Abberdale Ltd t/a Abberdale House

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

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 67 (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.

Care plans were updated regularly, which demonstrated the provider was reviewing people’s records in response to changing needs. However, we found some care plans contained missing information. During our inspection, we found 1 person’s diabetic care plan was not sufficiently detailed or robust. Staff were able to verbally describe the signs of episodes of hyperglycaemia and hypoglycaemia, and there was a community nurse protocol available, but at the time, this had not been incorporated into a care plan. The provider acted immediately to rectify this.

We received mixed feedback regarding people’s involvement in their care plans. Whilst people told us they felt kept informed about matters relating to their care and well-being, no one we spoke to could recall having seen their care plan. One person told us, “They [provider] had completed paperwork when I first arrived and were aware of a care plan.”

Before admission, the provider completed comprehensive assessments of people’s needs, preferences, and choices the service could meet their individual requirements. These assessments informed decisions about whether admission was appropriate and provided the foundations for developing personalised care plans from the onset. This demonstrated a proactive and person-centred approach to understanding people before they arrived, helping to ensure that the right support was in place from the onset.

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 and standards.

People had unrestricted access to food and drinks throughout the day and were supported according to their individual preferences and this was documented in care plans. Although set mealtimes were in place, these were not rigid, and people could choose to eat at alternative times if they wished. This flexible approach demonstrated the provider prioritised people’s comfort and autonomy over routine. People were offered a choice of meals, and where the menu did not appeal, alternatives were readily available. No one was left without a suitable option. Feedback from people about the mealtime experiences was consistently positive, indicating that mealtimes were well managed, and an enjoyable occasion. One person told us, “I’m having my dinner, it’s lovely, I love the puddings, I like cheese on toast, you don’t want for anything.” And another person told us, “The meals are good and the cook will do whatever you want.” Family members were also offered a meal when visiting.

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 moved between different services.

Effective communication systems were in place to ensure staff remained informed about people’s needs. Structured handovers took place at the start of each shift, providing staff with up-to-date information before they began work. Communication continued throughout the day, ensuring any changes to people's needs, appointments or planned visits were shared promptly across the team. This meant staff supporting a person at any point in the day had access to information. This approach demonstrated that the provider understood the importance of good communication to ensure people received a good quality of care.

Some staff worked flexibly across roles within the service, which helped maintain continuing care and supported the smooth day-to-day running of the service. It also supported staff development, their skill sets and promoted sharing of people’s needs across the whole team.

Feedback received from external professionals was positive and reflected well on the service. Professionals spoke highly of the standard of care provided and described a collaborative approach to supporting people’s needs, indicating the service worked effectively with external partners. One professional told us, “I have a good, open relationship with them [provider].”

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.

Staff had a good understanding of people’s individual health needs and knew when and how to seek advice from relevant healthcare professionals. This demonstrated staff were confident in escalating concerns to ensure people received timely clinical support when needed. A family member told us, “They [provider] take [name] out to the GP in their wheelchair.” This demonstrated staff supported people’s physical well-being and helped to ensure health needs were not overlooked.

Staff showed a strong awareness of how people might present when unwell, including those who might not be able to verbalise their pain and discomfort. Staff described these as changes in behaviour, facial expression, and body language, demonstrating their knowledge of the people they support. One staff member told us, “If someone wanted to sleep more or didn’t want to interact, this could be a sign; any concerns I would report to the GP.” It reflected a staff team that knew the people they supported well.

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

Most people we spoke to were content with the care and support they received. The registered manager had access to health systems that enabled them to send tasks to the GP, supporting prompt referral and follow-up. This system allowed the registered manager to track outcomes of health appointments and ensure any actions arising were followed up effectively, reducing the risk of health concerns going unresolved.

The provider had systems in place to regularly monitor and review people’s care and support. These systems enabled the provider to assess whether care was being delivered effectively, identify any changes in people’s needs, and make appropriate adjustments to care plans and support arrangements promptly. This helped to ensure that care remained person-centred and responding to people’s evolving needs, rather than being reviewed only when concerns or incidents had arisen.

The provider did not consistently ensure people were informed of their rights in relation to consent, nor were appropriate best interest processes always followed. Although staff offered people options, this did not fully uphold individuals’ rights when care and treatment decisions were made.

[SM1]We found mental capacity assessments had been completed for people who lacked capacity; these were decision-specific, which was a positive finding and demonstrated the provider had taken steps to establish whether people were able to make decisions for themselves. However, we found no evidence that best interest decisions had been completed where required in line with the mental capacity act 2005. Without the documentation, the provider could not demonstrate that decisions made on behalf of people have been reached lawfully or with appropriate oversight and involvement of relevant others.

Staff told us they actively supported people to make their own decisions wherever possible, and consent was sought throughout the care and support they provided. This was reflected in what we observed during our visit. People were offered meaningful choices in line with their individual needs, preferences and abilities and staff took the time to explain options in a way that people could understand. This demonstrated that staff had a good understanding of the principles of consent in practice and were committed to ensuring people’s right to make decisions about their own lives was respected and upheld on a day-to-day basis.