Abbey 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

This means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good. This meant people were safe and protected from avoidable harm. The provider was previously in breach of legal regulation in relation to people’s safe care and treatment, and staffing. Enough improvements were found at this assessment and the provider was no longer in breach of these regulations.

This service scored 62 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. At our last inspection we identified concerns in relation to the safe care and treatment of people. At this assessment we found the provider had responded to most of these concerns effectively and made necessary improvements. However, further development was required to ensure all areas of learning were embedded and sustained. For example, some environmental and infection prevention and control related risks raised at our last assessment had not been fully addressed or maintained. One relative told us, “I am very impressed. When we were looking for a home, we saw the Requires Improvement rating, but we feel they have taken on the recommendations.” Throughout this assessment the provider was responsive when concerns were raised, and improvements were made in a timely manner. For example, the registered manager completed a lessons learned document and shared this with the team when concerns with a person’s mealtime experience were raised. Staff described a positive learning culture at the service.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. The provider explained how people were supported to transfer between services safely, including printed copies of people’s key documentation being made available to assist with safe transfers and emergency situations. People’s relatives told us they were kept informed when people required medical support or were taken into hospital.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. People living at the service and their relatives told us they felt safe. One relative told us, "My [relative] feels safe there.” Another relative told us, “All the care my [relative] needs is provided. My relative will say, ‘I just feel safe’.” Care staff received safeguarding training and understood how to recognise and report signs of abuse. The provider had systems and processes in place to enable effective recording and ensure concerns were investigated effectively. These were supported by the provider’s policy and procedures.

The provider mostly worked well with people to understand and manage risks. Staff mostly provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. People were protected from risk through the use of personalised care plans and risk assessments. However, sometimes these documents were not always thorough. For example, we found some falls risk assessments did not always consider all potentially influencing medical conditions, but we observed people being supported by staff with their mobility safely. One relative told us, “We are safe in the knowledge that [relative’s] needs are being met.”

The provider mostly detected and controlled potential risks in the care environment. They mostly made sure equipment, facilities and technology supported the delivery of safe care. However, there were some areas requiring improvement. For example, people were mostly supported with mobility equipment that was clean and kept in good working order. However, one wheelchair was visibly dirty and safety straps on most wheelchair footplates were either damaged or missing. We raised this with the provider, and they took immediate action to make improvements. Health and safety checks were routinely completed, fire safety was well managed, and the provider’s internal audits promoted environmental safety. However, we did observe the door to a downstairs sluice was left unlocked, enabling people access an unclean environment and a hot water outlet with the potential to cause injury. We raised this with the provider and they immediately locked the door to reduce risk.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. We observed plenty of staff were on hand in a variety of roles to provide care and support the running of the service. Laundry and Domestic staff were available to complete daily cleaning. Kitchen staff were on hand to prepare people’s meals and manage the kitchen. Activity staff promoted engagement, and there were suitable numbers of care staff to provide daily care and support to people. A dependency tool and staffing rotas were in place to ensure suitable numbers of staff were available. The provider told us they have successfully made use of staff from their surrounding services to eliminate their reliance on agency staff. The provider went on to describe their innovative plans to recruit regional staff that would provide additional support to their services. Staff were knowledgeable and received training suitable to their roles. We received mixed feedback from people and their relatives about the availability of staff. For example, one relative told us, “They suffer sometimes from staff shortages.” Another relative told us, “The turnover of staff seems quite rapid. However generally there are enough staff to meet people’s needs."

Significant improvements had been made since our last assessment in relation to infection prevention and control, but the provider did not always ensure the risk of infection was kept to an absolute minimum. Service cleanliness was mostly maintained to high standard and housekeeping staff were working hard to ensure people had a clean environment to live in. People's rooms were cleaned regularly, communal spaces were clean and tidy, there were no malodours, and the service environment felt pleasant and clean. However, we did find a variety of infection prevention and control shortfalls. Such as the build-up of limescale on some water outlets, a small area of black mould in one washroom, one visibly dirty pressure cushion, one person’s toothbrush was congealed with dried toothpaste, multiple pedal bins throughout the service were nonfunctional, and the kitchen extractor fan was visibly dirty. We raised these concerns with the provider, and they responded to ensure all concerns were rectified in a timely manner and took action to ensure continuous improvement.

Significant improvements had been made since our last assessment in relation to medicines and the provider now made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People received their prescribed medicines in a timely manner by trained and competent staff. Medicine records were well maintained. Care plans and medicine protocols were in place to ensure staff had access to suitable guidance. Regular audits were completed to ensure compliance. The provider and staff worked collaboratively with local health services to ensure people’s medicine needs were met effectively. One relative told us, “[Relative’s] medications were managed well.”