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Abbey Nursing & Care Agency Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 16 January 2020

About the service

Abbey Nursing and Care agency is a domiciliary care agency providing care to people living in their own homes, so they can live as independently as possible. At the time of our inspection the service was supporting 36 people with personal care.

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

People’s medicines were not always managed safely. One person had not always received their medicine as prescribed, and medication administration records were not always completed accurately in line with national guidelines. Medication audits had not identified concerns with people’s medicines.

The provider could not demonstrate that all care workers had completed training which enabled them to meet people's care needs in a safe manner.

Audits and checks were in pace; however, these were not always effective at identifying concerns. There was a lack of robust oversight with aspects of the service. The provider has been in breach of regulation 17 (good governance) three consecutive occasions, which demonstrates a lack of continuous improvement and effective leadership.

People were involved in the development of their care plans and relatives were involved where this was appropriate. The plans generally contained person-centred information. However, some staff told us they did not always have time to read people’s care plans. Staff told us they got to know people during visits to their home and delivered care in line with their preferences. People and relatives told us staff generally knew people well, but there were concerns raised about newer members of staff not knowing people as well. People told us this did not impact on their level of care as newer staff were generally accompanied by more experienced staff on care calls.

Risks to people were assessed, and appropriate plans were in place to keep people safe. One person did not have a plan in place regarding a specific medical condition, but the registered manager made arrangements to complete this immediately. However, there were no systems in place to effectively analyse incidents to ensure learning could be implemented to prevent reoccurrence.

There was some mixed feedback from staff about the management of the service. Some staff felt the management team were not supportive and communication needed to improve.

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.

There were enough staff to meet people's needs. There were some concerns raised by staff and relatives regarding staffing levels, but the registered manager told us they had halted new packages of care until recruitment had been completed. People told us they had good relationships with the staff that supported them. People were treated with dignity and respect. Staff supported people to be as independent as possible and express their views about the service and their care.

People told us they felt safe with the care provided by Abbey Nursing and Care Agency.

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 (published 5 December 2018).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

At this inspection we have identified breaches in relation to the management of medicines, staff training and good governance.

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 th

Inspection areas

Safe

Requires improvement

Updated 16 January 2020

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 16 January 2020

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 16 January 2020

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 16 January 2020

The service was responsive.

Details are in our responsive findings below.

Well-led

Inadequate

Updated 16 January 2020

The service was not well-led.

Details are in our well-Led findings below.