Archived: Abbeyfield Care at Home (Tunbridge Wells)

Updated 28 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 12 February 2018. We gave the service 48 hours’ notice of the inspection visit because it is office based and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started on 12 February and ended on 12 February 2018. It included direct observation of care and support, interviews with people, their relatives and staff employed by the service, review of care records and policies and procedures. We visited the office location on 12 February 2018. The office was based in a supported living service where people receiving a regulated activity were living. We visited the office and the supported living service to see the manager and office staff; to review care records and policies and procedures; to speak to people, and observe the care they received.

The inspection team consisted of two inspectors. We spoke with the registered manager, two senior carers, two support assistants, five people and one person’s relative. We looked at three people’s care plans and the associated risk assessments and guidance. We looked at a range of other records including four staff recruitment files, the staff induction records, training and supervision schedules, staff rotas, medicines records and quality assurance surveys and audits.

This is the first time the service had been inspected.

Updated 28 April 2018

The inspection took place on 12 February 2018 and was announced to ensure that the management team and people using the service would be available during the inspection.

Abbeyfield Care at Home (Tunbridge Wells), from here on in this report referred to as Abbeyfield Care at Home, is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and supported living homes. Abbeyfield Care at Home provides a service to older people living with dementia, mental health conditions, physical disabilities, and sensory impairments. At the time of our inspection the service was only providing a Care at Home (CAH) service to people who live at Hale Court, independent living facility.

Not everyone using Abbeyfield Care at Home receives care under a regulated activity. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection six people were receiving care under the regulated activity personal care. This inspection focused on the care and support provided to the six people where they received a service registered by CQC.

At the time of our inspection there was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Risks to people had not been mitigated as risk assessments had not been updated regularly, and did not contain up to date information to enable staff to keep people safe. You can see what action we told the provider to take at the back of the full version of the report.

Care plans lacked personalised details and information needed by staff to provide people with a person centred service. You can see what action we told the provider to take at the back of the full version of the report.

A full programme of quality audits was not in place and shortfalls identified at this inspection had not been identified by the registered manager. You can see what action we told the provider to take at the back of the full version of the report.

People received their medicines when they needed them and staff were trained and competency checked to ensure they were safe to administer medicines to people. However, the recording of medicines was not always clear. We have made a recommendation about this in our report.

People were kept safe from abuse and harm and staff knew how to report concerns around abuse. There were sufficient numbers of staff deployed to meet people’s needs and ensure their safety. Staff followed best practice guidance for reducing the risk of infection, and people were protected from these risks. The service used incidents, accidents and near misses to learn from mistakes and drive improvements.

People had effective assessments prior to admission. This meant that care outcomes were planned for, and staff understood what support each person required. Staff were trained in key areas and had the skills and knowledge to carry out their roles. Staff could request additional training and had been supervised effectively by the registered manager. People were supported to receive enough to eat and drink, and staff ensured people received a balanced diet.

The service worked with other professionals such as people’s GPs and social workers to ensure care was effectively delivered. People maintained good health and had access to health and social care professionals.

People were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice. The principles of the Mental Capacity Act were being complied with and any restrictions were assessed to ensure they were lawful, and the least restrictive option.

Staff treated people with kindness and compassion. Staff knew people’s needs well and people told us they liked and valued their staff. People and their relatives were consulted around their care and support and their views were acted upon. People’s dignity and privacy was respected and upheld and staff encouraged people to be as independent as safely possible.

There was a complaints policy and form, including an accessible format available to people. Staff were open to any complaints and understood that responding to people’s concerns was a part of good care. People were supported in a personalised way that reflected their individual needs.

There was an open and inclusive culture that was implemented by the management team. People and staff spoke of a friendly and homely culture that was empowering. People, their families and staff members were engaged in the running of the service. There was a culture of learning from best practice, and working with other professionals and local health providers to ensure partnership working resulted in good outcomes for people.