Abbot Care Home

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

People told us they felt involved in their care and treatment, and their health needs were met. However, we received mixed feedback regarding fluid and nutrition and records showed long periods of time where people were not supported to have drinks. Clinical risk meetings were being held, and the oversight of risks and sharing information was being embedded into everyday practice.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

People and their relatives told us they involved in their care and treatment. People told us they had enough to eat and there was a choice which they enjoyed. One person told us, “I've chosen the chicken for my lunch it's very good food here and you can choose in the morning. You can always have a choice and it always well cooked. In the evening, we have soup and sandwiches which I like too.” Another person said, “The food is so good and you get plenty to eat and drink here.” A relative told us. “[Person] has put on weight since they’ve been here. They’re eating well and has to have puréed food but it looks OK.” However, there were some concerns from relatives about the amount people were drinking. A relative told us, “We think this place is good overall but concerned about [person] drinking enough and although they’re getting food brought to them, I'm not sure they’re eating much.” Another relative said, “We've asked for their fluids to be monitored as we felt they might not be drinking enough so we'd like that updated. Yes, we’re all concerned about their fluid intakes, so we want to know what they’ve drunk each day. We think sometimes [person is] dehydrated but also we know they’re not easy to get to drink but they need to.”

Care plans identified where people required support with maintaining their health and wellbeing, however this was not always transferred into the support people were receiving. People who were at risk of developing a urinary tract infection (UTI) or suspected of having a UTI, did not have drinks readily available to them. Records showed they had received a drink earlier that day but there was not a drink present with people to encourage a better fluid intake. We saw in records showed that throughout the times of 7.30am to 9.30pm people were receiving their planned amount of fluid. However, people had no fluids offered between the hours of 9.30pm and 7.30am, sometimes going up to 12 hours with no fluids recorded. A person in the dining room was eating their breakfast without any aids. As a result, food was spilling onto the table and on the person. This meant the person was dropping as much as they were eating leading to an inaccurate account of what they consumed. For another person who was sleeping all day, records viewed for this person stated they had eaten their meals, but we observed the full meals at both breakfast and lunch being removed untouched from their room. Processes in place did not identify these issues, the discrepancies in records or identify that action needed to be taken to make improvements.

We spoke with staff about people’s care and treatment needs. They were aware of people’s needs with regards to nutrition and knew who required modified foods and what the level was. We observed a staff member speak to the manager about their concerns relating to a person's diet and their eating. The manager spoke through with the staff member their concerns and worries. This shows that staff were able to raise where they felt people’s needs had changed or had observed changes. Staff told us that meetings were used to keep them update and where any new guidance was shared.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

People told us they felt they received the right care and treatment, and additional medical input was sought as needed. A person said, “I would like my hearing tested as I'm getting really hard of hearing now and I think that's being sorted for me.” However, one person did raise a delay in some treatment which was impacting on their wellbeing. We raised this with the management team who assured us they would support the person in getting these issues addressed. A relative said, “I never had any worries about [person] being here and everything the nurses did showed how capable they were and so kind to them.” Another relative said, “Here they now have one to one care and look at [person] now, (described improvements). With the care here they’ve got so much better, being here. I'm very happy [person’s] here, they saved them.” A third relative said, “This is a lovely place, there's a nurse for her on her floor so that's reassuring, l think there is one on every floor.”

Regular meetings were held amongst clinical staff to share information and enable oversight of people’s health and wellbeing. However, meeting minutes we saw showed that key people were not always in attendance. The registered manager confirmed that the schedule of meetings, their purpose and actions to be taken from them was still embedding in staff practice. The registered manager shared with us a plan of best practice implementation which included a provider initiative called ‘My Day’. The purpose of this was to make sure that one person was the focus of the day, on which all reviews would be completed. This included their health and wellbeing and a focus placed on the person being the centred of their care at the time, but also anticipating any future needs.

Staff felt they worked in a way that helped ensure people’s health needs were anticipated and met. A staff member said, “Clinically is very good and very experienced. I find the clinical meeting very good to discuss risk and the team is very supportive.” A staff member said, “GP will not visit weekly, this is not ideal at times, we do have weekly MDT meetings but this is reliant on us sharing what we have found. The time of the MDT meeting is not helpful either because the meds round is at the same time.” Staff said that they are able to contact the GP if they require support, however the GP did not routinely visit the service which meant that the reliance was on the staff to recognise people’s deterioration of health and escalate where needed. We spoke to one professional who was visiting on the day of our visit who said that when they have visited staff are responsive to their requests and that where individuals required referrals to other healthcare services these were done in a timely manner.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.