to continuously monitor the service had been improved to ensure people received a good quality service. The provider visited on a regular basis and engaged with people and staff. People felt they were listened to and their views respected. They were asked to provide regular feedback on the service provided.

People and staff spoke positively of the management team. The service was well-run by a registered manager who was supported by a care manager and deputy manager. The registered manager attended regular forums and events in the local area to build relationships. The service had good links with the local community and other professionals to promote and improve people’s health.

More information is in the Detailed Findings section below. For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk

Rating at last inspection: At the last inspection the service was rated Good (report published 17 August 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The Abbey Residential Home is situated next to the church in Old Malton. Accommodation can be provided for up to 24 people who require help with personal care; some people may be living with dementia. The service has 20 bedrooms; some can be used for shared occupancy but only one of them is currently used in this way. All of the bedrooms have en-suite facilities; 18 have an added bath and one has a shower. There are several communal rooms and seated areas for people to use.

The service had a registered manager in post as required by 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.

We undertook this unannounced inspection on 6 and 7 July 2016. At the time of the inspection there were a total of 21 people living in The Abbey Residential Home. At the last inspection on 16 January 2014, the registered provider was compliant with all areas assessed.

We found people were provided with a safe environment. Staff knew how to safeguard people from the risk of harm and abuse and how to deal with any information of concern. Risk assessments were completed to help guide staff in how to minimise issues of concern such as falls.

Staff were recruited safely and deployed in sufficient numbers to meet people’s current level of need. There was an issue raised about the tea time period, four days a week when staff felt stretched. This was mentioned to the assistant manager and they told us they would address this by ensuring one of two managers was available to help the staff team during this busy time.

We found people received their medicines as prescribed. Medicines were obtained, stored and returned to the pharmacy when no longer required. Staff recorded when medicines were received into the service and when they were administered to people. There were some minor recording issues and the need for protocols for medicines prescribed ‘when required’. This was mentioned to the registered manager to address.

People’s health and nutritional needs were met. We saw health professionals were involved and provided advice and treatment when required. People had their weight monitored and input from dieticians was sought when required.

People’s needs were assessed and care plans formulated. These helped to guide staff in how to support people in ways they preferred. We found staff supported people to make their own decisions and choices. The registered manager was aware of the action to take and who to consult if they felt someone lacked capacity and a decision was needed about their care and treatment.

We observed staff approach was kind, patient and caring; there were very positive comments about the staff from people who used the service and their relatives. We saw staff respected people’s right to privacy and treated them with dignity. The staff provided information to people so they could make choices, for example about their meals and what activities to take part in. Some people were very independent and could access the community independently; staff encouraged this and supported people to maintain the independent skills they had.

There was an activity co-ordinator who helped to plan meaningful activities; they made a record of who participated in them.

We saw staff had access to training considered essential by the registered provider and other courses which were more specific to the needs of people who used the service. The registered manager was currently completing a training analysis to see if there were any shortfalls which needed to be planned for in the coming year.

Staff told us they felt supported and we saw they received supervision and observation of their practice. This enabled staff to be developed in their role

We visited The Abbey and spoke with four people who lived there. People told us they were happy with their care and that members of staff were kind and supportive. People told us they were confident any concerns they might raise would be dealt with quickly and everyone spoken with expressed their satisfaction with the service. One person said “I highly recommend it here. From top to bottom they are all good.” Another person said “It’s marvellous here.”

People were consulted and we saw evidence that people received the care they needed through effective communication, care plans and risk assessments. We found that the home worked co-operatively with other providers to make sure people received the right care.

People who used the service were protected from harm and the risk of harm through training, updated policies and procedures and risk assessments.

Staff were suitably recruited to ensure they could offer the appropriate care.

Effective management systems were in place to promote people’s safety and wellbeing.

During our inspection on the 23 October 2012 people who used the service told us that the manager was nice and always available. They said she took time with them and never made them feel rushed. They also told us that the staff were always respectful when assisting them with tasks. They said that the staff had time to spend with them and often sat with them for a chat. People told us they were confident any concerns they might raise would be dealt with quickly and everyone spoken with expressed their satisfaction with the service. One person said "You couldn't wish for a better place, there isn't one" another person said "The food is excellent there is a choice and staff ask before the meal what you want"

Staff spoken with told us that the manager was supportive. They told us that they could access training as they needed it and they worked closely with the local surgery. Staff told us that they had time to spend with people who used the service and everyone had a choice about how they spent their time.

The manager told us that the providers were supportive of her role and they worked together to ensure the home remained in good order and that the care offered was positive and respectful.

People told us that they felt their views were respected and were acted upon about both their care and how the home was being run. People said this made them feel that they were central to all the decisions being made. One person said ‘Living here exceeds my expectations. I am asked for my views about everything. My every wish is known and respected’. Another person said ‘I am always asked if everything is alright. I would not want to live anywhere else’.

People we spoke with told us that they received the help and support they needed when they wanted it. People said they were consulted about their care, treatment and support options. One person said ‘The staff come when I need them. They are all very kind, they are a grand lot. I have a key worker who talks with me about my care, every month we go through the help I want to receive’.

People confirmed that they felt safe and felt protected by the staff. They said they knew how to raise issues if they had any concerns. One person said ‘I feel safe here. I have no complaints whatsoever’. Another person told us ‘I know if I had any concerns about anything the issue would be dealt with straight away’.

People we spoke with told us that there were enough staff to meet their needs in a timely way. One person said ‘There is always enough staff and they know what they are doing’. Another person said ‘If you want anything if you press the bell staff come at once. They are all wonderful from the cleaners to the management’.

People said they were very happy with the quality of the service being provided for them. People we spoke with said they spoke with the manager or provider everyday. They said the home was run for them and that they were treated like part of a large family. They all said that they were very happy living there. One person said ‘The quality of the service is very good, nothing is too much trouble. We all live as one big family and it is great’. Another person said ‘I cannot fault living here’.