Advent House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not make sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Even though someareas of care plans had good level of details, the provider could not demonstrate tools they used to support people to communicate effectively. We were told people would respond verbally, but from our observations, most people’s verbal communication was limited and would benefit from a communication tool to communicate effectively. We reviewed 2 people’s care plans which stated staff should be aware of intensive interaction to aid communication between them. No staff had completed this training. Staff told us they sometimes used Makaton to communicate with people, but it was not clear who with. We also found there was no pictorial documents/signage or posters to navigate people around the service.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. It was not always evident that people were receiving evidence-based care and treatment as required. The provider did not effectively use positive behaviour support (PBS) which is a recognised proactive support framework for people who find it difficult to communicate their anxieties effectively. The provider informed us they had made referrals for people to get support around this so they could support people to meet their needs effectively. Care plans were developed around people’s needs; however, some plans did not hold up to date information and there was a risk of people’s needs not always being fully met.

Staff worked closely with other agencies and professionals such as district nurses and GPs to ensure people received appropriate support.We received no concerns in relation to staff working with other agencies. During our visits we found there were no clear staff allocations in place showing how people got their shared support and individual support hours. Staff reported that staff were allocated on the day by the senior staff member to people, but this was not always a consistent approach. Staff reported at times they were allocated to the same person for long periods or multiple days and felt this was exhausting when they displayed continuous agitation. The manager could not evidence fair allocations but advised they would put a system in place to enable and monitor this. Staff had good knowledge of people and ensured they worked in their best interest.

The service did not always support people to live healthier lives. Everyone had an annual review completed, but there was no fully completed health action plans which would outline if any actions or goals were set from these reviews. We reviewed key worker records, person had shown interest in wanting to lose weight, but no plan had been implemented for this.

There was inconsistency in how the provider monitored people’s care and treatment to continuously improve it. Care records did not evidence that people’s health and wellbeing was routinely monitored. We also found there was a lack of feedback noted from medical or health professional’s appointments, so it was not clear if people were making progress or not.

The provider did not always follow the principles of the Mental Capacity Act 2005 (MCA). Upon review of people’s documents, we found one person had no documentation in place for consent to care and support.Most people had Deprivation of Liberty Safeguard authorisations (DoLS) in place, we reviewed these, and they included how people’s liberties were being deprived of. Staff understood the importance of gaining people’s consent before they supported them.