Abbots Care Limited (Hertfordshire)

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the service met people’s needs.

At our last assessment we rated this key question good. At this assessment, the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People felt care was person centred, A person said, “My care plan has been reviewed recently as when I first started with the company I was on [number] calls a day. Now, I have improved. I am down to [number] which I agreed.” Another person said, “The care is good and most of the staff are good and do what I expect them to do.” A third person said, “All the carers are very caring they help me with anything. I find it so lovely the carers really do care.”

However, some people felt this needed to be improved. A relative said, “Two regular carers are brilliant. They know the routine, they will take 5 minutes to ask how I am, and they make my life better.” They went on to say that some staff needed a better approach and there should be more training for staff especially in dressing the person they were helping appropriately.

The provider was invested in training their staff, so they could provide a person-centred service for people. There were additional checks and support in place to help ensure staff knew how to carry out tasks in the best way for people. A relative told us when their family member needed a stoma, Abbots Care arranged for a nurse to teach the staff how to change a stoma.

Staff told us they felt people were treated well and supported appropriately. A staff member said, “I would like to believe Abbots Care is providing quality care to its customers.”

Care plans provided detail about people to help enable staff to support them appropriately and in a person-centred way. A person told us staff recorded when they had supported them with tasks. They said, “They have to put a QR code and write what they have done, they are very efficient.”

Some staff said the document was too large to read on arrival at a person’s visit so when new staff attended, at times, people had to guide them. The provider was aware the size of care plans and access on arrival was a challenge so were working on ways to address this.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The provider and management team had a clear understanding of the health and social care needs of the people they supported. They ensured there was access for people to use services and health support in the community.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People and their relatives were provided with information in a format which suited their needs. The provider issued handbooks with key information about the service to people they supported.

Some people did not have access to their care plans. The provider had added this to their service improvement plan to resolve.

People and their relatives gave mixed views about the office teams and provider’s response to their feedback, queries and complaints. A person said, “The care I receive is generally good; I ring the office if I am unhappy and they sort it out for me which makes me feel a lot better.” A relative said, “If I was unhappy with anything I would ring the office, and they would sort things out for me.”

However, some relatives felt it took a while for improvements to be embedded. A relative said, “I have raised concerns, the management inform the carers, and it improves for a while and then slides back which is frustrating for the family.”

The provider was aware there had been come communication issues and were working on ways to address this. This included introducing care coordinator calls to people. A report provided to us stated that all complaints they had received were responded to within the required timeframe.

Complaints were recorded and responded to in accordance with the provider’s complaints policy. A review completed by the provider stated they were all completed in the required timeframe. When we have had the need to share information of concern with the provider, we have found them to be receptive and responsive to the information. They have provided us with an investigation and outcome for all issues we have raised leading up to and during this assessment. Many of the point raised, the provider was already aware of and working on a resolution.

A statement taken from the provider’s internal monitoring report stated, ‘The significant increase in complaints received is welcomed following our review of how we gain feedback and promote clients, families and professionals to feedback to us when our service is not what is expected. Care worker conduct and quality of care continue to be the biggest area of concern, we are continuing to investigate each complaint in full, looking to establish root cause and trying to rectify bad habits and poor practise through additional training, coaching and mentoring. If care workers are then still unable to reach the required standard within their role, we are actively carrying out disciplinaries and in some cases ending employment with Abbots Care. Communication concerns are rising and to improve this we are constantly reviewing resources within teams and how the use of Artificial Intelligence (AI) such as the new chatbot on the well-being app can support and improve communication.’

There were surveys completed and the actions from these compiled to enable resolution to any areas needing addressing.

The service received a large number of compliments from people and their relatives about the care and support they had. These included, ‘[Staff member] is fantastic, she is absolutely lovely, I wouldn’t know what to do without her. Carers cook for me, they help me with whatever help I need.’, ‘The carers look after me and help me live longer, they support me with all the care needs provided to me.’ and ‘The service provides me with a routine, my social and emotional needs, keeps me safe. What Abbots do well - Kind, caring, patient, friendly and respectful.’

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People could access health and social care professionals and services when needed. Staff supported people to access these services when needed. This included contact with the GP, nursing or mental health teams and calling ambulances when urgent care was needed.

Staff were aware of people’s right to have equal rights in accessing services and recorded their decision making in care notes.

The management and office team supported staff with this when needed. For example, when resolving an equipment or medicines issues.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The management team had oversight of care and support provided. This helped them ensure staff were aware of people’s rights to equal experiences and outcomes and could challenge this should it be needed.

People’s care plans noted if they had a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) in place and any additional documentation, such as power of attorney, in relation to their future planning. For those receiving end of life care, there was a plan in place. This included all relevant information to help ensure staff supported people appropriately and in a way they had chosen.

Staff supported people with compassion, at times, visiting outside of work hours to provide additional support to family members.

The service had previously supported a person without any family. The local authority was responsible for managing the money for the person’s funeral. As the person passed away at the weekend, the money was not readily available. The provider’s care and management team worked with the funeral directors to ensure there was not a delay, and the person was treated with dignity after they had died. The staff member stayed with them until the funeral director arrived. As the person had no family, staff attended the funeral to ensure the person had a proper send off.

There was end of life care training as part of the induction process. A member of the management team told us specialist training would be delivered to staff supporting people at the end of their life should this be needed.