We carried out a review of the data available to us about Abi House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Abi House, you can give feedback on this service.
Abi House is a residential care home registered to provide accommodation and personal care for up to 7 people, who have a learning disability and/or autistic people. There were 6 people living in the home at the time of our inspection. The building has 2 floors and a communal kitchen, dining area and lounge. The service is located in Worthing, close to the seafront and local shops.
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.
People’s experience of using this service and what we found
Right Support: Model of Care and setting that maximises people’s choice, control and independence. The service follows a low impact, low demand model of support; for example, minimising intrusive sensory barriers. This means reduced unnecessary noise and visual stimulus with the aim to provide a calm home which supports people to enjoy their life with reduced anxiety or emotional upset. Abi House used assistive technology to support people to engage in the world around them. For example, 1 person had a therapy /companion robotic cat, which responds to the person and has cat like movements and sounds.
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.
Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. Staff supported people to play an active role in maintaining their own health and wellbeing.
Staff, people and their relatives cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.
Right Care: Care is person-centred and promotes people’s dignity, privacy and human rights.
People received kind and compassionate care. Staff protected and respected people's privacy and dignity. Staff understood and responded to people’s individual needs.
People's care, and support plans reflected their range of needs and promoted their individuality, wellbeing and enjoyment of life. People could take part in activities of their choosing at the service or in the wider community and pursue their own interests. Staff received training and support to provide care effectively.
Staff worked in partnership with healthcare professionals to maintain people’s health and wellbeing.
People told us they felt safe with staff. A person told us they liked all the staff. Relatives had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of potential harm.
Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.
Staff placed people's wishes, needs and rights at the heart of everything they did. The stable management and staff team supported people to receive consistent care from staff who knew them well. We observed people receiving compassionate and empowering care which was tailored to their needs throughout the inspection.
Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. All the relatives we had contact with were complimentary and positive about the service and the care and support their loved ones received.
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 23 October 2019)
Why we inspected
The inspection was prompted in part due to concerns received about maintaining family contact. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, caring and well-led sections of this full report.
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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice:
The service had installed an outside wooden cabin after the onset of the COVID-19 pandemic to facilitate safe visiting. The structure was divided into a smaller 'cubby' area and a larger room with seating which could be readily ventilated. We were told that people enjoyed having this extra space and used it often.
The provider had made physical improvements to the premises to keep people safe from the risk of infection. For example, they had installed more en-suite bathroom facilities so people living at the home did not have to share a bathroom. An extra window had been fitted on the first-floor landing to improve ventilation.
The service had carried out detailed risk assessments to enable people to visit and stay with their families safely. The assessments included contingency planning, for example, if a person or a family member had a positive lateral flow device test result while they were away so their return could be safely delayed if necessary. The impact of COVID-19 restrictions, for example, in limiting people's chosen activities had also been considered and mitigating actions and alternatives put in place to maintain people's physical and mental wellbeing.
The service had made use of a range of resources to ensure that infection prevention and control measures were well understood and implemented effectively by the whole staff team. For example, the service had made use of NHS materials and training for staff on how to don and doff personal protective equipment (PPE) correctly and checked that everyone could do this effectively. The management team had completed an NHS 'Train the trainer' course on the use of PPE to provide additional internal support for staff. The service carried out a weekly audit that included an observational check that staff were using PPE in line with the guidelines.
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.
People’s experience of using this service and what we found
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.
People and relatives spoke highly of the service they received at Abi House. Comments included; “I love it. It’s lovely” and “My advice now is that Abi House marks high on all of your five key questions and high on another which is how well they have now managed change.” The service had strong person-centred values and placed people’s wellbeing at the heart of their work. People received personalised support which met their needs and preferences.
People’s needs were assessed and care was planned and delivered to meet legislation and good practice guidance. People’s support plans contained personalised information which detailed how their care and support should be delivered to ensure they lived happy lives. Staff worked hard to provide people with varied activities and stimulation that met their interests and specific individual needs.
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. Staff actively involved external healthcare professionals in building and delivering people’s support to ensure this best met their needs in a way which promoted their independence as much as possible.
People were supported by kind and caring staff who worked hard to promote their wellbeing. Staff knew how best to communicate with people and enabled people to make choices wherever possible. Staff knew people well and could interpret people’s communication methods, such as body language, facial expressions, exhibited behaviours and vocalisations. Staff were proud to work for the service and treated people with respect and dignity. The service promoted equality and diversity and worked hard to meet all of people’s individual needs.
Risks to people’s health, safety and wellbeing were identified, assessed and acted upon. People were protected from potential abuse by staff who had received training and were confident in raising concerns. There was a thorough recruitment process in place that checked potential staff were safe to work with people who may be vulnerable to abuse and avoidable harm.
People received their medicines as prescribed by their doctor and there were processes in place to manage the ordering, storing and disposal of medicines. Incidents and accidents were investigated, and actions were taken to prevent reoccurrence. Abi House was clean, welcoming and pleasantly decorated. People, relatives and healthcare professionals spoke highly of the staff who received training and supervision to meet the needs of the people living in the service.
There was strong leadership at the service. People and staff spoke highly of the registered manager and the service manager who oversaw day to day activity. There was a positive culture at the service with people, relatives and staff feeling their voices were listened to.
There were effective quality assurance systems in place to assess, monitor and improve the quality and safety of the service provided. Significant improvements had recently been made following the appointment of a new service manager and processes had been updated.
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 March 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.
Abi House is located Worthing and is registered to provide accommodation for a maximum of seven younger adults living with Autistic Spectrum Disorder, learning disabilities and associated challenges. At the time of inspection five people were using the service.
At the time of our inspection, a new manager had recently started at Abi House although they had worked for the provider for some time. They were making their application to become registered as the manager with CQC. A registered manager is a person who has registered with the Care Quality Commission 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. The person referred to in this report as 'the manager' is the person who has applied to CQC to become the registered manager for the service.
People were protected from the risk of harm and abuse because staff had received the training they needed to recognise and report abuse. Risks associated with everyday living had been identified and managed so that people were protected and staff were aware of what they needed to do to reduce risks. Staff were recruited safely and staffing levels ensured that people were safe and received the care and support that they needed in the way that they preferred. People received their prescribed medicines by staff who had been trained to do so, although the provider had recognised that some improvements were required to the storage and administration of medicines.
Staff were provided with the training they needed to meet peoples specific needs. Staff had regular supervision to reflect on and develop their practice. The principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguarding (DoLS) were understood by staff who ensured that they sought people's consent and did not unlawfully restrict their liberty. People's dietary needs were met and they were supported to eat and drink sufficiently. People had access to a range of health care professionals to meet their healthcare needs.
Staff knew people very well and were kind and sensitive to their needs. Staff were observed providing personalised care and it was evident they clearly understood people's individual needs. Staff ensured people's privacy and dignity was respected and maintained at all times. Where people required additional support staff supported them using appropriate methods of communication for their individual needs.
Where possible, people were involved in the planning and review of their care and support needs. Care plans were person centred and were regularly reviewed. People were encouraged and supported by staff to pursue their interests and hobbies and activities were tailored to people's likes, choices and abilities.
Staff, spoke positively about the manager who was committed to providing a person centred service; ensuring people had a good quality of life. There were systems in place to regularly assess and monitor the quality of the service provided and people living and working in the service had the opportunity to say how they felt about the home and the service it provided.
We spoke with two people who use the service, the manager, the trainee manager and two support staff.
Below is a summary of what we found. The summary describes what people who used the service and the staff told us, what we observed and the records we looked at. If you want to see the evidence supporting our summary please read the full report
Is the service safe?
All of the people we spoke with told us they felt safe. One person told us, "I feel safe here."
Safeguarding procedures were in place and staff understood their role in safeguarding the people they supported. Staff were aware of the provider's whistle blowing policy. Staff knew about risk management plans and we found that people were supported in line with those plans. This meant people were cared for in a way that protected them from harm.
Is the service effective?
We saw from the records we looked at that the staff had received the information, training and managerial support they needed to do their job effectively. There were arrangements in place that ensured staff had the most up-to-date information about people's support needs. Support plans we reviewed detailed people's individual preferences, likes and dislikes. Where individual people displayed behaviour that challenged the service, staff managed the situation appropriately and promoted people's dignity and respect. This meant that because staff had a good knowledge of each person's care needs and preferences they were able to provide effective support.
Is the service caring?
People told us that they were looked after by kind and caring staff. One person told us, "The staff are very kind." People's preferences, interests and diverse needs had been recorded and care and support was provided in accordance with people's wishes.
Is the service responsive to people's needs?
People and family members were asked their views about the service and the provider acted on comments that people made. One person told us, "They always help me." Where support staff had noticed people's changing needs, their support plans were updated to reflect this. We found staff discussed people's care needs with them and their family on a regular basis. Systems were in place to make sure the manager and staff learned from events such as accidents and incidents, complaints and checks made on the service. This reduced the risk to people and helped the service to continually improve.
Is the service well-led?
We found the provider had a clear complaints procedure and that people who used the service knew how to make a complaint.The provider had quality assurance and risk management systems in place. We found the registered manager checked that risks were managed effectively. Staff told us they were clear about their roles and responsibilities and understood the quality assurance and risk management systems. This helped to ensure people received a good quality of care. Staff told us the service was well organised and they felt supported by their manager.
We spoke with four staff who spoke confidently about people, their needs and how they communicated. Staff said their observations influenced people's care plans. We observed staff interacting and communicating with people with words and gestures that people could understand. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.
We found that staff supported people's choices through verbal and non-verbal methods of communication. People's consent was obtained and their choices upheld. Where people did not have the capacity to consent, appropriate arrangements were in place to protect their rights.
We found that staff had received appropriate training and support to manage the new client group at the home. Staff told us they felt supported and had good access to training.
An effective complaints procedure was in place and staff took this form of feedback seriously.
People's care and treatment was planned and delivered in line with people's needs and preferences. A full assessment of people's needs was done at the start of their care and was continually reviewed. People were included in discussions about their care. Specific medical and physical conditions were planned for and there were clear instructions for staff in how to support people. People's rehabilitation goals were reviewed and discussed frequently to ensure people were being supported to meet these goals.
People were safe from the risk of abuse and neglect. Staff had received appropriate safeguarding training and understood how to identify and report concerns. People who lived at the home told us they felt safe living there.
Staff received appropriate support and training. A new manager had been recently appointed and gaps in training were being addressed. Staff told us they felt supported in their roles and had high job satisfaction.
The provider had systems in place to assess their own quality. The provider responded appropriately and swiftly to any concerns about quality.