15 June 2023
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
The inspection was carried out by 1 inspector and 1 Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service a short notice period of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 5 May 2023 and ended on 23 May 2023. 1 Expert by Experience made telephone calls to people and their relatives on 9 May 2023. We visited the location's office on 15 and 16 May 2023. We continued to review evidence until 23 May 2023.
What we did before the inspection
We reviewed information we had received about the service since registration. We also sought feedback from local authorities in areas where the service operated. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
During the inspection we spoke with 2 people using the service and 3 family members. We also received email feedback from 1 additional person.
We spoke with 12 members of staff, including 7 care assistants, the care coordinator, the community facilitator, the service user liaison officer, the registered manager and the operations manager.
We reviewed a range of records. This included 5 people's care and support plans, as well as people's medicines records where they received support with this task.
We looked at 3 staff files in relation to recruitment, training and supervision. We reviewed a variety of records relating to management of the service including policies and procedures, accident and incident records, compliments and complaints and audits of the service. We received feedback from 3 local authorities including 1 service commissioner.
15 June 2023
About the service
Abbots Care Buckinghamshire is a service providing care and support to people in their own home. At the time of the inspection the service was supporting 8 people, some of whom received support from a live-in staff member. People supported included both children and younger adults, people with physical or sensory impairments, and older people. Some people using the service lived with dementia.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
At the time of the inspection, the location did not provide care or support for anyone with a learning disability or an autistic person who required personal care. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
People told us staff were genuinely caring and provided safe and dignified care. Staff supported people to maintain their independence where possible and involved people in day to day decisions about their care and support.
People’s needs were holistically assessed to identify goals and consider what was important to them. People received person-centred care which was responsive to their needs. Staff could speak in detail about people they supported, with knowledge about people's likes, dislikes and preferred routines. People were supported to participate in social and leisure activities in line with their interests. People told us they were in control of their care and that staff respected when they needed space and privacy in their own home.
People were cared for by staff who were suitably inducted, trained and supported. Staff deployment aimed to provide continuity of care, and the service worked to match people with suitable staff, based on factors such as staff skills, experience, personalities and shared interests.
Staff, people and families told us the service was well-managed. The service was supported by an established provider with a clearly defined quality management system in place to ensure the service identified and acted on areas for continuous improvement and learning.
We found safe care and treatment was provided. People were safeguarded from risks of abuse and risks of infection. We found staff had a good understanding of risks, however risk management records lacked sufficient detail and we have made a recommendation about this. We also identified additional detail was required in relation to medicines records and the service was responsive to our feedback.
Staff were safely recruited and there was a focus on recruiting staff with the right values to deliver person-centred care. The provider also focused on maintaining safe staffing levels, including through the provision of staff support and recognition schemes to maximise staff retention.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service did not consistently evidence how people’s mental capacity to initially consent to the service was assessed, and we have made a recommendation.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 16 January 2019 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We have made recommendations in relation to risk management and recording consent to care. The provider was responsive to our feedback and informed us of actions they planned to take.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.