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Abbey Nursing & Care Agency Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 5 December 2018

The inspection took place on 8, 9 and 18 October 2018 and the first day was unannounced. The service was last inspected in March 2018 and was rated ‘Inadequate’ overall.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and specialist housing. It provides a service to older adults, younger adults with a disability and children. At the time of this inspection the service was supporting 44 people.

Not everyone using Abbey Nursing and Care receives regulated activity; the Care Quality Commission (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 manager in post who had been registered with CQC since October 2010. 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 and their relatives told us they received care and support that was safe.

Recruitment processes had improved. All relevant documentation was collected prior to staff commencing employment. Where required risk assessments were completed to ensure staff were suitable to work with vulnerable people. But control measures in place to reduce risk had not been carried out as stipulated.

Most people were supported safely because the provider had assessed the risks involved and staff had sufficient details and guidance to carry out their duties safely. We found one example where no guidance had been developed and the registered manager addressed this issue during the inspection.

People using the service were protected from harm due to the agency’s reporting systems and staff knowledge. Staff were well-informed about the types of abuse and the action they would take if they suspected that abuse was taking place.

People were supported by staff who knew and understood their needs. People and their relatives told us they had consistent staff supporting them. People told us staff most times arrived punctually for their visits and they were informed if staff were running late.

People told us staff had good hygiene practices and wore personal protective equipment (PPE) when carrying out their duties. This should help to ensure that people were protected from the risk of infection.

Where required, people were supported to take their medicines safely. Staff had the relevant training and competencies to administer medication safely and recorded these appropriately.

Staff had the right knowledge and skills and received continuous support to function in their caring role. People and their relatives told us staff did their jobs effectively. Staff received an induction and mandatory training prior to working with people. There was evidence that all staff were supported with ongoing training including refresher training as required. However, we found two examples where staff should have completed refresher training in one topic area but there was no record of this. Staff received regular supervisions and appraisals to help ensure they received the necessary support to carry out their roles.

People’s rights were protected because the service worked within the principles of the Mental Capacity Act (MCA). Staff sought people’s consent before undertaking tasks. Care records we looked at contained evidence that people had consented to the care they received.

Where assessed as a need, people were supported to maintain good nutrition and hydration. Everyone we spoke who required this support told us they were satisfied with the way staff consulted them prior to carrying out the task.

People told us the service supported their access to heal

Inspection areas

Safe

Requires improvement

Updated 5 December 2018

The service was not always safe.

Recruitment processes adequately ensured suitable care staff were employed.

The registered manager did not always demonstrate that safeguarding incidents were investigated effectively.

Specific guidance relating to people’s identified risks were not always in place to help staff support them safely.

Effective

Requires improvement

Updated 5 December 2018

The service was not always effective.

Staff had received an adequate induction. For some staff, refresher training had not been completed as identified.

The service was working in line with the Mental Capacity Act. There were systems in place to assess people’s mental capacity and monitor for change.

The service supported people to access healthcare professionals when required.

Caring

Good

Updated 5 December 2018

The service was caring.

People received kind and compassionate support by staff who were trained to do so.

Staff treated people with dignity and respect and encouraged people to maintain their independence according to their ability.

People’s equality and diversity needs had been considered and recorded in their care plans.

Responsive

Good

Updated 5 December 2018

The service was responsive.

People were familiar with the complaints process and told us their complaints had been dealt with appropriately.

Care plans were person centred and contained a holistic assessment of people’s needs. This included personal histories, communication needs and equality and diversity information. Care records were reviewed regularly or when people’s circumstances changed.

Well-led

Requires improvement

Updated 5 December 2018

The service was not always well led.

The registered provider’s oversight of the quality of the service had improved. However quality audits needed to be more robust.

The registered manager had made appropriate notifications of incidents to the Care Quality Commission as required by law.

People told us their feedback or their views on the service they received had been sought.