Abbots Care Buckinghamshire received an overall Good rating at its first inspection in May 2023, with all five key questions rated Good; staff were found to be genuinely caring, and the provider demonstrated strong quality management systems and staff retention measures. Recommendations were made regarding risk assessment documentation, medicines record-keeping, and evidencing consent and mental capacity assessments, to which the service responded promptly.
Concerns (10)
moderateRecord keeping: “Some risk assessments lacked sufficient detail. For example, 1 person's environmental assessment of fire risks did not consider the barrier posed by a safety gate at the front door or the use of emollient creams.”
moderateMedication management: “We found some records contained insufficient guidance for staff in relation to the use of as and when required medicines. One person was prescribed a psychotropic medicine at a variable dose, due to anxiety.”
moderateMedication management: “1 person's MAR audits in February, March and April 2023 had identified recording errors. The audits did not state what action was planned or taken.”
moderateConsent / capacity: “Care records supplied for some people during the inspection did not adequately evidence why family members had signed key documents, including consent to receive care, on their behalf.”
moderateCare planning: “1 person's review in March 2023 identified a risk assessment was required in relation to their behaviour. This was not in place at the time of our visit.”
moderateStaff competency: “1 person's risk assessment for a health complication instructed staff to 'Check blood pressure every 5 minutes'... the person's regular staff member confirmed they had not received training to operate a blood pressure machine.”
moderateIncident learning: “One person had experienced a recent fall. A staff member closed the incident record citing 'no further concerns', however no falls risk assessment had been documented.”
minorRecord keeping: “Staff daily records did not consistently provide a full account of how people's needs were met, with some records consisting of a 'ticked' list of tasks.”
minorGovernance: “We found information was not accessible during our visit to explain gaps in staff employment histories. This information for 2 of 3 staff was provided following our visit.”
minorPerson-centred care: “We received variable feedback as to whether care needs assessments had explored if people would feel more comfortable supported by male or female staff.”
Strengths
· People and families consistently reported staff were genuinely caring, compassionate and treated people with dignity and respect.
· Strong staff continuity and matching based on skills, personality and shared interests promoted person-centred care.
· Robust safeguarding systems, with regular courtesy calls, monthly oversight of safeguarding data, and appropriate referrals to local authorities.
· Provider maintained a low staff turnover rate through retention schemes, a wellbeing app, staff awards and liaison officers.
· Quality management system aligned with British Standards Institution standards, including 6-monthly quality reports and trend analysis.
Quality-Statement breakdown (20)
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies to provide consistent, effective, timely care; Supporting people to live healthier livesNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careNot rated
well-led: Engaging and involving people using the service, the public and staff; Working in partnership with othersNot rated