Archived: London Care Abbotswood

London Care Abbotswood provides care and support to people living in specialist 'extra care' housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented or owned and is the occupant's own home.

Not everyone who lived at London Care Abbotswood received personal care. CQC only inspects where people receive personal care; this is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. There were 32 people receiving care and support at the time of this inspection.

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

People and their relatives spoke positively about the service and the caring nature of the staff. A relative said, “I think they are amazing, absolutely amazing. I can’t stress how wonderful it is. A lot of them go beyond their duty.” A paramedic practitioner who worked closely with the service shared, “I have only ever witnessed good care being given and a very positive approach to care by the carers, with great interaction between them and the residents.”

People felt safe with the staff who supported them. Risks to people had been identified and assessed and were managed safely by staff. Staff supported people to take their medicines or reminded them when they were due. As a result of the Covid-19 pandemic, staff had received additional training in infection prevention and control. The provider had clear systems to reduce the risk and spread of infection and we observed some of these in practice.

People considered the service was well-organised. The registered manager provided a visible presence and was available to people if they wished to discuss their care. People were encouraged in their involvement and development of the service and their feedback was valued. Quality assurance systems were in place to measure and monitor the standard of the service and drive improvement. Areas of concern identified at our previous inspection had been addressed.

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 (22 May 2020) and there were two 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

We received concerns in relation to the management of medicines, people’s care needs, safeguarding and confidentiality. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 requires improvement to good. This is based on the findings at this inspection. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

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.

London Care Abbotswood is a domiciliary care service providing personal care to 30 people older people at the time of the inspection. This service provides care and support to people living in specialist ‘extra care’ housing. People using the service lived in a block of 62 flats within one building in Rustington.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

The provider had not ensured that the systems and processes to assess, monitor and improve the quality and safety of the services provided were sufficiently robust. Quality assurance checks had been carried out but were not always effective at addressing and resolving areas in need of improvement.

Records were not always complete and accurate. When people had specific health diagnoses, there were not always plans in place to support staff to provide safe and consistent care. The provider had not always ensured that staff were suitably skilled to meet people’s different needs. The provider had not ensured that professional boundaries between staff and people had been maintained.

The provider had not ensured the correct notification of all incidents had been sent to CQC as required.

Risks to people’s health, safety and wellbeing were not always appropriately identified and planned for.

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. However, records did not always accurately reflect this.

People told us they felt safe. Staff understood safeguarding and how to report any concerns about people’s wellbeing and abuse. There were enough staff available to meet people’s needs. Medicines were managed safely. Infection prevention and control was well managed. When things went wrong, lessons were learnt and ways to reduce the risk of reoccurrence were put in place.

People needs, and preferences were assessed before they started receiving support from staff. Staff were supported with training, such as supporting people living with dementia and specific health conditions such as Parkinson’s and diabetes. People were supported with preparing meals and drinks, as needed. People were supported to access health care support as needed.

People were involved in making day to day decisions about their support and reviewing their care and support. People’s privacy and independence was respected. Care plans and assessments were regularly reviewed and updated when things changed. People were confident to complain if they need to, and complaints were responded to in an effective and timely way. People were supported in a dignified and personalised way at the end of their lives.

People’s views of the service had been sought, and action taken where appropriate. Staff worked in partnership with other professionals.

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 Requires Improvement (published 14 January 2019).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches of Regulations in relation to good governance and notifications of incidents 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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

London Care Abbotswood provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

People using the service lived in 62 one or two bedroomed purpose-built flats in Abbotswood.

Not everyone using London Care Abbotswood receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager in post at the time of the inspection. 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.

We received variable feedback from people about the planning of their care visits. Some people told us that they would like to know which staff to expect and when. This feedback had also been received by the provider through other systems, but no action had been taken to discuss or resolve the issue.

When accidents and incidents had happened, the records did not consider how to reduce the risk of it happening again. This had been acknowledged by the provider as an area requiring improvement and they were in the process of finding ways to improve the recognition of lessons that could learnt from these.

Audits of the records relating to medicines had not always been completed robustly. Whilst the risk to people was considered low; most other errors could be explained as the person being out during their expected visit or the member of staff forgetting to sign the form, this was an area which required improvement. Other quality assurance had been completed robustly.

One person described London Care Abbotswood to us, “It’s a very pleasant place here and it’s not often you meet anyone who is grumpy or unsociable or unhelpful.” Staff knew people well and treated them with kindness, dignity and respect. Another person told us, “Generally speaking it’s very good.”

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

There were sufficient staff available to meet people’s needs and people told us they could change their care visit times to suit if they needed to. Staff were trained to meet people’s needs, including a specific training programme when they began working at the service. Robust recruitment processes ensured suitable staff were employed.

People’s needs were assessed before they began using the service. Care plans were personalised and considered people holistically. Risks to people were considered and mitigated. Risks around people’s environments and the spread of infection were also considered and managed.

People told us they could raise any concerns with staff and the management team. Complaints were managed effectively.

There were good links with healthcare professionals and other agencies ensure people had the right support. When needed, people were supported with end of life care, by the staff team and their work with other agencies. Other professionals told us that staff worked in partnership with them.