We carried out a review of the data available to us about Abbey House - Evesham 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 Abbey House - Evesham, you can give feedback on this service.
Abbey House – Evesham is a residential care home providing personal care to up to six people who live with learning disabilities and autism. At the time of the inspection there were six people living at the home.
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. The size of the service having a negative impact on people was mitigated by the building design fitting into the residential area. 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 showed us they liked the staff supporting them and had developed close bonds with staff caring for them. Relatives told us staff were exceptionally considerate and extended their caring approach to people’s relatives, too. Staff used their knowledge of people’s unique needs and preferences to ensure they were included in day to day decisions about their care. Staff treated people respectfully and assisted them to maintain as much independence as possible.
Staff understood people’s safety needs and assisted them to reduce risks to their safety. People were supported by staff who understood what action to take if they had any concerns for people’s well-being. Systems were in place to reduce the chance of infections and to ensure people had the medicines they needed to remain well, both at Abbey House – Evesham, and when people chose to spend time in the community.
People’s needs were assessed and reviewed as their needs changed. Staff were supported to provide good care to people through opportunities to develop their skills further. People were supported to have enough to eat and drink, based on their preferences. Staff supported people to attend appointments with other health and social care professionals, so they would enjoy the best health possible. 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.
People’s preferences and needs were focused on when their care was planned. Relatives’ views were an integral part of care planning arrangements. The views and advice from other health and social care professionals was considered when people’s risk assessments and care plans were developed. This helped to ensure people would enjoy a good quality of life. Systems were in place for managing any complaints, concerns or suggestions and to take learning from these. 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 enjoy new experiences and maintain their independence.
Staff had received compliments for the way they sensitively supported people at the end of their lives. The registered manager planned further development of people's care plans, to identify their wishes in the event of their sudden death, so people's preferences would be known.
Relatives were complimentary about the way care was organised and the home was led. Staff felt supported to provide good care, which was informed by best practice standards. The registered manager was supported by the provider to check the quality of the care provided and to drive through improvements to benefit people living at the home. This included continuing to develop ways of successfully working with other organisations.
Rating at last inspection
The last rating for this service was Good (published 21 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
At the last inspection on 16 December 2014 the service was rated as good. There was a registered manager in place at the time of our 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.
People at Abbey House live with complex learning disabilities and were unable to verbally communicate with us. We spent our time with people in the communal areas of the home; we observed how staff interacted with people and how people responded to staff. From what we saw and heard the atmosphere in the home was calm and relaxed. People were free to mobilise around the home through their choice. People were happy and responded well to the staff who were working on the day of our inspection. Relatives we spoke with felt their family members were looked after well and kept safe by the staff who worked there.
People lived in a safe environment as staff knew how to protect people from harm. Staff recognised signs of abuse and knew how to report this. Risk assessments were in place and staff took appropriate actions to minimise those risks without taking away people’s right to make decisions.
There were sufficient staff on duty to meet people’s needs and keep them safe. Staff worked flexibly to reflect people’s activities that were happening that day. People’s medicines were administered and managed in a way that kept people safe.
The provider supported their staff by arranging training in areas that were specific to the people who lived in the home. People received care and support that met their needs and reflected their choice. Staff provided people’s care in line with their consent and agreement; staff understood the importance of this. We found people were supported to eat a healthy balanced diet and with enough fluids to keep them healthy. People had access to healthcare professionals and attended appointments where required.
We saw staff treated people in a dignified and respectful way. Relatives told us that they felt staff treated their family member kindly, with dignity and their privacy was respected.
We saw that relatives, healthcare professionals, and where appropriate, the people, were involved in the planning their care. Relatives we spoke with and records we viewed showed that relatives had expressed their views and decisions and they were listened to and acted upon in-line with the person’s best interest.
Relatives knew how to complain and felt comfortable to do this should they feel they needed to. We looked at the providers complaints over the last 12 months and found that no complaints had been received.
Staff told us the provider visited the home and ensured people were happy with the service they were receiving. The registered manager demonstrated clear leadership. Staff were supported to carry out their roles and responsibilities effectively, so that people received care and support which was in-line with their needs and wishes.
We inspected Abbey House on the 16 December 2014. Abbey House provides accommodation, personal care and support for a maximum of six people whose primary condition is learning disabilities. At the time of our inspection there was a registered manager. 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 found that people were kept safe by trained staff who knew how to protect people. We found that people were cared for in a supportive way that did not restrict their freedom. There were sufficient staff to meet people’s needs.
People’s medication was stored and managed in a way that kept people safe. People received their medication at the correct times by staff who were trained to do so.
People who lived at Abbey House were unable to tell us verbally if the staff were kind and caring however we observed that people were relaxed and calm in the home. We saw care staff spoke kindly to people and maintained their dignity when providing assistance. People were supported to remain independent and received assistance when they needed it.
We found that the provider was meeting the legal requirements for the Mental Capacity Act (MCA) (2005) and the Deprivation of Liberty Safeguards (DoLS). Staff understood what this meant for the person and the way in which they were to be cared for.
People were provided with a healthy balanced diet that matched their dietary requirements. Relatives spoke about the good support people were offered with maintaining their nutrition where there were concerns. We observed people received regular fluids and staff supported those who needed assistance.
Abbey House had an experienced team of staff and management who knew people well. This meant that the registered manager knew what people’s needs were, what skill mix of staff they had and was able to ensure that staffing levels remained at a safe level for each shift. Staff told us that they had no concerns around staffing levels that they were able to meet people’s needs and did not need to use agency staff.
We found that the service was responsive towards people’s social needs. Staff showed us how they used people’s history and past experiences to develop activities that people enjoyed and that they were personalised to their choice. Staff knew people’s likes and dislikes and respected their wishes.
Relatives told us they found staff and the registered manager approachable and told us they could raise any complaints or concerns should they need to. Most relatives we spoke with told us that they had never needed to complain or had anything to complain about. One relative had raised concerns and the registered manager had responded to this.
Through regular meetings and using an ‘open door’ policy we found that the registered manager promoted a positive culture, in which they invited people to talk with them about any concerns they may have. We found that when concerns were raised to the provider, the provider had acted promptly and appropriately.
We found the registered manager had systems in place to ensure that the quality of the care was monitored. Checks such as medication and environment were carried out and completed monthly. Where there were any actions following these audits they were followed up and improvements had been made.
We found that people were being supported to make choices and decisions about the care that they received. One relative told us: "What we have seen are staff that will always try to listen to what the people want".
We saw that people appeared relaxed and comfortable. They were being cared for in a way that they preferred. The relatives we spoke with were positive about their experiences of the home. One person said that the: "Service is excellent". Another relative told us that people living at Abbey House are: "All very well cared for".
We found that medicines were being appropriately stored and administered.
There was a complaints policy in place and people were being supported to raise any concerns.
The relatives told us they were happy with the standard of care provided at the home. One said, 'We're extremely pleased. X is very happy. You can tell he's always happy to go back there. We regard it as a home from home. The staff are virtually family.' Another told us, 'They always seem to go the extra mile under very difficult circumstances. '
The relatives we spoke with told us that they knew how to raise concerns. One said, 'If I wasn't happy about something I'd speak to the manager or the deputy. I feel they'd listen. Actually there are a number of staff I could speak to.'
They said that staff understood the needs of people who lived at the home and so were able to provide appropriate care and support. Talking of their own relative they said, 'They know his character very well.'
People were not able to talk us about their care and treatment. We observed how care workers met the needs of people who lived at the home. Care workers were able to talk to us about each person as an individual, understanding their needs and abilities and how they communicated their thoughts and feelings. We saw that people who lived at the home appeared comfortable and relaxed and were positive when interacting with care workers. The home provided activities and social interaction in an atmosphere that was calm, quiet and inclusive.
People accessed services in the local community and five people had attended a day centre, four days a week. The home had considered the age range of people living in the home in deciding how to meet their health, care and welfare needs. There was good care worker involvement which provided constant care, praise and encouragement for people who lived at the home.