Archived: Abingdon

Abingdon is a residential care home providing personal care and accommodation for up to nine people. There were nine people living at the home at the time of this inspection. The home accommodates people with a learning disability and/or autism.

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

People were safe from harm as the service had assessed for risks, including the risk of the spread of infection. People’s records were accurate and up to date.

People said they felt safe living at the home. Staff knew service users well. Staff had safeguarding training, and any concerns were monitored and managed by staff.

There were enough staff as the service had taken initiative in active recruitment. People told us they felt there were enough staff and that there was always plenty of staff to speak to. There was a consistent and stable staff team meaning service users had positive interactions.

We found a positive atmosphere within the home. Service users told us they were happy and that staff were able to support them with anything.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

The home did not have any distinguishable features which identified it as a care home. The staff were able to manage the service like a small personalised home. There were communal areas for people to use as they wished, and private spaces also. The office door remained open at all times and service users felt comfortable using this area and talking to staff.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 4 March 2021) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We carried out an announced comprehensive inspection of this service on 27 and 29 October 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve. We identified breaches in relation to infection prevention and control measures.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Abingdon on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Abingdon is a residential care home providing personal care and accommodation for up to 9 people. There were seven people living at the home at the time of this inspection. The home accommodates people with a learning disability and/or autism.

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

People were placed at significant risk of harm because the provider had failed to adequately assess the risk of and control the spread of infection in relation to COVID-19. As a result, the provider was in breach of regulation. Infectious clinical waste was not disposed of safely, staff did not always don and doff PPE in line with the relevant national guidance and infection risks to people and staff had not been effectively assessed and managed.

Quality assurance processes at the home had failed to identify the failings in infection prevention and control measures that we found during our inspection. The provider’s policy designed to specifically guide staff on managing COVID-19 did not consider or provide guidance on the safe disposal of infectious clinical waste.

People told us there were enough staff at the home. One person said, “The staff are there if I need them or need a chat.” There was also enough staff on duty to carry out regular checks on people and provide them with assistance when needed if people had to self-isolate in their rooms.

People said they felt safe living at the home. One person told us, “I do feel safe. Staff know me, they know how to help me. I like all of them.” Staff had received safeguarding training and safeguarding concerns were appropriately monitored and managed by staff.

There was a positive and caring culture amongst staff at the service. Staff knew people they supported well and cared about their wellbeing. People told us they were happy living at the home.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, 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 providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

The home was in keeping with other domestic properties in the area and there were no distinguishable features which identified it as a care home, such as signage. The home provided people with shared housing that had a small-scale domestic feel. The layout of the home enabled people to share several spacious communal areas or, if preferred, enjoy their own space and privacy in their rooms. Staff demonstrated a positive and caring attitude towards the people who lived at the home.

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

Rating at last inspection

The last rating for this service was good (published 28 March 2020).

Why we inspected

As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This inspection began as a targeted inspection looking at the IPC practices the provider has in place. However, in light of our findings the inspection was extended to a focused inspection to review the key questions of safe and well-led.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well-led key questions section of this full report.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Abingdon on our website at www.cqc.org.uk.

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified a breach in relation to infection prevention and control measures at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up:

We will request an action plan from the provider to demonstrate 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Abingdon is a residential care home providing personal and nursing care to seven people aged 18 and over at the time of the inspection. The service can support up to nine people. The care home accommodates people with a learning disability and /or autism.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to nine people. Seven people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

We saw many examples where staff had supported people to become more independent, make choices and increase their physical and emotional wellbeing.

Abingdon is located in an area that enabled people using the service to participate in their own local community. People were active each day and enjoyed local community facilities. Social activities also took place at home, with regular trips to local places of interest, restaurants and pubs.

The service was highly effective at promoting people's independence. This included personal care and daily activities such as laundry, cleaning their home, shopping, preparing meals and drinks.

Risks that people faced had been assessed and those identified were safely managed. Medicines were managed safely. Staff showed a good understanding of their roles and responsibilities of keeping people safe from harm. People were supported to access healthcare when needed.

People were encouraged and supported to eat and drink well. People were given a choice of suitable meals

and snacks. Staff supported people to make meals of their choice throughout the week.

People received care from a consistent staff team, who had worked at the service for a number of years. Enough staff were employed each day to meet people's needs, keep them safe and give them the opportunity to take part in their chosen activity.

Staff received a range of training appropriate to their role and people's needs, and were supported by the registered manager and senior support workers through regular supervision.

Effective systems were in place to check the quality and safety of the service. The environment was clean and safe and in a good state of repair.

The leadership of the service promoted a positive culture that was person-centred and inclusive. The registered manager and the staff team showed a desire to improve on the service provided and in turn the quality of life experiences for the people at Abingdon.

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

Rating at last inspection. The last rating for this service was Good (published 27 September 2017.)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Situated in a residential part of Southport, Abingdon is a care home offering a service for up to nine people who have a learning disability. At the time of the inspection, there were seven people using the service. The home is situated over three floors. The home has two large lounges, a dining room and a garden at the rear.

At the last inspection, in April 2015 the service was rated ‘Good’. We found during this inspection that the service remained ‘Good’.

We found that risk was well assessed and information was updated regularly. Staff used restraint as a last resort in line with good practice guidance. Staff were able to describe the course of action they would take if they felt anyone was at risk of harm or abuse, this included 'whistleblowing' to external organisations. Medication was stored securely and administered safely by staff that had been appropriately trained. Our observations and discussions with staff confirmed that the staffing levels were sufficient for the support which needed to be provided. The registered manager had systems and processes in place to ensure that staff who worked at the service were recruited safely.

The registered manager provided us with a staff training plan and this showed staff received training to ensure they had the skills and knowledge to support people living at Abingdon. This included autism training to help staff understand and support people with autism and positive behaviour support training. All newly appointed staff were enrolled on the Care Certificate. Records showed that all staff training was in date.

The service operated within the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Records demonstrated that processes were in place to assess people’s capacity and make decisions in their best interests.

People we spoke with were complimentary about the staff, the registered manager and the service in general. People told us they liked the staff who supported them. The provider adopted a caring approach throughout the service towards staff and people living at Abingdon. This was evident through initiatives such as ‘Above and Beyond’ awards for staff, an employee recognition scheme and through the creation of a ‘Dignity Tree’, a visual aid to promote dignity within the service.

People were supported to raise complaints or concerns about the service through the use of comment cards and easy-read policies. Complaints were well managed and documented in accordance with the provider's complaints policy.

Staff we spoke with demonstrated that they knew the people they supported well, and enjoyed the relationships they had built with people. Care plans were person centred and contained relevant information in relation to a person’s wishes, choices and preferences. Positive behaviour support plans were in place for those people who displayed challenging behaviour and assessments were regularly reviewed and updated.

The registered manager had a number of different systems in place to assess and monitor the quality of the home, ensuring that people were receiving safe, compassionate and effective care. Such systems included regular audits, staff and ‘resident meetings’ as well as ‘resident comment cards,’ annual surveys and relevant health and safety and infection control checks.

Further information is in the detailed findings below.

We found at this inspection people lived in accommodation that was suitable for their needs. Improvements had been made regarding maintenance, decoration and safety checks. This included making sure hot water was delivered at a safe temperature and the provision of new flooring, carpets, shower rooms and windows. A person who lived at the home told us the home was " A nice place to live now."

We looked at different parts of the home and found a lack of maintenance. The hot water supply to the home was also not subject to safety checks to minimise the risk of scalds when bathing.

During the inspection we found people received effective, safe and appropriate care and support to meet their individual needs. People had a plan of care and a number of documents were in an easy read format. Care documents had pictures and signs to help people's understanding. The care documents provided the staff with the information they needed to support people with their individual needs. External health care professionals had been contacted, where needed, to ensure people's health and welfare.

At the time of the inspection we saw there were sufficient numbers of staff on duty to support people with their individual needs. Staff interviewed had a good knowledge of the care and support people needed. We saw staff accompanying people out from the home during the inspection to take part in their chosen activity.

Systems were in place to monitor and improve the service provision. People and their relatives had access to a complaints procedure, should they wish to raise a concern or comment about the service.