Abbey House

Updated 16 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This unannounced comprehensive inspection took place on 5 December 2018. The inspection was completed by one inspector. A dental inspector was also present who looked in detail at how well the service supported people with their oral health.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also looked at notifications sent in to us by the provider, which gave us information about how incidents and accidents were managed.

We observed interactions with people to establish how well they were supported and their relationships with the staff. We spoke with seven people who used the service, the registered manager, five support workers and a speech and language therapist. Following the inspection, we spoke with five relatives and received written feedback from three relatives and two health/social care professionals involved with the service.

We looked at a selection of documentation in three people’s care files including their medication records. We also looked at a selection of records used in the management of the service. These included staff rotas, staff recruitment and training records, quality assurance audit checks, accident and incident records, maintenance checks, surveys and minutes of meetings with staff.

Updated 16 February 2019

This unannounced comprehensive inspection took place on the 5 December 2018.

At the last inspection in January 2016 we rated the service good overall and in four key questions. The caring key question was rated outstanding. At this inspection we found the service had improved its overall rating to outstanding.

Abbey House is registered to provide accommodation for persons who require nursing and personal care for up to 13 younger adults living with a learning disability and or autistic spectrum disorder related conditions. Most younger adults attend the local Linkage college facility full-time and reside at the service during term-time only. The service is a large detached period property in a central location in the town close to all local amenities. At the time of the inspection the service was supporting 13 people.

The care service had not been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance in that it was registered to accommodate up to 13 people and would be considered a more congregate setting, however the service was registered prior to the Care Quality Commission(CQC) implementing this guidance. Values such as, choice, promotion of independence and inclusion underpin the ethos of the service and what it continually strives to achieve for people. People with learning disabilities and autism using the service can live as ordinary a life as any citizen during their placement at Abbey House. Following graduation, many people have chosen to stay in the area, living in residential care settings or supported living placements as they have developed such close friendships, support networks, secured regular work placements or paid employment and feel part of the community.

There was a very experienced, popular and well-established registered manager in place at the time of our inspection. A registered manager is a person who has registered with the 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.

This service was selected to be part of our national review, looking at the quality of oral health care support for people living in care homes. The inspection team included a dental inspector who looked in detail at how well the service supported people with their oral health. This includes support with oral hygiene and access to dentists. We will publish our national report of our findings and recommendations in 2019.

The genuinely caring and inclusive culture at the service was outstanding. Staff demonstrated extremely caring values and showed a very positive regard for what was important and mattered to people. Staff were compassionate and kind and went ‘above and beyond’ to ensure people received positive outcomes. The trust developed between people and staff helped promote people’s independence, confidence and helped them achieve excellent outcomes. The registered manager and staff were very proud of the support they provided and people’s achievements were celebrated.

Respect for equality, diversity and inclusion was fully embedded within the service and integral to everything the staff did. Staff used innovative and effective ways to communicate with people and follow each person's wishes on their preferred method of communication.

The registered manager and staff had an excellent understanding of people's needs. A wide range of educational, vocational, leisure and voluntary activities were offered to people who used the service to aid independent living and support strong community inclusion. Staff found ways to improve people's lives by introducing creative activities that opened new possibilities for people and encouraged them to be active and healthy. Positive risk taking was driven throughout the organisation to support people to lead fulfilling lives and reach their full potential.

The service was exceptionally well-led by a registered manager who demonstrated strong values, led by example and had embedded an open and caring culture. They worked in partnership with other organisations, shared best practice and strove to continually improve the service. Robust quality monitoring systems ensured any shortfalls were identified and addressed. Improvements were driven by the consistently high levels of constructive engagement with people, their relatives, staff and stakeholders; whose views were valued and supported positive changes within the service. People’s concerns and complaints were taken seriously.

Staff were very positive about the team work, the support they received from the registered manager and about the empowering culture that was promoted by the service. Staff felt valued, had a high level of job satisfaction and were very proud to work at Abbey House.

The service provided safe care to people. Staff completed safeguarding training and could describe the action they would take if they had concerns. Positive behaviour plans directed staff to effectively support people’s behaviour that challenged the service. People were supported to take their medicines independently and safely. Staff completed assessments to help minimise the risks people had. There were sufficient staff deployed to meet people’s needs and they were recruited in a safe way. The environment was safe and comfortable.

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. When restrictions on a person’s liberty was necessary the registered manager had ensured the correct application had been made to protect the person's legal rights. People’s nutritional needs were well met. Staff were provided with a learning and development programme that nurtured their knowledge, skill and professional development. Staff undertook champion roles to promote good practice across the service and benefitted from regular meaningful supervision and appraisal to ensure their well-being and high-quality care.