Abi-support Ltd

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.

The provider was previously registered at a different address. The rating at the previous address was good.

At this assessment the rating had changed to Requires Improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to people’s safe care and treatment.

This service scored 54 (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 peoples care and treatment were effective, because people’s health, care and wellbeing had not always been assessed to consider their needs.

People we spoke with were confident their individual needs had been appropriately assessed and fully understood. We heard, “The manager has done some special training and has taught the staff. Now, nobody is surprised by my condition, they know how to manage me. They know how to maximise my ability to turn myself in bed, they don’t make me feel useless”.

We reviewed people’s documentation such as care planning and risk assessments. Assessments were not up-to-date or adequately routinely reviewed for staff to understand people’s current needs. For example, we identified there were missing risk assessments, for, diabetes, allergic reactions, financial risk, refusal of personal care, nutrition and refusal of medications.

Information in place about people’s health conditions was not always relevant to the person and did not adequately identify how this affected them or identify their support needs.

Where people required support with moving and handling, there was limited guidance to ensure staff had the correct information to support people. Daily notes evidenced staff understood people’s needs well and provided adequate support.

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. However, we found there was limited documentation to ensure best practice was followed.

People’s needs were not always assessed using a range of assessment tools to ensure their needs were reflected and understood. Records contained limited detail on how to ensure people were supported to reposition and avoid skin integrity concerns. For one person we reviewed, they were unable to mobilise without support which put them at increased risk of skin breakdown. Although the service had taken correct action when skin integrity concerns had been identified, such as contacting the district nurse. The pressure area deteriorated when professionals were no longer involved in their care. There was no information within their care planning about support to repositioning and how to support the person to effectively manage pressure care concerns.

There were clear guidelines in place for people with SALT [Speech and language therapy] needs for staff to follow, where people had SALT needs, staff evidenced their understanding and correct action was detailed and documented effectively in people’s care notes.

Relatives we spoke with told us, “They watch [person] when they are eating as they are at risk from choking. [Person] has choked before, the carers rang 111, they [staff] coped well.”

The provider did not always work well across teams and services to support people.

Staff did not always have access to the information they needed to appropriately assess, plan and deliver people’s care, treatment and support as important up to date information was missing.

When people received care from a range of different staff, teams or services, it was not always co-ordinated effectively. Where professionals had been involved in people’s care and provided guidance, this documentation was not always available to staff, or in people’s care planning documentation.

Professionals had been contacted by the service, regularly and the service kept them up to date on people’s changing needs, guidance from professionals was not always included in people’s information to guide staff to deliver evidence-based care.

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.

Ther service had processes in place to identify risks to people’s health and wellbeing and took appropriate action to support people.

Relatives we spoke with told us, “[Person] has been refusing food. I spoke to the Manager, and it has been agreed that the carers continue to prepare the meals for [person] and try to encourage [person] to eat.”

People were supported to medical appointments and encouraged to make healthier choices to promote and maintain their health and wellbeing.Care notes evidenced staff provided support around activities and knew people well.

The provider was not always able to evidence they routinely monitored people’s care and treatment to continuously improve it.

People’s care and treatment was not routinely and continuously monitored to improve outcomes as care plan auditing in place did not effectively identify the concerns we found during inspection. Some people’s care planning had not been updated to reflect their current needs or reviewed following changes to their care.

Review meetings took place with people, not everyone had received a review, and reviews did not always document the service followed up on people’s feedback on their care.

We could not always see joined up documentation regarding action taken to monitor and improve people’s outcomes.

Body maps were completed regularly, although they contained limited actions. The service had separate records which evidenced these concerns were addressed promptly and effectively with the relevant professionals.

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

Where people had limited capacity, there was no supporting capacity assessments in place to evidence how decisions had been made around their capacity, and if support was provided within their best interest. Implementation of the Mental Capacity Act required further attention to ensure people were acting in people’s best interest and had the right to do so.

Staff effectively documented they offered people choice, asked for consent and provided options around choice to people. However, people we spoke with told us, “Some of the carers can seem a bit harsh, the way they talk to you, a bit bossy. I tell them the way I liked to be dressed but one of them does not take any notice”.

Staff understood the importance of asking for consent prior to providing care and support.