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Inspection Summary


Overall summary & rating

Requires improvement

Updated 20 December 2018

The inspection took place on 9 and 10 October 2018 and was unannounced. At the previous inspection we found the provider did not have a robust recruitment process in place and concluded this was a breach of regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found improvements had been made and the provider was no longer in breach of this regulation.

At the previous inspection we found the provider had not submitted all relevant notifications to the CQC. We found this was a breach of Regulation 18 CQC (Registration) Regulations 2009 Notification of other incidents. We found improvements had been made and the provider was no longer in breach of this regulation.

Since the last inspection Advent House no longer provides nursing care and has updated their registration with the CQC to reflect this.

Advent House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Advent House accommodates up to ten people in one adapted building.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service has a registered manager in post. ‘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.

Staff were kind and patient. It was clear they knew people well and how to meet their needs. The systems and processes in place to manage medicines were safe. Risks associated with people's care were identified and managed. However, these were not always documented.

People were supported by sufficient numbers of staff to meet their needs. Staff recruitment records demonstrated the service was ensuring staff were subject to the appropriate scrutiny.

The service followed the principles of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

New members of staff did not receive appropriate training and supervision. There was no clear record of what training staff had undertaken and when it was due to be refreshed. We concluded this was a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Care plans contained up to date information regarding people’s care and support needs. People enjoyed meaningful activities.

Staff felt supported and had seen improvements in the home. Staff told us they were asked to provide feedback on the service and felt listened to.

The registered manager and deputy manager completed regular audits in areas such as, Deprivation of Liberty Safeguards (DoLs), finance, accident and incidents, medication, infection control and safeguarding. They had begun to complete audit action plans to ensure issues identified were addressed.

The provider’s audits were contained within the registered manager’s supervision notes. They did not always record the exact information they had checked. Any outstanding actions were recorded so they could be followed up at the next supervision. A monthly operations report was emailed to the provider by the registered manager. However, there was no area within the form for comments or to record any action taken by the operations manager or directors in relation to the information in t

Inspection areas

Safe

Requires improvement

Updated 20 December 2018

The service was not always safe.

The systems and processes in place to manage medicines were safe.

Risks associated with people's care were identified and managed. However, these were not always documented.

People were supported by sufficient numbers of staff to meet their needs.

Effective

Requires improvement

Updated 20 December 2018

The service was not always effective.

New members of staff did not receive appropriate training and supervision.

The service followed the principles of the Mental Capacity Act 2005.

People were supported to maintain a balanced diet.

Caring

Good

Updated 20 December 2018

The service was caring.

People were treated with dignity and respect.

People's independence was promoted and they were involved about matters relating to their care and support.

Responsive

Good

Updated 20 December 2018

The service was responsive.

Care plans contained up to date information regarding people’s care and support needs.

People enjoyed meaningful activities.

There were systems in place to respond to complaints.

Well-led

Requires improvement

Updated 20 December 2018

The service was not always well-led.

The provider did not operate effective systems and processes to make sure they assessed, monitored and mitigated the risks relating to the health, safety and welfare of service users.

Staff told us they felt supported and listened to.