Abbey Support & Services Limited is a domiciliary care agency providing personal care to people living in their own homes. At the time of the inspection, the service was providing support for 24 people residing in Leicester.

Abbey Support & Services Limited had a registered manager. 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 announced inspection site visit took place on 3 December 2018.

Abbey Support & Services Limited was previously inspected by the Care Quality Commission on 8 August 2017, where we had identified two breaches of the regulations. The overall rating for the service was requires improvement. During this inspection we found the required improvements had been made.

Following the last inspection of 8 August 2017, we asked the provider to complete an action plan to show what they would do and by when to improve medicine systems and processes and to ensure effective governance of the service. We found improvements had been made.

People’s records provided information as to the medicine they were prescribed and who was responsible for its administration, such as family members or staff. Staff signed records, where they had the responsibility for administering medicines or applying prescribed creams.

Systems to monitor the quality of the service were found to be effective. Where shortfalls were noted by the registered manager action was taken by them to bring about improvement. The action taken was recorded and communicated with staff.

People’s safety was promoted by staff who implemented the guidance as detailed within people’s risk assessments and care plans. People received their medicines in a safe way. Staff were knowledgeable about people’s care and support and the importance of using equipment to support in the delivery of care safely.

People and their representatives spoke positively about the consistency of a team of staff in the provision of care, which meant people were comfortable and relaxed when they received personal care and support.

People’s needs were assessed to ensure the service and staff could meet their needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrict way possible; the policies and systems in the service supported this practice.

Staff received support from the registered manager, through supervision and checks to ensure they were competent to carry out their roles effectively. Staff received the training they needed to provide safe and effective care to people.

People and their representatives spoke of the positive relationships they had developed with staff. The registered manager had received positive feedback about the service. People’s dignity and privacy was promoted and staff were aware of the importance of confidentiality.

People’s views and those of their representative had been sought to develop care plans, which were regularly reviewed by the registered manager. People’s care plans had considered the individual needs of each person and the role of staff in meeting these Staff who provided care, were able to speak with people in most instances in people’s first language.

People’s knew how to complain and their concerns had been investigated and action taken to address the issues raised.

Systems were in place to monitor the quality of the care being provided, which included seeking the views of those using the service and family members. A range of audits were undertaken to evidence the quality of the care and the accuracy of records used to record people’s care and support. There was an open and transparent approach to the management of the service, which included team meetings, supervision and c

This announced inspection took place on 8 August 2017. Abbey Support & Services provides personal care to people who live in their own homes in the community. There were 24 people receiving personal care at the time of this inspection.

The provider was also the registered manager at the time of our inspection. 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.

We identified that the provider was in breach of two of the Regulations of the Health and Social Care Act 2008 (regulated activities) Regulations 2014. You can see at the end of this report the action we have asked them to take.

There was a risk that people would not receive their medications safely. Staff administered medication to people however they had not received clear guidance to ensure that the medicines that they administered were safe for them to give to people. Records were not always kept to show that staff had given people the correct medicines.

People and their relatives told us that they felt safe. Staff were aware of their responsibility to keep people safe. Risks were assessed and managed to protect them from avoidable harm.

Staff had received training and guidance to understand how to recognise abuse and report any concerns that they may have. Safe recruitment practices had not been followed.

People received support at the times that they wanted to and could be assured that staff would provide the care that they wanted them to.

Staff had received training and supervision to meet the needs of the people who used the service. Staff told us that they felt supported.

People made decisions about their care and the support they received. Their consent was sought. The registered manager understood their responsibility to ensure people were supported in line with the Mental Capacity Act 2005 (MCA).

People’s health needs were met and when necessary, outside health professionals were contacted for support. People were supported to have enough to eat and drink.

People’s independence was promoted and people were encouraged to make choices. Staff treated people with kindness and compassion. People’s communication needs were identified and supported. Dignity and respect for people was promoted.

The care needs of people had been assessed. Staff had a clear understanding of their role and how to support people who used the service. People contributed to the planning and reviewing of their care.

People, their relatives and staff felt that the registered manager was approachable and action would be taken to address any concerns they may have. People were kept informed of changes to the service and their feedback was sought.

There were not always robust systems in place to check the quality of the service provided. The provider was not always following their own policies and procedures.

The registered manager was aware of their responsibility to report events that occurred within the service to CQC and external agencies.

We carried out an announced inspection of this service on 29 July 2013. Four breaches of legal requirements were found. This was because the provider did not ensure that the planning and delivery of care ensured the welfare and safety of people using the service. The provider did not make suitable arrangements to ensure that service users were safeguarded against the risk of abuse. The provider did not operate an effective recruitment process. And the provider did not have suitable arrangements in place in order to ensure that persons employed at the service received appropriate training.

We undertook this announced inspection on 12 August 2015 to check that improvements had been made and to confirm that the provider had met legal requirements.

Abbey Support and Services is a domiciliary care service providing care and support to people living in their own homes. The office is based in Leicester and the service currently provides care and support to people living in Leicester and in Leicestershire. At the time of our inspection there were 25 people using the service.

The service had a registered manager. This 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.

People told us they felt safe using the service. They said their care workers identified themselves on arrival and this made them feel safe. All staff had had safeguarding training and knew what to do if they had concerns about the well-being of any of the people using the service. Staff also understood risk and how to protected people from risky situations.

People said they thought the staff were well-trained and knew how to support them effectively. Staff had a thorough induction and on-going training to keep their skills up to date. Staff were safely recruited to help ensure they were fit to work with people who use care services.

Staff supported some people with their meals. People said they were pleased with the choices they were given and how their meals were prepared and served. Staff were flexible with meals and understood that people might change their minds about what they wanted on a day to day basis.

People said staff were aware of their health care needs and knew when to call the GP or other healthcare professionals if they needed them. If people appeared unwell staff knew what to do. If people needed support with their medication staff provided this safely.

People told us the staff were caring and treated them with dignity and respect. They gave us many examples of staff member’s caring approach to them. Records showed that people’s care was provided by either a single staff member or a group of two to three care workers. This enabled people to get to know the staff who supported them.

People were directly involved in the planning of their care and encouraged to be independent and made choices about how they wanted their support provided.

Staff provided a personalised service that was responsive to people’s needs. Care plans highlighted people’s individual preferences, although some lacked detail. The registered manager said she would address this. Care workers visited people and discussed their support needs with them before providing care.

The service’s complaints procedure was in need of updating and the registered manager said she would do this. Records showed that if people raised concerns these were taken seriously and the staff worked with people using the service and relatives to resolve them.

All the people we spoke with said they were happy with the service which they said was well-run.

People told us the registered manager often visited them in person to check on their well-being and monitor their care and support. People using the service were consulted and their opinions sought on all aspects of the service. Changes and improvements were made as a result of this.

People told us that they were happy with the care and support they received. One person told us: “They are excellent, always on time and very, very helpful.” Another person explained: “I am quite happy with them and they can speak gujurati, so, so far so good!”

We looked at the care planning and risk assessment process and found that although care plans and risk assessments were in place, not all of these documents reflected the current support the people were receiving and some risk assessments had been completed, whilst others had not.

We checked the service’s recruitment processes to see whether support workers had been recruited appropriately. We found that the required checks, including references and a check with the DBS (Disclosure and Barring Service) had not always been carried out prior to them working in the community.

At the time of our visit support workers had yet to receive the formal training required to ensure that they could proficiently meet the needs of those they were supporting. This included safeguarding adults training, Infection control training and food hygiene training.

At the time of our visit the provider was in the process of developing a monitoring system to ensure that they could assess and monitor the quality of the service being provided.