Archived: Abbey Care

Abbey Care is a family run, domiciliary care service providing support to 120 people living in their own homes. The service supports older people and people who are living with dementia or other conditions. It also supports younger people, people who are physically disabled or people living with mental health problems and some people with sensory impairments. The service aims to support people to continue living in their own homes. The service is based in Haywards Heath, and provides a service to people within the local area as well as in Burgess Hill, Cuckfield and Lindfield in West Sussex.

The registered manager has been in post since 2010 and has recently taken over the running of the business following the retirement of the previous owners. 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 were protected from harm and abuse as they were supported by staff who had undertaken the relevant training and who knew what to do if they had concerns about peoples’ safety. Risks had been assessed and managed to ensure peoples’ safety. People received their medicines safely from staff who were trained and assessed as being competent to administer medicines. There were enough staff to ensure that all visits were covered. People told us that they felt safe, one person told us, “It’s a reliable service and that makes me feel safe, knowing that they will always come.”

Staff were well supported and had access to the training they needed to carry out their role effectively. One care worker told us, “I just find that you get the support and back up here, there is always someone to support you.” Staff understood their responsibilities with regard to the Mental Capacity Act 2005. People told us that staff always asked for their consent before providing care. One relative said, “They know what they have to do but they still ask, I hear them making sure before they start.” People were supported to have the food and drink they needed and to access health care services. A health care professional told us, “Abbey Care excel at providing feedback. They are very proactive. If they tell me someone had deteriorated and needs more support or a piece of equipment I know that is the case.”

Staff had developed caring relationships with people and treated them with dignity and respect. One person told us, “I can’t praise them enough really, they are all wonderful.” Staff knew the people they were caring for well and people told us they felt their views were listened to. Staff had a good understanding of the importance of maintaining people’s confidentiality and there were safe communication systems to support this.

People received a personalised service and their care plans reflected this. Staff told us that care plans were updated regularly to ensure they were accurate and to accommodate changes in needs. People were happy with the care provided and spoke of a flexible service. One person said, “If I need more time, then they stay longer, there is never an issue.” People knew how to make complaints and were confident that any concerns they raised were dealt with appropriately.

People and staff spoke highly of the management of Abbey Care and said that the service was well run. A health and social care professional told us, “Care providers that are as good as this are as rare as hen’s teeth. They are consistently good, proactive and very caring.” There were robust systems and processes in place to ensure that the quality of the service was monitored and maintained. Feedback from people, staff and health care professionals was collected and used to drive service improvements. Staff spoke of an open culture where they were able to get the support they needed at any time. One staff member said, “It’s a really, really, good company to work for. It’s like one big family. It’s the only company I have worked for that cares as much for the staff as they do for their clients.”

The registered manager and provider demonstrated that they were committed to the continuous development of the service.

During this inspection we looked at outcomes relating to consent to care and treatment, care and welfare of people who use services, meeting nutritional needs, suitability of staffing and assessing and monitoring the quality of service provision. We used the information to answer the five questions we always ask; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service and the staff told us.

Is the service safe?

Individualised care plans detailed the support and care each person required. People confirmed they received the care they needed in a way that they preferred. The service ensured relevant healthcare professionals were involved as needed.

People were supported to be able to eat and drink sufficient amounts to meet their nutritional needs. The provider had systems in place to assess people's nutritional and hydration needs and we saw that these systems were used and evaluated appropriately. We also saw that systems were in place for recruitment and selection of qualified and skilled staff with appropriate checks in place.

Is the service effective?

We observed people being supported to make their own choices about the care and support they received. This included being able to make changes to the timing and level of support to meet their needs on a day to day basis. Staff were observed to support people in a calm and respectful manner and with dignity. People told us they were involved in decisions about their care and their choices and preferences were central to how care was planned.

One person we spoke with told us "They're very good. I'm happy with everyone. They come when they say they will." Another person told us "They do things in the way I want them to be done."

Is the service caring?

Staff were aware of people's needs and preferences and took account of these when providing care and support. We observed office staff speaking with people in a way that was caring and showed respect for their wishes and choices. People we spoke with and their relatives told us staff were caring. One person told us "Nothing is too much trouble for them."

Is the service responsive?

We saw that care plans were reviewed regularly in line with people's assessed needs and that their views had been taken into account in how their care and treatment had been planned. People we spoke with told us staff were responsive to their changing needs. One relative told us "They will come when we need them to. We can change things to suit us and they will do what they can to support us."

Is the service well-led?

The service was well managed and there were clear lines of leadership and communication in place. People we spoke with told us the manager and provider were very visible within the service and that they felt able to raise concerns with confidence that they would be addressed. We saw a number of feedback processes in place for people, their representatives and staff to provide feedback on the service and we saw that this feedback was acted on. Comments from care workers included "We're able to give good care. The management are really supportive so we're never out on a limb."

We found that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. There were clear care plans and risk assessments in place which were regularly reviewed.

There were systems in place which protected people from the risk of abuse. There were up to date policies on safeguarding vulnerable adults and staff were trained in safeguarding.

Staff were supported in their roles and received the training they needed. One member of staff said "It's one of the best agencies I've worked for". Staff received regular supervision and there were team meetings where staff could discuss any issues.

We found that the provider had an effective system to regularly assess and monitor the quality of service that people received. People who used the service had opportunities to make comments about the service and improvements were made when necessary.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained. Records were kept securely and those records for the management of the service were kept up to date.

People using the service were satisfied with the care provided and told us the carers were 'very kind' and always treated them with dignity and respect. One person said 'They never let me down, whatever the weather' and another said 'They are always willing to do that little bit extra'. There was a general feeling that the carers were very helpful and that the care provided was of good quality.

There were appropriate systems in place to recruit staff and support training. Staff were satisfied with the training provided and the staff we spoke to enjoyed their job and told us the provider was always very supportive.

We found evidence of quality management processes including complaints, compliments and incident management. There was evidence of these being recorded and acted upon and people who use the service told us they knew how to raise issues if they needed to. However, we saw that certain reviews and risk assessments were in place but not regularly updated and risk assessments and care plans for pressure sores were not recorded. There were audits in place for monitoring call times, medication and care provided but no formal documentation to evidence they had been carried out. The provider has advised us they are addressing this.