Abbot Care Home

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 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 remained requires improvement.

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.

People had assessments in place to identify their needs and preferences. However, information within care plans and risk assessments was not always accurate, complete or reflective of people's current circumstances.

Some assessments and care planning documentation was detailed and included guidance for staff on how to support people safely, however we found inconsistencies in records relating to areas such as nutrition, hydration, swallowing risk, skin integrity, mobility, wheelchair use and seizure management. As recorded in the risk section. This meant assessments were not always used effectively to ensure care records remained current and provided clear guidance to staff.

Most people and relatives we spoke with told us they were involved in assessments. A relative told us, “We were both involved in the care planning process, we had a review 2 weeks ago. They talk to me about [family members] pills and they talk regularly.” Another relative said, “They wrote the care plan, and I was involved and inputted into it, and I am aware of updates, their needs are reviewed.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Staff generally demonstrated a good understanding of people's individual needs and were able to describe how they provided support. However, records did not always evidence care was delivered in line with planned interventions. For people who experienced distressed reactions, ABC charts recorded incidents but did not consistently document what was happening prior to the distress, triggers, de-escalation strategies, outcomes or the effectiveness of interventions. Although care plans contained person-centred approaches to reduce distress and support positive outcomes, records did not consistently demonstrate whether these strategies had been implemented, reviewed or adapted following incidents.

As a result, the provider could not always demonstrate behavioural support strategies were evidence based, regularly reviewed or adjusted in response to people's changing needs and experiences. This limited assurance care and treatment were consistently planned and delivered in a way that reflected what mattered to people and promoted positive outcomes.

The provider worked well across teams and services to support people. They ensured people only needed to tell their story once by sharing assessments of their needs when they moved between different services.

Staff spoke positively about working at the service and told us teamwork was good. One staff member said, “Working as part of a team means that we can support one another and provide better care to residents.” Another staff member told us, “I feel that the home is working well currently. We are all working in the same way, whereas previously, due to the high number of managers, nothing was consistent. I feel this is no longer a concern, and we all work as a team.”

When people's health needs changed, the provider worked positively with other agencies and healthcare professionals to ensure people received the support and treatment they needed in a timely manner.

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 were mainly happy with the food they received at the service. A person told us, “The grub is good. I can have anything I want (I usually have egg and chips).” A relative said, “Food and drinks are offered frequently, meal at 12 pm and cakes later on, food is really good and [family member] likes the food and seems to always have something.” However, we did receive a person’s feedback relating to the food being cold. A person told us, “By the time the food gets to me it is often quite cold. Cold chips aren’t nice.” Observations of mealtimes we completed were not always positive and we have expanded on this in the responsive section.

People had access to healthcare support and specialist advice when required. Records showed staff monitored people's health closely and sought timely advice from healthcare professionals when concerns were identified.

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

During our review of 14 care plans, we identified a number of inaccuracies and inconsistencies that had not been identified through the provider's own audits. In some cases, accurate information was available in one section of a care record but had not been updated elsewhere, resulting in conflicting guidance for staff. As a result, the provider could not always demonstrate care and treatment were being effectively monitored, reviewed and adapted to improve outcomes for people. A professional told us, “There appears to be inconsistency with the patients care. I have attended the nursing home previously to meet with the nursing home floor lead who supported my concerns and aimed to make positive change.”

Although audits had identified some issues, they had not identified all the concerns found during the inspection. This reduced assurance that quality assurance systems were consistently effective in identifying and addressing risks and areas for improvement.

Following feedback, the provider responded proactively and advised named staff members had been allocated responsibility for reviewing care plans and addressing identified inconsistencies.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. Staff had a good understanding of the need to gain consent, and that people had the right to decline care. We reviewed assessments which were completed in line with the principles of the MCA.

Staff knew about the importance of gaining consent from people before supporting them and never forced people to do things they did not want to. We observed consent before carrying out tasks and staff knocking on people’s doors before entering. A relative told us, “[Family member] chooses to watch the television and join in with the things they want to, chooses to go to bed and everything.”