Abbey Care

Updated 18 November 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 1 inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 6 October 2022 and ended on 11 October 2022. We visited the location’s office on 6 October 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used information gathered as part of monitoring activity that took place on 4 July 2022 to help plan the inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 2 people who used the service about their experience of the care provided and 4 relatives. We spoke with 8 members of staff including the registered manager, care co-ordinators and care workers.

We reviewed a range of records. This included 4 people's care records and medication records. We looked at 2 staff files in relation to recruitment and training. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 18 November 2022

About the service

Abbey Care is a domiciliary care agency providing personal care to people living in their own homes. At the time of the inspection, the service was providing care to 37 people. Some of the people supported had a learning disability or autism.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right support: People's independence was respected and promoted.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right care: People received care that was tailored to their needs and wishes.

Right culture: There was a strong, person-centred culture. People received care from highly motivated staff who were proud to work for the service.

Medicines were not always managed safely. Not all records showed that people received their medicines as prescribed. Staff currently administering medicines had not had their competency assessed in line with best practice guidance.

Auditing systems were in place. However, we found that they were not always effective. This meant there was a risk that opportunities to improve quality and safety could be missed. We made a recommendation regarding this.

Staff knew people well and could describe the action they would take to reduce the risk of avoidable harm when delivering care. Accidents and incidents were recorded and responded to appropriately. Staff were safely recruited and deployed in sufficient numbers to meet people's needs. People and relatives told us they felt safe when staff supported them. Comments included, "I feel safe because I know [person] is safe, we trust the carers.” Staff followed good infection control practices and used PPE to help prevent the spread of healthcare related infections.

People's needs were assessed when they first started using the service and assessments were detailed and focused on people's personal likes and preferences as well as their physical care and support needs. Staff checked on people's well-being and told us what they would do if they had any concerns about people's health. One person told us how staff went above and beyond and checked on them between care calls when they were not feeling well. Staff received an induction and completed mandatory training to carry out their job roles effectively.

There was a strong, person-centred culture within the service. People and their relatives were overwhelmingly positive about the care and support they received. Comments included, " I don’t know what I'd do without them [staff] , they are all good. The look after me well." People received sensitive support to maintain their privacy, dignity and independence.

Care plans contained detailed information about people's routines, likes, dislikes and preferences. Care was focussed on ensuring people achieved positive outcomes. People's care plans contained some details for staff to help them communicate with them effectively. Staff supported people to stay in contact with those important to them. There was an effective complaints management system in place.

The registered manager and staff team were open, receptive to feedback and keen to develop the service. People and relatives felt that the service was helping to meet their needs, preferences and outcomes. The service involved people and their relatives in a meaningful way. People and relatives gave us positive feedback about the friendly and positive nature of the registered manager and staff team.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 16 November 2020 and this is the first inspection.

The last rating for the service under the previous provider was Good, published on 18 August 2017.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

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

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the safe administration of medicines at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.