Abbot Care Home

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person centred care.

This service scored 57 (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 were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

During our review of care records, some care plans and risk assessments were not always accurate, complete or up to date. In addition, distressed reaction records did not consistently demonstrate whether person-centred strategies identified within care plans had been implemented, reviewed or adapted following incidents of distress. This reduced assurance people's experiences, wishes and changing needs were consistently informing care planning and delivery.

We received mixed feedback from people and relatives. A person said, “They have tried to make my room as it was when I was at home. I have my sofa from home and one of the lounges has my armchair because I can’t use it." A relative told us, “They take time as they have to, I make sure they wash her hair and blow dried, and her hair is done once a week.” Others added, “I think [family member] is left in bed a lot and I think they could be encouraged to get up. I have wondered if it is easier for [family member] to stay in bed.” Another relative said, “I want her to have someone to talk to, sometimes [family member] isn’t moved from the table to the television. Sometimes they don’t get [family member] out of their wheelchair.”

Staff were able to talk about people’s preferences, and a staff member was able to tell us about how 1 person liked eggs for their breakfast. Another person who liked to sit in the same place at the dining table and what it meant to 1 person having their two fluffy toys on their walker and how these were important to them.

The provider understood the diverse health and care needs of people and their local communities, so care was joined up, flexible and supported choice and continuity.

People had access to a range of healthcare professionals, including GPs, chiropodists, district nurses and Speech and Language Therapists (SALT), when referrals were required. Records showed referrals were made appropriately when people's needs changed, helping to ensure they received timely specialist advice and support.

Staff worked collaboratively with external health and social care professionals to support people with their ongoing health needs. Care records contained evidence of professional involvement and recommendations, and staff demonstrated an understanding of the support people required from different services. This helped to ensure changes in people's health and wellbeing were identified and responded to in a coordinated way.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Care plans contained information about how people preferred to communicate, including any support, adaptations or approaches staff should use.

All care plans were electronic, and this enabled them to be printed off for family, hospital appointments and transfers. We were informed all organisational documents could be provided in an alternative language for people and staff who required this.

The provider had processes in place to support people and their relatives to raise concerns and provide feedback. People and relatives knew how to make a complaint if needed; however, feedback about how effectively concerns were resolved was mixed.

A relative told us, “I did have a complaint, and I went to the manager, and the manager sorted it out.” Another said, “I would go to the nurse first and then to the manager if it wasn’t sorted out and they would sort the problems and listen to me.” However, other relatives did not feel concerns were always addressed effectively. One relative told us, “Things don’t get sorted out.” They then said they had not always felt listened to.

People and relatives had opportunities to share their views through regular resident, relative and staff meetings. Records showed feedback and actions taken were discussed at subsequent meetings and used to support service improvements. However, the mixed feedback received indicated the provider was not always effective in demonstrating concerns had been fully addressed or people consistently felt listened to. This meant opportunities to learn from feedback and improve people's experience were not always maximised.

The provider did not always ensure people experienced equitable access to all aspects of care, support and wellbeing.

While people had access to healthcare professionals and specialist services when required, opportunities to access meaningful occupation, social engagement and the wider community were not always consistently available.

Care plans contained information about people's communication needs, preferences and health conditions to help staff provide personalised care. People were able to access healthcare services when their needs changed, and referrals were made to appropriate professionals when specialist support was required.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Although information about people's individual needs, preferences and circumstances was available, this was not always used effectively to tailor care and improve people's experiences. As a result, some people did not consistently receive opportunities that reflected their individual wishes, interests and social needs. For example, some people and relatives told us they would like more opportunities to spend time outdoors and access activities meaningful to them, but these opportunities were not always available. This meant the provider was not always effective in identifying and addressing barriers that could impact people's wellbeing, engagement and overall experience of care.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Care plans contained information about people's advance care planning wishes and preferences; however, feedback from relatives indicated they had not always been involved in discussions about end-of-life care or consulted about people's wishes.

Relatives told us communication regarding future care planning was not always consistent. This meant the provider could not be assured people's preferences had been fully explored, reviewed or shared with those important to them.

During the inspection we noted there were a number of people being cared for in bed and not all care plans indicated the reason why. We asked the provider to review all people cared for in bed to ensure the reasons for this were clearly evident. Whilst the provider's review identified there was not a blanket approach to this care, they did find more work was needed to ensure care plans reflected the reasons for this.