Archived: Abbots House Registered Supported Living

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Staff did not always have a person-centred approach. We found a breach of a legal regulation in relation to person-centred care. People’s care had been affected by the conduct and approach of staff. We received feedback from multiple relatives and a staff member about some staff repeatedly being on their personal phones while supporting people. Therefore, they were not fully engaging with people. The language used by staff was not always empowering or involving the person. Staff also had poor confidentiality when speaking about people in front of others. The provider had also identified, and we had reported to us, examples of unprofessional conduct by staff which is not person-centred. The provider had already commenced work to work with staff to make improvements.

People could access and ask for support when they needed this. However, we were concerned about the level of oversight staff would have of a monitor in place to monitor a person’s health condition, if staff were not present in the area where the monitor was located.

Despite this, people had personalised care plans in place and staff knew people well. People were supported to be independent; people told us this, staff were able to give examples how they supported this, and we observed this. People were taking part in individualised activities; however, the feedback we received from others was that this did not go far enough and there was scope to extend the variety of activities available for people.

Staff told us they generally felt well supported and appreciated. However, we had been contacted multiple times by anonymous whistlebower(s), but as they had remained anonymous, we could not explore things further with them. Staff had team meetings and could access resources for support.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives told us they observed staff using their phones during work time or staff sitting at a table in the communal area, instead of interacting with and supporting people. One relative said, “Staff are on their phones quite a bit. I don’t feel I can ask them why they’re on their phones.” Another relative said, “I want staff to engage with my relative and engage with other people with learning disabilities. Staff are not there to just sit there. It’s not just ticking boxes and that’s how I feel it is.” Another relative also said their relative had told them staff would be on their phones while supporting them out in the community.

A staff member also told us there had been instances of staff looking at their phones whilst working rather than engaging in an activity. This is not treating people with kindness, compassion and dignity or in a person-centred way.

Other health professionals did not raise any concerns about the conduct of staff. One professional said, “All engagements with the individual and staff interaction with myself they have appeared respectful.”

We observed one staff member answer their personal phone while at work. The staff member was not directly supporting a person at the time, so this did not impact anyone, but this was still considered work time. Staff were kind when interacting with people but were not always mindful of their behaviour or language. For example, they would speak about people in front of them without always including the person or using infantilised language. While people did not seem uncomfortable about this, it is important for staff to have professional boundaries and be respectful, so people know to expect the best care and support at all times.

Staff had poor confidentiality while speaking in communal areas or they would leave documents containing personal information out in communal spaces with no staff present, so other people could access it.

Despite this, people appeared to have a positive relationship with staff; people knew who the staff were and appeared comfortable interacting with them. People often went into the registered manager’s office and clearly had a positive relationship with the registered manager also.

People did not raise any concerns with us about being treated as an individual. However, some people were being restricted from accessing certain communal areas at certain times of the day in order to support ones person’s needs. However, this approach did not always take into account the needs of all.

Staff knew people’s individual likes and dislikes and understood people liked to partake in different activities. However, staff were restricting some people from communal areas due to 1 person's needs, so people were not all treated individually.

We did not receive any concerning feedback from partners about people being treated as individuals.

We observed people partaking in individualised activities, some did colouring, some watched TV, some went out to the local shops, a walk or caught the bus to shops further afield. However, as we observed the staff approach was not always empowering and we were told of (and saw records related to) instances of unprofessional conduct, we could not be sure people would always be treated as individuals.

People had personalised care plans in place, which were specific to them. These contained details about their preferences, health conditions and support needs. People were offered the opportunity to discuss their religious needs or their sexuality, if they chose to.

For those who were able to tell us, they said they were supported to remain as independent as possible. One person told us, “Oh yes, I make sure I am [involved in decisions], and my relative. I am involved.” One person told us about how they were supported to manage their condition, “Staff help me prepare, but I do it myself.” Another person told us staff supported them when they were having a shower, but they did most of it themselves.

Staff were able to give us examples of how they supported people to be as independent as possible, such as offering choices and supporting people to carry out their personal hygiene or other tasks, rather than completing things for them. One staff member said, “I try not take things away they can do themselves, it would take their independence away. They can chop veg and put something in the oven or help to do washing and cleaning.”

People were supported with their medicines in a personalised way; some people were able to manage some aspects of their medicines and we observed they had access to these, whereas others relied on staff to administer all of their medicines.

Some people were also supported to access the community independently and they came and went as they pleased. This access was tailored to each person’s needs.

People had care plans in place to guide staff about the level of support people needed.

People had access to staff throughout the day and night if they needed them. One person used a phone to communicate with staff and ask for support so staff could attend to them when needed.

Staff were aware of people’s ways of communicating their needs – such as by phone calls, letters, emails, as well as verbally.

One person had a sensor in place at nighttime, which would alert staff if they became unwell. The monitor for the sensor was in a communal space for staff to hear during the night, however staff would not always be in this communal area at nighttime. The monitor could not be moved far otherwise the signal would not reach so it may not work. Therefore, there was a risk this may not always be effectively monitored. However, the person had not come to any harm as a result of this.

We observed staff answering the phone to a person when they called the staff mobile phone and supporting them. People also approached staff throughout the day to ask a question, ask for support or just chat.

Staff told us they generally felt supported. One staff member said, “I feel appreciated. I always get thanked for what I do, both management and my colleagues do.”

Staff told us about a scheme where they could nominate colleagues if they went above and beyond at work. However, we had been contacted repeatedly by anonymous whistleblower(s). Therefore, at least 1 staff member was not satisfied at work, but we had not been able to explore this in more detail with the whistleblower(s) as they had not left their contact details.

Staff told us, and we saw the minutes of, team meetings where there were discussions about the service, ideas from staff, and things staff needed to be reminded of or aware of. There was a free confidential phone number staff were able to use for support and counselling, if they felt they needed to use. This was both for personal and work-related support.