Abbeycare and Nursing

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We identified one breach of regulation. During our assessment of this key question, we found concerns around the governance and leadership of the service which resulted in a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because there was a lack of effective oversight and governance to ensure people received care and treatment that met their assessed needs. There were shortfalls in peoples care which had not always been identified and when this had occurred there was insufficient action taken to ensure people received timely and appropriate support to meet their needs. Care plans and risk assessments did not contain current contemporaneous information in respect to peoples changing needs. Improvements were required in relation to records to ensure the service were following the principles of the Mental Capacity Act (MCA).

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff said people were at the heart of the service. The management team's primary focus was to develop people's skills and confidence and provide them with the tools needed to live more independently. Staff said the provider worked hard to instil a culture of care in which staff truly valued and promoted people's individuality, protected their rights and enabled them to develop and flourish

The provider had a plan in place which included visions and values for the company which staff were aware of and upheld. The registered manager, management team and staff demonstrated a positive, compassionate, and caring culture which enabled people to experience positive care.

Staff said the registered manager had a good knowledge of the service, people living there and staff said overall they felt supported by the management team. However, some relatives,staff and health care professionals felt communication in the service needed to improve.

Organisational processes had failed to ensure that management at the service had worked effectively to ensure safe care delivery and effective governance. Feedback from, relative’s, staff and healthcare professionals showed improvements was required to ensure there was a listening culture that promoted trust and was focused on learning and improvement.

Staff and managers were able to share their views and felt supported in speaking up and sharing ideas. There were good systems for communication with and support of staff. Overall,staff told us they knew how to speak up and felt confident raising concerns. They told us they were listened to, and their views were respected.

There were processes for staff to speak up and tell the provider and others if something was wrong. Staff had training to understand about this. There were opportunities for staff to raise concerns anonymously. Feedback was gathered and action from feedback was taken to drive improvements. There were policies in place on whistleblowing and staff were aware of how to whistle blow should the need arise.

Staff felt respected, supported, and valued. They said the service promoted equality and diversity in daily work and provided opportunities for development and career progression. They could raise any concerns without fear.

The provider had policies and procedures in place regarding equality diversity and inclusion. Staff were provided with contracts of employment which gave them information about their rights and expectations as an employee.

Staff had mixed feelings about the support they received from the management team. Some staff were positive and told us they felt they could go to the management team with their concerns. In contrast, other staff said there was a lack of communication and consistency from management.

The systems to assess, monitor and improve the service were not sufficiently robust. Records of care and support were not accurate or up to date and staff did not always have access to clear information about the people they were supporting. The failure to ensure complete and contemporaneous records meant we were unable to identify if people had received the care and support, they required. Improvements were required in relation to records to ensure the service were following the principles of the Mental Capacity Act (MCA).We found gaps in staff training. Staff had mixed feelings about the support they received from the management team. Some staff were positive and told us they felt they could go to the management team with their concerns. In contrast, other staff said there was a lack of communication and consistency from management. This was echoed by feedback from healthcare professionals.The provider responded immediately during and after the inspection. They confirmed all the risk assessments had been reviewed and updated and put in place.

We could not be assured that people were supported by staff who collaborated and worked in partnership with health professionals. There was evidence of involvement from other health care professionals in people’s care plans, and staff made referrals to ensure people’s health needs were met. However, health professionals expressed concerns about the staff skills and training and directions from healthcare professionals not being followed.

While staff told us people received regular input from community health professionals and people were supported to attend appointments, there were shortfalls in communication with health professionals, which resulted in continued risk of potential harm.

Health and social care professionals who had contact with Abbeycare and nursing expressed concerns with inconsistencies in information shared and shortfalls in some staff members knowledge. For example, one told us, “We have concerns regarding care plans for several people not being followed. These include the management of fluid balance, behavioural management plans, contracture stretches, stool charts, dysphagia plans, and pressure care plans.”

Processes in place at the service had failed to ensure that information recorded about people was always up to date, accurate, or sufficiently detailed. This meant that when information was shared about people between services, the quality of this information could not be guaranteed. Systems in operation had failed to gather feedback from visiting professionals or ensure the service was always working collaboratively. As a result, leaders increased the risk of missing opportunities for learning designed to improve the quality of support people received.

Throughout the inspection the registered manager was honest and open with us. They acknowledged the shortfalls identified at this inspection and were eager to put processes in place to ensure people receiving care and support were safe and protected from harm. The management team understood their duty of candour, to be open and honest when things went wrong. They were committed to improving the service. Staff had mixed feelings about the support they received from the management team. Some staff were positive and told us they felt they could go to the management team with their concerns. In contrast, other staff said there was a lack of communication and consistency from management.

We found the provider's processes for driving continuous improvements and learning required improvements. For example, staff gave us mixed feedback about the quality of training and this was confirmed by healthcare professionals who expressed concerns about the training and skills of staff.