Abode

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has stayed the same.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Care plans and risk assessments were not always up to date or reflective of people's current needs. For example, one person's care plan referred to a catheter that had been removed. We also found a person using bed rails without a current risk assessment in place. This meant staff could not always rely on care records to provide accurate information and risks were not always effectively managed.

People were able to access healthcare services when required and could see a doctor if necessary. People who were independent in their mobility said they were free to move around the home as they wished. Communication care plans were in place, including support for people whose first language was not English.

Relatives did not always feel involved in care planning and told us they often had to request updates rather than being routinely included in discussions about changes to care.

Overall, although people had access to healthcare and support to maintain their independence, improvements were needed to ensure care planning, risk management and involvement of relatives.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff were aware of individual dietary requirements and could describe what this looked like for different people. People were able to eat and drink when they liked, and food was of a good nutritional value. However, people reported the choice of food was limited and felt this could be improved.

National assessments tools were in use, for example to consider whether people were at nutritional risk, and to assess their overall level of support need.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

Staff worked well together and had regular handovers and team meetings. A member of staff said, “We all work as a really good team.”

Staff made referrals to external agencies but there was not always clear recording of healthcare professional’s involvement in people’s records. For example, visits were recorded but no outcome of the visit for a person who had occupational health visits. This meant not all staff were aware of the instructions given during these visits, so these were not followed.

There was not a consistent positive working relationship with other professionals. Professionals were often left waiting to gain access to the building for prolonged time which had an impact on their workload. We made the provider aware of this and they committed to addressing the issue.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People had access to a dentist and optician and on the day of inspection people were having their hearing checked.

Food was freshly prepared on site. However, people did not always report the food in a positive way. A person said, “The food is very ordinary and choice is poor. It's always the same if you don’t want the set meals. Eggs some way or a toastie." Another person said, “Food is ok but not much choice and it's usually just soup or sandwiches at night.”

People were having their weight monitored regularly. People told us they could request to see a doctor, and this would be arranged.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

People’s care plans were reviewed, though this did not always effectively identify the issues we found in people’s care plans. We found that a person’s care plan mentioned a catheter that the person no longer had.

People were having their weight monitored and skin was regularly checked for signs of pressure damage. Appropriate assessment tools for skin and nutrition were used to monitor people’s health.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

People had consent forms in place for CCTV in the home. Mental capacity assessments and best interest meetings had been completed for most people. However, we found a person using bedrails with no evidence that a mental capacity assessment and best interest discussion had taken place with the relative This posed the risk the person had an unnecessary restriction in place. We discussed with the provider and the bedrails were removed.