Abihealth Care - Southwest Office

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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

We reviewed 7 quality statements relating to person-centred care, care provision, integration and continuity, providing information, listening to and involving people, equity in access, equity in experiences and outcomes, and planning for the future. We found staff and leaders worked with other agencies to make sure people’s needs were met. People could have access to information suitable for them and there were policies to support this. Information was provided to people on how to make a complaint and there was a handbook and policy in place to support this. Staff and leaders were aware of the need to ensure fair and equal treatment to everyone and there were policies to support this. Staff had received training in equality, diversity and inclusion. However, we found care plans did not always consider current legislation nor nationally recognised evidence-based guidance to guide staff. Staff completing the assessment and care plans did not have knowledge of relevant National Institute for Health and Care Excellence (NICE) guidance. The service did not help people to plan for the future. We also found staff had limited understanding of Accessible Information Standards (AIS). However, we saw no evidence of AIS adaptations being required by service users during our assessment.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Most people had been involved in setting up their care plans. Some relatives told us they had accessed people’s care plans and notes via the electronic care application. People felt their needs were being met. However, some relatives told us they felt language barriers had impacted some people with complex needs, when managing the emotional needs of people with dementia.

Staff told us the care plans were written and changed by the care co-ordinator. However, we found some care plans did not always have person specific information available. For example, during the on-site assessment, we identified one care plan did not provide information on how a person wanted to have their long-term condition managed. The care plan did not always consider current legislation or nationally recognised evidence-based guidance to guide staff. Staff we spoke with could not demonstrate up to date knowledge of relevant National Institute for Health and Care Excellence (NICE) guidance. The provider took steps to revise the care plan during the assessment however, it had not been fully embedded.

People told us the service had worked with other care providers and health services to ensure they received continuity of care.

Staff and leaders told us how they worked with other agencies to make sure people’s needs were met.

We asked the local authority for feedback and no concerns were raised about the way the service ensured continuity of care for people.

There was evidence of referrals and communication with agencies on behalf of people who were supported by the service. People’s care records demonstrated the service had worked with other care providers and health services to ensure people received continuity of care.

Most people we spoke with did not raise any concerns about the information they received from the provider. However, some people told us they would like to receive a phone call if staff were going to be late, as this hadn’t always been the case.

Leaders told us people could have access to information in whatever way was suitable for them. Some people had requested their care plans in a paper format rather than digital and this was provided. Staff told us they felt people understood them and people had not asked for adaptations.

The provider had an AIS policy in place and people's communication needs were documented in care plans. We saw no evidence of AIS adaptations being required by service users.

Most people told us they knew how to raise a concern. Where concerns had been raised, people told us they were satisfied with the response and outcome.

Leaders told us they completed annual feedback with people and relatives. People were encouraged to raise concerns directly with staff or the office. Staff were able to reflect on complaints made to help with their learning.

A handbook was provided to people when support commenced which had relevant contact details to make a complaint. The provider had a complaints policy and process to manage complaints. Complaints were added onto the case management system with actions and outcomes. Complaint audits were completed by the manager and learning was shared with staff.

People told us they were supported to access the services they needed. They told us the provider amended care visits if they needed to attend other appointments. One person told us staff had helped them get added to the GP prescription list after they had been discharged from hospital without medication.

Staff told us that people had access to the support they needed. This could be from office staff, family or other professionals they needed access to such as the GP.

We asked the local authority for feedback and no concerns were raised about the way the service ensured equity in access for people.

There were examples of where the provider had taken steps to ensure people had access to the equipment and services needed.

People told us the provider and family members supported them to access external health services. People’s care plans contained current information about their wishes in relation to how their social, cultural and spiritual needs should be met. Some people and their relatives told us language barriers had impacted some people with complex needs, for example when managing the emotional needs of a person with dementia and adapting their communication style to suit.

Staff and leaders were aware of the need to ensure fair and equal treatment to everyone.

Staff were assessed on their language skills before their application was accepted. English language training was provided to staff when they arrived in the UK. Training records showed staff received equality and diversity training as part of their induction. This helped staff awareness of discriminatory behaviours and practices. The provider had not received any reports of concern from service users or relatives regarding language barriers.

One person told us they had a Do Not Resuscitate form displayed in the house and the provider was aware of it. Other people told us the provider had not discussed with them their wishes about the future.

Staff told us they did not support people in planning for the future. Comments included “this is not something that we do, that I am aware of,” “I don’t get involved in this” and “the family do this. I do not get involved.” One staff member told us “[manager] is looking at this because it’s a difficult subject for people and I’m not sure we need to know about this to do our jobs."

Staff had received training on end-of-life care. However, there was minimal information available in the care plans we reviewed regarding people’s wishes on planning for the future. The provider was taking steps to rectify this.