Abi House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff and leaders promoted an open proactive culture to safety events. Incidents were reported and investigated which resulted in lessons learnt and supported continued improvement of practice. People and their relatives spoke positively about the staff and management team. They told us they could approach them with any ideas, worries or concerns. They had confidence action would be taken.

Managers were open and transparent, and it was evident they had worked hard to continually improve the service to provide people with safe, effective and person-centred care.

There was a process in place to monitor incidents, accidents and near misses. This ensured all accidents or incidents were individually reviewed and formally analysed monthly so prompt action could be taken where required. At the time of this assessment the manager told us, although the system was working well, they were looking at further developing it to record a more detailed analysis of incidents. The service demonstrated organisational learning and continued improvement.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored.

Staff and leaders had a collaborative approach with people and partners to maintain safe systems of care. People had detailed plans to take with them if they needed to go to hospital or for appointments. We reviewed records which demonstrated relevant and timely contact with external health professionals.

People and relatives told us they felt safe at the service. One person said, “I am safe and comfortable, I like it here.” This was echoed by other people who lived at Abi house.

Staff demonstrated knowledge about their role in safeguarding people. Positive behaviour support plans were in place for people who needed them, and staff were able to tell us how they implemented the guidance into practice. Staff told us they were proud they had been able to help people manage upset and anxiety and incidents were infrequent as a result.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). Staff received training in the principles of the MCA and understood their role and responsibility in upholding those principles. The manager kept an overview of all DoLS. Individual support plans reflected when restrictions were in place and the reasons for the restrictions.

Records were reviewed and demonstrated the service had a system to manage safeguarding concerns, and this included the type of alleged abuse, people involved and description of the incident as well as the outcome and any lessons learned.

Risks were managed in a way which supported people to be as independent as possible and so that they could enjoy activities they liked doing.

The manager and staff demonstrated detailed knowledge of the needs and preferences of people living at Abi house. Managers and staff shared a positive, person-centred approach to the management of risk. Management ensured risks to people were regularly reviewed, and guidance to staff updated as needed. Staff were knowledgeable about risks to the people they supported. For example, where people required support to manage change in their life, additional support had been put in place to help them understand what was happening. This had partly reduced the impact on the person. Staff spoke confidently and accurately about the support people needed to manage their epilepsy and other health conditions.

Processes were in place to record and audit incidents which led to the identification of trends and actions were put in place to mitigate the risks.

People indicated positively about the building and their bedrooms. Each person’s room was decorated to their own personal tastes and interests. People had individual plans in place to aid their evacuation in the event of fire. These were specific to the needs of each person. At the time of our visit, significant building work being carried out. This was to create better exit routes and improve access to laundry facilities. People were supported to manage the extra noise and disruption and were safely supported to watch or engage with the workers as they wished. One relative said, “I am overjoyed about the maintenance. They are managing it well and still supporting the people who live there to move around, the owners are committing to improving the home maintenance has got a lot better.”

The house was clean and fresh with shared areas decorated in an uncluttered fashion to suit the needs of people but remaining homely with framed photographs on some walls.

Managers told us there was a plan for further maintenance and decoration as part of a rolling programme.

Staff had received fire awareness training and understood the actions they should take should a fire occur. Staff were clear about the regular safety checks to be carried out. One staff showed us the food checks carried out in the kitchen. Staff told us they participated in regular training around all aspects of environmental safety.

Records confirmed staff training.

Systems were in place to identify and manage foreseeable environment risks within the service.

This meant people, visitors and staff were effectively protected from the risk of harm. Equipment was monitored and maintained according to a schedule. In addition, gas, electricity, and electrical appliances were checked and serviced regularly. Fire safety risks had been assessed by a specialist and where necessary action taken to ensure the environment was safe.

Staff were consistently recruited through an effective recruitment process that ensured they were safe to work with people. Appropriate checks had been completed prior to staff starting work which included checks through the Disclosure and Barring Service (DBS). DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Abi house had a consistent staff team, who knew people well. Some staff had worked at Abi house for several years and could talk about change and improvement which had happened over time. New staff completed a full induction and probationary period. Training had been identified and provided to staff. These included safeguarding, Mental Capacity Act (MCA), medication, fluids, and nutrition, and moving and handling. Staff spoke positively about their experience of training and said the more bespoke training around people’s specific health and well-being was particularly useful. Staff demonstrated a clear understanding around autistic spectrum condition and how it affected each person differently and the support each person needed from staff. A staff member said, “You can’t just apply the training as its given, everyone is different so you must adapt.”

People and relatives spoke positively about the numbers of skilled staff that supported them. One person said, “I do like it, they [staff] are kind and nice.” Another person said, “I tell staff if I don’t feel well, and they get me a doctor.” One relative commented, “They [staff] do bend to his ways of what he likes and will accommodate him which is why he is happy there.” Another said, “There is a good level of staff to provide the care he needs and keep him stimulated.”

People were supported to live in a clean and maintained environment, where processes were in place to support staff to manage risks of infection and apply safe food hygiene practices. Regular checks were made to confirm cleaning was done and food checks such as fridge temperatures were recorded.

People received their medicines as prescribed, and they could have 'as required' (PRN) medicines when needed. We observed staff supporting people to receive their medicines in line with their wishes and guidance recorded in their support plans.

Staff had been trained to administer medicines and had been assessed as competent to do so safely. The provider's procedure ensured this was reassessed at least yearly. Guidance was in place to help staff understand when to give people their medicines and in what dose.

Staff were able to give detailed information about the medicines people took and what they were for. For example, a staff member described the protocol for giving medicine to a person who preferred to receive their medicine in a certain way.

People told us they were happy with the way staff supported them with medicine. One person said. “They tell me what it’s for, every time.”

Suitable arrangements were in place for obtaining, storing, administering, recording, disposing safely of unused medicines and for auditing of medicines systems. The provider undertook a review of the procedures for recording daily stocks of medicines. Systems were in place to ensure when additional medicines, such as antibiotics, were prescribed. Audits of medicines were undertaken to identify any discrepancies with stock levels and ensure records of administration were fully completed. When issues happened, prompt and appropriate actions were taken to mitigate any risk and address the underlying cause to reduce reoccurrence. Incidents were reported to external agencies and families were informed.