Abi-support Ltd

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

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 management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to the governance at the service.

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.

The provider had a shared vision, strategy and culture, based on transparency, equity, equality and human rights, however we were not always assured the service understood the challenges and the needs of people and their communities.

Staff and leaders ensured risks to delivering the strategy, including relevant local factors, were understood, however, there were limited actions in place to address concerns found during the inspection. Although the service monitored and reviewed progress, oversight of actions was not in place to ensure documentation evidenced there was a commitment to delivering person-centred care.

Staff and leaders demonstrated a positive, compassionate, listening culture that promoted trust and understanding between them and people using the service and was focused on learning and improvement.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. However, our inspection found the oversight and governance of the service did not meet the expected standards resulting in breaches of regulation.

We received positive feedback from people who use the service and their relatives about the registered manager, we heard, “The Manager is great, she listens, she managed a tight team. Everything is wonderful and efficient, everything works well” and “She is jolly nice, a good listener”. Most staff we spoke with felt leaders were compassionate and felt able to raise their concerns about people, and they would be listened to.

The provider fostered a positive culture where people felt they could speak up, and their voice would be heard.

Where concerns had been identified with staffing, this was promptly discussed and addressed in team meetings. There was evidence staff were listened to and actions created from team meetings.

Staff found team meetings useful and felt action was taken and followed up appropriately. Staff told us, they felt able to raise concerns and were confident they would be listened to, and their concerns acted upon. We heard, “Yes, I feel able to speak up, and any concerns raisedare dealt with” and “If I have a concern, they [management] sort it, and if I feel it hasn’t been managed, I would be able to bring it up again.”

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Where staff raised concerns about challenges they faced at work, we heard the provider took appropriate action to support staff.

Staff felt supported to give feedback and were treated equally.

Governance was delegated throughout the team and systems of accountability were shared. However, there was limited oversight of the effectiveness of the quality processes in place at identifying areas of improvement. For example, quality checks had not identified risks to people's health and safety had not been comprehensively assessed.

Quality assurance audits had been completed. However, systems and processes had not been effective in identifying the shortfalls we found at this inspection.

Medicines were not managed, safely. Medication audits had not identified the concerns found during inspection. Risk mitigation plans were not sufficient to prevent risk of harm. Although we found no evidence of harm had taken place, there was the potential for people to be harmed.

Oversight of actions to improve documentation and identify areas of improvement were not available to ensure effective monitoring could take place.

Weekly operations meetings were held to discuss changes and actions required. However, actions were not always documented to evidence the positive action taken. Care planning audits were not in place for all people, and audits had not identified disparities found during inspection.

Incidents and accidents were managed effectively, the provider took action to ensure they contacted the relevant people. However, documentation in place did not always evidence people’s injuries and support required following this as it had not been adequately updated.

The service sought people’s feedback via an external agency. Where concerns had been raised, there were no follow up actions in place to ensure people’s concerns were addressed.

Spot checks and supervisions were in place. Where areas of improvement had been noted within, there was not always an action or a timeframe recorded. The service assured us this was an oversight and care coordinators checked and discussed training needs and actions regularly.

Actions around team meetings were detailed, there was good follow up of issues identified such as care note writing, and management of risk within team meetings, where staff were provided with scenarios and examples to aid development and learning.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

Professionals involved with the service felt the service listened to and acted upon advice and worked in partnership, however, we also heard communication could be difficult when requesting updates.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

There was good evidence of documented investigations, actions and lessons learnt when things went wrong. Learning and improvements were discussed in detail within team meetings, and lessons learnt were shared with staff.