Abney & Baker (Bath) 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.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Managers assessed people’s needs before they started using the service to ensure their needs could be met. Staff told us they received detailed information about people’s needs and were given the time to read people’s documents thoroughly.

There were detailed care plans and staff developed risk assessments in partnership with people so that they could take positive risks. For example, one person was supported to undertake daily walks to help with reablement and another person was supported to leave their house and go to a restaurant for a meal.

Staff reported any changing needs they noticed when supporting people. We saw evidence of regularly reviewed and updated tasks to reflect these changes. For example, following a hospital stay a person’s needs increased. The provider re-assessed the person’s care package and identified areas where additional intensive support could be given to promote recovery and re-gain skills. This meant the person required less long-term care and had a better quality of life.

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.

One person told us they were not only supported with their physical needs but were also supported with their emotional needs during their care visits. They told us “I have not had this support with previous care companies”. This meant the provider was just as focused on emotional well-being as they were on physical well-being for people.

Staff received regular training in areas such as nutrition, dementia care and safe handling, which ensured their knowledge remained up to date. Care records reflected this, showing how staff used best practice guidance to support people with complex needs.

Staff communicated effectively with people, fostering a calm and trusting relationship. They demonstrated a clear understanding of each person’s needs and preferences, which helped build positive relationships.

People appeared comfortable with the support they received and were actively engaged in activities of their choosing. Comments included: “the [staff] are just wonderful, and they really know me and know my likes and dislikes” and “[my relative] receives the same carer which is really good for [person] as they have dementia”.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people joined the service.

For example, when a person joined the service, their assessment was shared with the care team to ensure everyone understood their needs.

When additional support from external agencies was needed, the provider demonstrated effective communication and collaborative working. We saw clear evidence of partnership with community nurses, who were actively involved in assessing and responding to people’s changing health needs. This ensured timely interventions and continuity of care.

People told us that staff collaborated effectively with external professionals, including community nurses, GPs and hospital teams, to ensure their care was well co-ordinated and responsive to their individual needs.

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. For example, the provider was in the process of developing an additional service which focused on rehabilitation and maintaining of independence skills so that people would have the opportunity for intensive interaction while reducing the need of longer-term care and support.

Staff informed managers of changes in people’s health. For example, we viewed staff had recorded new concerns via their helpdesk, and the manager then took action when required. The provider ensured they made referrals to health professionals where needed and this was supported with risk assessments to referrals were made to appropriate health professionals to support people to remain safe.

People’s independence was promoted within their care records. For example, where people were recommended exercise to maintain a healthy lifestyle, we saw evidence they were supported to access the community with staff, and an exercise plan was drafted with input from physiotherapists. This meant people were supported using a holistic approach to maintain a healthy life.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes for people were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff kept daily records of the support offered. These records noted any change in needs and where additional support was required, these changes were shared with healthcare professionals.

The provider maintained records of team meetings and meetings with people. However, these did not always contain detailed actions to ensure people were receiving effective support. For example, a person was displaying more distressed behaviour than usual. Records indicated staff had discussed an increase of support hours however there was no recorded follow up to this discussion. We spoke to the provider who took action to ensure team meeting actions were followed up.

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

Staff demonstrated an understanding of consent and what giving permission looks like. Staff demonstrated this by giving us practical examples. One member of staff said: “I will always ask if someone wants me to support them with their personal care”.

During our first day we found the provider’s care records did not always clearly document people’s mental capacity. This meant the provider could not be fully assured people’s consent had been gained appropriately. However, during the second day, we saw the provider had taken action and updated their records to ensure that mental capacity was indicated. They had also updated their assessment forms to include clear details regarding people’s mental capacity.

Relatives provided positive feedback about how staff gained consent before undertaking tasks with people and people told us staff asked for consent before supporting with personal care tasks. Comments included “the carers are great at asking what support I want and when I want it. I have a great relationship with them”.