We carried out a review of the data available to us about Abbots Care Limited (Hertfordshire) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Abbots Care Limited (Hertfordshire), you can give feedback on this service.
Abbots Care Limited (Hertfordshire) is a large domiciliary care agency providing personal care and other support related services in Hertfordshire. The diverse range of services provided meant there were approximately 911 people receiving support from Abbots Care Limited at the time of this inspection.
The agency provided a wide range of services including domiciliary care; flexi care scheme; live in services; specialist care from home services, parent support and supported living, and a rapid response service. 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
People received exceptionally effective care and support from the Abbots Care staff team. People were supported to have control and choice over their care and to help develop their own care plan based on their needs, wishes and what was important for them. The care and support people received was extremely effective and enabled them to remain in their own homes and continue to live as independently as possible.
External professionals including local authority representatives and healthcare professionals gave unanimously positive feedback about how the care delivered had enhanced people’s lives. People were overwhelmingly positive about the calibre and the skills and knowledge of the staff team as well as the care provided for them. People said they felt staff were knowledgeable and knew how to deliver care and support in an effective and safe way.
Staff received a robust induction, ongoing training and supervision and felt well supported by the provider. The provider had developed designated 'champions' in the service who actively supported staff to make sure people experienced good outcomes and to support them to remain longer in their own homes.
People received the support they needed to eat and drink and were supported to access healthcare professionals to help maintain their health and well-being. Consent to care had been obtained from people, and staff were aware of people’s rights in relation to offering choices.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. Care was centred around each person’s individual needs. People said staff were polite, kind, caring and respectful. The providers ethos, values, attitudes and behaviours were shared by leaders and care staff ensuring people using the service were supported to lead confident, inclusive and empowered lives.
The provider worked exceptionally well with external professionals for the benefit of people who used the service. The provider continued to maintain excellent working relationships with commissioners and local authorities from their catchment area to develop new services in response to the needs of people in the community, especially during the COVID-19 pandemic.
There continued to be a positive, open and empowering culture within the service. Feedback about the leadership and management of the service was overwhelmingly positive. The provider and senior management team were dedicated to promoting a positive, inclusive culture at the service. Quality monitoring processes continued to be robust, and these clearly evidenced actions taken to continually improve the service.
People felt safe supported by staff from Abbots Care Limited (Hertfordshire). Robust safeguarding systems and processes were in place and people were kept safe from harm. Staff demonstrated they knew the process to follow if they were concerned about people’s safety or if people may be at risk of abuse.
People’s individual risks were assessed, and measures put in place to help reduce the risk of harm. People’s medicines were managed safely, and they received their medicines as prescribed. Staff understood infection prevention and control and were provided with appropriate personal protective equipment. Staff had received training and frequent updates regarding COVID-19 and how to prevent community transmission.
The provider and staff continued to be responsive to the needs of people who used the service. Staff supported people to live as full a life as possible. The strong community links and wide range of social initiatives that had paused during COVID-19 restrictions were being re-instated for people to access regularly; supported by staff and volunteers.
People and relatives felt the staff were caring and thoughtful. People said their dignity was maintained and their right to privacy was respected. People's needs were fully assessed before they started using the service. People and their relatives were aware of how to raise concerns should the need arise, and many compliments had also been received by the service. People were asked their views and feedback obtained was analysed so any shortfalls could be addressed, and positive experiences shared with the staff team.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Outstanding (published 05 May 2020).
Why we inspected
This was a planned inspection based on our ongoing monitoring of the service.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Abbots Care Limited (Hertfordshire) is a large domiciliary care agency which provides personal care and other support related services in Hertfordshire, Buckinghamshire and North London. This inspection covered the services provided in Hertfordshire. The diverse range of services provided means that a large number of people were supported with the regulated activity of personal care. At the time of the inspection there were approximately 648 people who received personal care with a total of 10,000 hours provided per week.
The agency provides a wide range of services which include, domiciliary care; flexi care scheme; live in services; specialist care from home services, parent support and supported living, and a rapid response service.
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
People told us they felt safe being cared for by staff from Abbots Care Limited (Hertfordshire). Robust safeguarding systems and processes were in place and people were kept safe from harm. Staff demonstrated they knew the process to follow if they were concerned about people’s safety or if people may be at risk of abuse.
People had their individual risks assessed and, where risks were identified, measures were put in place to reduce the risk of harm. People’s medicines were managed safely, and people received their medicines as prescribed. Staff were aware of how to reduce the risk of the spread of infection and were provided with personal protective equipment, where appropriate.
Staff received an induction, ongoing training and supervision and felt well supported by the provider. People received the support they needed to eat and drink sufficient quantities, when identified as required. Support was provided to access healthcare professionals and people were supported to maintain their health and well-being. Consent to care had been obtained from people, and staff were aware of people’s rights in relation to offering choices.
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 supported this practice.
The provider and staff were exceptionally responsive to the needs of people who used the service, by providing a wide range of person-centred support and activities in line with people's wishes. Staff supported people to live as full a life as possible. There were strong community links and social initiatives that people were supported to access regularly; supported by staff and volunteers.
People told us they felt the staff were caring and thoughtful. Feedback from relatives was positive. People’s dignity was maintained and people’s right to privacy was respected. Personal information was stored securely to ensure it remained confidential.
People's needs were fully assessed before they started using the service. Care plans were developed and kept under regular review to ensure information remained current. People were encouraged and supported to participate in a range of innovative and diverse events organised by the provider and supported to follow hobbies that were of interest to them.
People and their relatives were aware of how to raise concerns should the need arise. Many compliments had also been received by the service. People were asked their views and feedback obtained was analysed so that any shortfalls could be addressed, and positive experiences shared with the staff team.
The provider had developed an excellent working relationship with commissioners and local authorities from their catchment area to develop new services in response to the needs of people in the community. Commissioners and representatives from the local authority were extremely positive in their feedback about the services provided by Abbots Care Limited (Hertfordshire). They told us, “Abbots Care are a key strategic partner of HCC and they overwhelmingly deliver local authority funded business and their new charity to deliver additional opportunities for people shows a real love for the people they interact with and the staff willingly participate.”
There was a positive, open and empowering culture. Feedback about the leadership and management of the service was overwhelmingly positive. Systems were in place to help staff keep safe while lone working. The provider was dedicated to promoting a positive, inclusive culture at the service. Quality monitoring processes were robust, and these clearly evidenced the action taken to continually improve the service. In a recent contract monitoring visit the provider achieved an ‘Excellent’ overall rating.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 14 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We gave the provider 48 hours' notice that we would be visiting the office to make sure that the appropriate people would be there to assist us with our inspection.
Abbots Care Limited was registered on 21 November 2010 with the Care Quality Commission. Abbots care Limited is a large organisation which offers personal care and other related services in Hertfordshire,
Buckinghamshire and North London. This inspection covered the services provided in North, West, South and East Hertfordshire reaching out to approximately 1020 people.
The services provided include, domiciliary care; flexi care scheme; live in services; specialist care from home services, parent support and supported living, and a rapid response service.
There was a registered manager in post who was also the managing director of the company. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The provider had specialist staff teams trained to offer a wide range of care and support tailored to the individual needs of people with complex health and social care needs. These included people with behaviours others may find challenging; adults and children with learning disabilities and mental health needs, dementia and other complex life limiting conditions which required staff to have specific and specialist knowledge. For example tracheostomy care and support, palliative care, PEG feeds (Percutaneous endoscopic gastrostomy) are used for people who are unable to swallow or eat enough and need long term artificial feeding and Stoma care ( An artificial opening that allows drainage to occur from an internal organ)
People told us they felt safe whilst staff provided care and support. Staff understood how to keep people safe and risks to people's safety and well-being were identified and managed. We found that people's needs were met in a timely manner by sufficient numbers of skilled and experienced staff. The provider operated robust recruitment processes which helped to ensure that staff employed to provide care and support for people were fit to do so. People were supported to take their medicines safely by staff who had been trained and assessed as competent.
Staff understood how to keep people safe and risks to people's safety and well-being were identified and managed. We found that people's needs were met in a timely manner by sufficient numbers of skilled and experienced staff. The provider operated robust recruitment processes which helped to ensure that staff employed to provide care and support for people were fit to do so. People were supported to take their medicines safely by staff who had been trained and assessed as competent.
Staff received regular one to one supervision from a member of the senior management team which made them feel supported and valued. People received the support they needed to eat and drink sufficient quantities and their health needs were well catered for with appropriate referrals made to external health professionals when needed.
People and their relatives complimented staff for being kind and caring. Staff were knowledgeable about individuals' care and support needs and preferences and people had been involved in the planning of their care where they were able.
The provider had arrangements in place to receive feedback from people who used the service, their relatives, external stakeholders and staff members about the services provided. People were confident to raise anything that concerned them with staff or management and were satisfied that they would be listened to.
There was an open and respectful culture and relatives and staff were comfortable to speak with the registered manager if they had a concern. The provider had arrangements to regularly monitor health and safety and the quality of the care and support provided for people who used the service.
The provider had developed close working relationship with commissioners and local authorities from their respective catchment areas to develop new and innovative services in response to the needs of people in the community and hospital settings. This has had a positive impact on the people who needed these services and used the services of Abbots Care.
Due to their on going commitment to deliver an effective and responsive service the provider developed, in partnership with Watford General Hospital and Hertfordshire County Council a ’Delirium Recovery Pathway’ service which supported and returned people back to their own homes who may have otherwise been moved to long term placements. They provided specialist live in workers who assisted and rehabilitated these people until the delirium had been reduced and they regained their previous level of independence. The service also worked in partnership with local Clinical Commissioning Groups (CCG) to support a ‘Rapid Discharge Service.’ This pilot facilitated the discharge of 28 people who received short term care in their own homes following their stay in hospital.
Abbots Care were considered by the local authority in Hertfordshire to be a progressive provider who was proactive in designing high quality and person centred homecare services and who have improved discharge rates from hospital .They also considered that Abbots Care have demonstrated a detailed understanding of the ‘ethos’ of re-ablement by working with other professionals, such as occupational therapists to increase people`s opportunities to regain functional skills.
People received detailed information in a service user guide that explained how to complain and who to complain to and offered an overview of the services provided, offices opening hours and responsible staff contact details for each department within the service. The provider appropriately logged and responded to complaints. They investigated each complaint and if improvements were needed these were implemented and shared with the staff team to ensure there was learning outcome as a result of the issues raised.
We found that the provider was meeting the standards we had inspected. People and their relatives had been consented to their care and support they needed. People received care and support in line with their agreed care plans. Staff had been provided with the relevant training and support so that they were competent in their roles. There was a quality assurance system to assess and manage the quality of service. Records and confidential information had been kept securely and safely.
We found the service to be very well structured. All office staff we spoke to had clear lines of accountability. This meant that people received a service in their own homes that was efficient and met their current assessed needs. If people's needs changed, appropriate referrals were made to other services such as occupational health, or the district nursing service.