Abbots Care Limited (Hertfordshire)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment, the rating has remained Good.

This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People and relatives felt they had enough support and information when they started using the service. A relative said, “[Person’s] care plan was done via the hospital and we went through this with someone from Abbots Care who told us what to expect and the family had added to it stating [person] forgot to eat so carers would make sure they ate their food and measured their drinks.” The relative said they felt listened to and care staff worked with them to see what things worked best.

Staff felt they were given enough information when they started supporting people. A staff member said, “We receive updated information about a service user’s needs before we begin support, including care plans and risk assessment.” Another staff member said, “The Community Facilitators usually visit new clients fairly quickly to conduct assessments and provide us with relevant information on the person’s care plan in preparation for our visits. We may encounter cases occasionally where we meet new clients on the Reablement service prior to their assessments being conducted. We have received training in such cases to provide the essential care needed, especially in relation to medication support and other needs.”

The service worked with a trusted assessor which helped them provide a robust and effective assessment for people to ensure their needs would be met in an appropriate and safe way.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe. A person said, “They make me feel safe. They are very supportive.” Another person said, “Safe, very much so. I’ve had no incidents with them. No problems.” Relatives also felt their family members were safe using the service. A relative said, “Absolutely safe, they are always very kind to [person] from the reports we get. [Person] has never mentioned anything, we are very happy with them.” Another relative said, “100% safe, they are competent, they know they are [nationality] and deal with their language well. They know their needs and how to deal with them. If there is a problem they call me, it’s easy.”

Staff knew how to recognise, and respond to, abuse. A staff member said, “If I had concerns for someone's safety, I would follow safeguarding procedure immediately. I have received safeguarding training and feel confident in raising any concerns. I know the proper channel to do so.” We were told by people and relatives’ that staff were kind, patient and caring in their approach.

Safeguarding concerns were processed, reported and recorded appropriately. Staff received training.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe. A person said, “They make me feel safe. They are very supportive.” Another person said, “Safe, very much so. I’ve had no incidents with them. No problems.” Relatives also felt their family members were safe using the service. A relative said, “Absolutely safe, they are always very kind to [person] from the reports we get. [Person] has never mentioned anything, we are very happy with them.” Another relative said, “100% safe, they are competent, they know they are [nationality] and deal with their language well. They know their needs and how to deal with them. If there is a problem they call me, it’s easy.”

Staff knew how to recognise, and respond to, abuse. A staff member said, “If I had concerns for someone's safety, I would follow safeguarding procedure immediately. I have received safeguarding training and feel confident in raising any concerns. I know the proper channel to do so.” We were told by people and relatives’ that staff were kind, patient and caring in their approach.

Safeguarding concerns were processed, reported and recorded appropriately. Staff received training.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People and their relatives told us they felt staff supported them safely. A person said, “I walk with a stick, and they make sure I am safe before they leave.” Another person said, “I feel totally safe in the company of the carers. I have two carers as they assist with moving. as I am unsteady on my feet.” A relative said, “My loved one is prone to pressure sores and doesn’t have any at the moment. The carers are vigilant in identifying any sores and will let the office know if they have any concerns and the office staff will inform the family.”

People had individual risk assessments, and these gave staff guidance and were reviewed as needed. A staff member said, “I believe risk assessments are completed for all clients and any issues would be highlighted in the relevant care plans. We are also trained to conduct safety checks on all equipment that we may utilise to support our clients such as hoists and hospital beds.”

Accidents and incidents were monitored to help reduce reoccurrences and ensure all required actions were taken. Some people stated some accidents or incidents had not been reported to the management team or recorded in the person’s notes. The provider had identified this had been an area for development and taken action to address this.

This included additional checks and more robust recording. The management team stated they found an increase but this to be due to better reporting from staff. A statement taken from an internal monitoring report stated, ‘Overall the reporting and recording of incidents and accidents has increased dramatically since we introduced a real time reporting function. We have also raised awareness of the important of raising a concern with all staff. This has led to us being able to identify concerns that need urgent attention such as medications that have run out, clients who are in mental health crisis or at risk of self-neglect so we can put in place actions to support or raise further concern to NOK’s, safeguarding teams and medical professionals.’

A member of the management team told us, “We have been training staff to report anything and everything and we will review the information. Often it does not need to be reported but it is better they report. We have a team whose role it is to review the information, report to safeguarding if needed and take any other actions needed.”

People and relatives told us staff helped ensure their safety in their homes. A person said, “They use the key safe always, introduce themselves and make sure the building is secure when they leave.” However, a relative said, “My loved one wears a pendent and sometimes the carers forget to put it on before they leave which causes the family to be concerned as in the past they have fallen, if the carers forget the family ring the office. ” The provider was not aware of this issue and commenced an investigation following the feedback.

Care and support were carried out in people’s own homes. Assessments were completed by the management team to help ensure staff member’s working environment was free from hazards.

Staff had received training in relation to safety hazards and checked these points on their visits. Staff were aware of hazards and how to reduce these. A staff member said, “When we go into people’s homes, safety checks are done by office and also as carers we also check to see if it’s safe and if not, we raise concerns.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People and their relatives told us staff mostly arrived when expected and stayed for the required time. A person said, “The carers usually turn up on time, they have never let me down.” Another person said, “90% of the time the carers turn up when expected I have only been let down once and I rang the office who sorted it straight away. If I have any appointment to attend and need to leave on time, I ring the office in advance and they make sure the carer is on time. It all works well for me.”

However, some people did tell us staff were at times late. A person said, “[Staff member] is my main carer, I won’t know who I will have on the other days. On those other days it can be five to eleven, or five to twelve. I’ve told them I’m not happy with it being late.”

Most people and relatives told us they normally had a call if staff were going to be late. Some people did say communication about staff being late or which staff were coming at times needed to be improved. We reviewed records of visits and found most were on or around the scheduled visit times. These were monitored by the provider with a new AI system being trialled for better oversight and this would also inform people if staff were running late.

Staff told us there were enough of them to provide visits to people on time and stay for the planned visit time. They told us visits were not missed and on occasions where they would be late, the office staff would contact people to let them know. A staff member said, “In general, there are enough staff to meet the needs of the people we support, while sometimes occasional delays can happen, but they are managed well, and communication is smooth and easy.” Another staff member said, “Calls are sometimes late, impacted by circumstances such as a need to extend a client’s visit to provide essential care or delays due to traffic. I have not experienced any calls that have been completely missed, only delayed. The biggest challenge we face on the round would be a lack of adequate travel time between client visits.” The provider advised that the scheduling app planned in travel times for in between visits. This was at times impacted by roadworks.

There was oversight of visits to check for late or missed calls. Action was taken when this occurred to help prevent it happening again. There was an action in place for the office team to improve on calling people if staff were running late.

Staff said they felt they had enough training and support for their roles. A staff member said, “I feel I have enough training with Abbots Care in regard to executing my duties as a carer. When it comes to training Abbots Care keeps on training us with refresher courses, online and face to face. Whenever I am due for a training Human Resources reminds me through emails to attend to these courses, where we are trained to provide best quality care. They make a follow up on our competency like after a training a professional in that field will come to observe we can perform specialised care.”

We saw that mandatory training had been completed by all staff and supervision took place which supported staff and assured the management team of their competency and learning.

There was a recruitment process in place which helped to ensure those employed were fit to work in a care role. A checklist was in use to ensure all required documentation was obtained. This included criminal record checks, references, checks on any employment gaps and the applicant’ right to work in the UK. A staff member said, “My interview was scheduled, and I did my interview then was asked to send my paperwork and references.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People and their relatives told us staff practiced good infection control and used Personal Protective Equipment (PPE) when needed. A person said, “The carers all wear PPE when doing personal care and they dispose of it after use.”

Staff were aware of how to reduce the risk of infections and had received training. A staff member said, “We were taught to wear our PPEs correctly and when not feeling well inform the office so that we are excused from work. Disposing used PPEs is also essential in reducing spread of infection. PPEs reduce spreading infection from one house to another so wear them when I step into someone house and remove all when I leave and make sure to bin them appropriately. So, on a work day I carry more than enough PPEs so as not to run out of them.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Systems were in place to help ensure safe management of medicines. Staff supported some people to take their medicines, for others they prompted them to take their medicines.

Staff had received training and there were checks carried out to help ensure staff were working safely.

Medicines audits were carried out to give the provider oversight. Where medicine errors and issues had occurred, an action plan was in place to address this. For example, follow up calls with the pharmacy and contact with the GP.