Archived: Abbots House Registered Supported Living

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We found a breach of a legal regulation in relation to person-centred care. People had missed out on a regular communal meal due to previous issues of staff conduct. This meant people’s individualised preferences had been impacted by staff conduct. However, there was feedback from relatives and staff that the variety of activities was lacking and more proactive planning by staff was needed.

We received mixed feedback about the use of communication tools. We observed people used a variety of methods, such as staff drawing pictures, the use of a telephone, via email and verbally. However, it was felt other communication tools could be explored to further complement people’s communication and to fully empower people to communicate their needs. There was also mixed feedback about how feedback was acted upon. Relatives felt able to approach the registered manager and management. However, it was felt feedback was not always acted upon, or improvements were not always sustained. There was a meeting with the people who used the service, but this had not been regularly undertaken so there was a missed opportunity for people to offer their feedback.

People had access to the local community and to other support services. There was a core staff team for each person who reviewed people’s support and goals. The provider was working with commissioners to review how people’s support hours were planned and used to allow greater flexibility. People had been offered the opportunity to discuss their future plans, such as plans for the end of a person’s life, if they had wanted to.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People had missed out on a regular communal meal due to previous issues of staff conduct. This meant people’s individualised preferences had been impacted by staff conduct. Despite this, people told us they liked the staff. One person said, “I love my core team. I’ve got a good relationship with quite a lot of the staff.” A relative told us, “I know there’s one or two staff who have invested quite a bit with their relationship with my relative. My relative has good relationships with key staff.”

Staff knew people well and knew people’s individual likes and dislikes. However, the provider had identified instances of staff not always acted or speaking appropriately in front of service users and they were having to take action to address the approach by staff.

As we had observed staff not always interacting with people in the most appropriate way, we could not be sure people were always receiving the most person-centred care as staff were not always mindful of their approach.

The accommodation was in a residential area, with access to local shops, local green space, and buses to go further afield. One person was also able to undertake volunteering work in multiple organisations, with their relative helping facilitate and organise this.

The provider told us they liaised with those who fund people’s support in order to discuss ways of working and ideas of how commissioned hours could be utilised in a more flexible way. However, this process had only started following our site visit so there had not been sufficient time to fulfil and embed these changes yet.

Partners did not share any feedback about people’s care provision or access to services.

Each person had commissioned hours, and these were planned on the rotas and the use of them tracked to ensure people received their commissioned support. Work was ongoing to start using these hours more flexibly for people.

People had access to documents in an easy read format to assist them in understanding them, for example information leaflets and surveys. One person also used a phone to communicate with staff. However, there was a lack of communication tools used, other than staff drawing for a person, so some people may not always have access to the tools to empower them to access information or communicate effectively. Despite this, we still saw people interacting with staff.

Some people may have benefitted from using visual aids, such as prompt pictures or photos, however we were told these were not always in use. One staff member said, “Staff don’t use [communication] tools – I think we need to use them.” This meant people may be disadvantaged as they did not always have access to extra tools to support their communication or to support staff in helping people to make choices. Despite this, one person responded well to staff drawing them pictures and we were told this was used regularly.

People had care plans in place to direct staff about how people communicated and needed information, such as verbally or whether they needed easy read information. However, as we received feedback the use of communication tools had not always been used but were felt to be needed, we could not be sure how effective people’s plans were.

People and relatives told us they felt involved in their care. Relatives felt able to complain. One relative said, “I’d go to the [registered manager] in the front office, I’d feel able to.” However, there was mixed feedback about whether action taken in response to feedback and complaints would be sustained. One relative said, “We can go to [the registered manager] and they resolve things, they are more approachable and helped us with the problems we’ve had.” Whereas another relative told us, “I have spoken to management if I think things aren’t right. Everything is ok for a little bit and as soon as I take my foot of peddle it goes back to how it was before. They did listen to me and say it’s not good enough, but it happens again. I get exasperated and tired from it all.” Another relative told us, “We were told my relative would receive support [in a specific area]. It seems to have improved slightly; it needs keeping on top of.” Despite this, one relative said, “[The registered manager] seems approachable. I don’t feel there’s any unapproachable staff. The staff seem open and friendly. That’s the impression I get.” Another relative told us, “I get along pretty well with the [registered] manager. I feel they are open and honest with us.” Another relative said, “I do feel [the registered manager] does listen to me.”

Staff had mixed feedback about how listened to they felt, and whether action was taken in response to feedback.

There were mechanisms in place to offer people, relatives and staff the opportunity to give their opinion about the service. However, we could not be sure these opportunities always meant feedback was acted on. There were meetings for people and staff. However, meetings for people had not been regularly undertaken so they had not had frequent opportunity to come together as a group to discuss the service. One meeting had recently been undertaken and an action was in place on the provider’s action plan to ensure these continued regularly.

People were supported to access other support services. People were accompanied to medical appointments, either by staff or by relatives where relatives preferred to attend. People were also encouraged to maintain relationships. Some people had relatives who were heavily involved in their lives and often facilitated contact. There were no restrictions on visiting, people could have visitors whenever they chose and were able to visit friends and family at a time to suit them. One person said, “My relative is very supportive. My relative is able to visit whenever they want.”

The registered manager explained that if someone was unable to attend an appointment by visiting the venue the appointment was supposed to take place, they would try and facilitate a visit in people’s own homes, where possible. Staff knew people and relatives enjoyed spending time together and we aware some people liked to visit and stay with relatives for longer periods of time.

Each person had a ‘core team’ of staff, who were named staff heavily involved in the care and support of that person. The core team would still support other people and other staff would also be involved in supporting the person, but these core staff would have a specialised insight into their nominated person. The core team would have team meetings to review the support for that person and record these.

People told us they had access to activities and hobbies of their choice, such as arts and crafts, going out for walks, shopping, partaking in sports like badminton and athletics. There was also a local park and café people regularly accessed. People also very much enjoyed the communal bingo on a regular basis. People also had personalised activities in their bungalows, such as puzzles, computers and games consoles.

However, there was feedback from relatives and staff that the variety of activities was lacking and more proactive planning by staff was needed.

A relative told us, “I don’t think they do enough activities in the actual place. [My relative] does like [activity] and I think they’ve been once all the time my relative has been there. Sometimes [my relative] can’t go out because they have not got enough staff.” Another relative told us, “My relative’s horizons are so big. They restrict my relative and my relative hasn’t got the life they deserve.” Another relative said they felt staff did not look into options for events or activities for people to try, “There’s loads of stuff going on in the city. It feels like there is no middleman. Management and support staff, but no one directing.”

There was mixed feedback from staff. Staff were aware of the activities people liked to partake in, however, some activities had not been taking place (such as the communal meal) due to staff conduct. One staff member said, “We need to do more in the communal space and have more going on with activities, it has slacked off lately.”

The provider had recognised there were issues with the lack of flexibility of how the commissioned hours for people were planned and used. This meant people had not always had flexibility of choice. The provider had also recognised the culture issues with staff. The provider was taking steps to address the culture concerns and were working with commissioners to develop a better approach and we will check this has improved at the next assessment.

We did not directly discuss people’s end of life wishes with them but did discuss it with some relatives. One relative said, “The only thing they have asked me about are [my relative’s] religious beliefs if anything happened to them.”

Key workers for people reviewed people’s goals and longer-term future aims in their key worker meetings so action could be set on how to progress to these being achieved.

People had personalised care plans in place about their needs and wishes, if people or their relatives had wanted to discuss this.