Archived: Abbey Care and Nursing @Home Limited

At our last inspection on 23 April 2014, the provider was meeting the regulations that were assessed.

The registered provider is registered to provide personal care to people who live in their own homes. Primarily people receiving the service had complex learning disabilities and /or complex health needs. The service was commissioned to provide end of life care. The registered provider is registered to provide services to:- Learning disabilities or autistic spectrum disorder; Mental Health; Older People; Sensory Impairment and Younger Adults. The registered provider supports people who live in the Sheffield area and support packages range from 24 hour support to 4 hour visits. At the time of our inspection there were 42 people receiving a service from Abbey Care and Nursing @ Home Limited.

When we visited there was a registered manager in post, this person was also the registered provider. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

There were clear procedures in place to recognise and respond to abuse. Staff had received training in this area.

People received the level of support they required to safely manage their medicines.

Risks to people's health and safety were managed and plans were in place to enable staff to support people safely.

There were sufficient numbers of staff to ensure people's needs were met in a timely way.

People were supported by staff that been through a thorough recruitment process and had received appropriate training which was relevant to their roles. This meant people were supported by staff who had the knowledge and skills to provide safe and appropriate care and support.

People received the assistance they required to have enough to eat and drink and have their nutritional needs met.

People were involved in the planning and reviewing of their care and making decisions about what care they wanted. People received the care they needed and staff were aware of the different support each person required.

People were supported to maintain their hobbies and interests and staff recognised the importance of making sure people who received care and support in their homes did not become socially isolated.

People felt able to make a complaint and knew how to do so.

Positive and caring relationships had been developed between staff and people who used the service and staff recognised the importance of people maintaining and developing new friendships. People were treated with dignity and respect.

People were provided with a safe, effective, caring and responsive service that was well led. The organisation’s values and philosophy were clearly explained to staff and there was a positive culture where people felt included and their views were sought.

Is the service safe? Is the service effective? Is the service caring?

Is the service responsive? Is the service well led?

Below is a summary of our findings. The summary is based on our observations during the inspection, speaking with people who lived at the home about their experience and talking to staff and the provider. We also reviewed documentation and records kept at the home.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

The provider ensured people's views and experiences were taken into account. People's privacy and dignity was respected by staff to make sure people felt safe. People who use the service were given appropriate information and support in a way that they were able to understand the delivery of their care.

Care needs of people were assessed by experienced senior staff. Following assessments care and support was planned and delivered in a way that was intended to ensure people's welfare and safety. We noted people were given opportunities to make their views known so that the agreed care suited them and therefore they were safe.

The provider explained the procedures they followed when considering deprivation of liberty (DoLS) of an individual. They said the only time this was considered was to ensure the safety of the individual and others around them. We also noted people who used the service were only deprived of their liberty when this had been authorised by the Court of Protection, or by a Supervisory Body under the Deprivation of Liberty Safeguards.

The provider had made suitable arrangements by ensuring staff were competent in identifying the possibility of abuse and prevent abuse from happening so that people were protected from the risk of abuse or unlawful or excessive control or restraint. We found examples where the provider had responded appropriately to allegations of abuse.

The provider had made sure staff who handled medicines were trained and assessed to be competent so that medicines belonging to people were handled safely, securely and appropriately. We saw evidence where spot checks had taken place by senior staff. They had identified unexplained gaps in the medication administration records and these had been investigated and actioned.

There were effective recruitment and selection processes in place to ensure suitably qualified, skilled and experienced staff were employed. Appropriate checks were undertaken and only when satisfactory results were obtained staff began work with the agency

Is the service effective?

People who used the service understood the care and treatment choices available to them. During the initial assessment staff made sure the person seeking care and their representatives were made aware of the choices available to them. We saw documentation of people's likes, dislikes and preferences in their care records. Staff told us people were given time to make their decisions so that the care delivered to them would be to their satisfaction and therefore it would be effective.

People's needs were assessed and care and support was planned and delivered in line with their individual care plan. We noted that regular care reviews had taken place to ensure the plan of care and support was appropriate and effective. People and their relatives confirmed they were happy with the care and support by care workers.

Is the service caring?

We were informed by people who used the service and their relatives that individuals felt their diversity, values and human rights were respected by staff who delivered care and support. Staff said they had received training on valuing people's diversity and protecting people's human rights. They gave us examples which confirmed they had a good understanding. The training manager said they used scenarios to test staff's understanding of the above. People told us they were able to discuss personal matters with their care workers without feeling worried.

People's care and treatment was planned and delivered in a way that protected them from unlawful discrimination. We observed staff treating people with respect and helped them with their daily activities such as personal care and social activities. A relative said staff encouraged and enabled people to 'live a normal life'.

Is the service responsive?

People were supported in promoting their independence and community involvement. On the day of our inspection a number of people were out attending centres or taking part in activities outside their homes. Some people had their own transport and care workers were able to take them out and the others used the transport provided by the agency. Depending on the ability and preferences of people, staff offered them a variety of activities and helped them take part. One person told us that they were helped by the care workers to maintain their independence and get involved in the community activities.

Care and treatment was planned and delivered in a way that was intended to minimise risk and enable people to live a fulfilled life. Staff used robust risk assessments when planning care and support. The plan took steps to minimise any harm to people and others.

There were effective recruitment and selection processes in place to ensure suitably qualified, skilled and experienced staff were employed. The provider had systems in place to refer staff to the appropriate bodies if they were no longer fit to work in health or social care settings.

Is the service well-led?

The provider made sure staff were trained and had the necessary skills and experience to meet the needs of people they delivered service to. Care workers were given sufficient information by senior staff so that when they met people they were able to communicate in a way people understood. We saw documentation of people's likes, dislikes and preference in their care records. This meant the provider had taken measures to ensure staff were made aware of people's preferences and understood the care and treatment choices available to people.

There were arrangements in place to deal with foreseeable emergencies. The manager and staff we spoke with were knowledgeable about the procedures to follow if there was an emergency. We saw instructions within care plans as to how people should be evacuated in the event of an emergency. The provider had made sure staff were familiar with the policies in place to deal with emergencies.

The provider through their training manager ensured people's care and support reflected relevant research and guidance by making arrangements so that staff accessed necessary training and development.

The manager ensured all care workers and senior staff worked closely with community workers and other professionals including people's GPs. This is to ensure people received a seamless service.

There were systems in place to learn from investigations of incidents and accidents and also to take account of complaints and comments from people.

People who use the service, their representatives and staff were asked for their views about their care and they were acted on. The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. Staff meetings and supervisions were used by the providers to share information and make necessary improvements.

People's care needs were supported by risk assessments to make sure plans of care took into account the risks to people who used the service. One person said staff helped them use a hoist which they said had made their life much safer and comfortable.

Another person commented, 'Staff are mindful of preventing people from infection. They wear gloves when handling soiled linen and always wash their hands before they move on to the next task.'

When more than one provider was involved in the care, people who used the service said care workers were very supportive and organised appointments, trips to the hospital and to the GP.

People's needs were met by staff using equipment in a way that had regard to people's dignity, comfort, safety and promoted their independence.

Two relatives said staff were competent and knew people's needs and treated them appropriately. We found staff were in receipt of training and development to help them to be competent.

People were aware of the complaints system. None of the people we spoke with were afraid of voicing their opinions with the provider.

Staff explained they had a good rapport with other organisations involved in people's care. They said they worked to minimise unnecessary misunderstanding and protect people's care.