Advent House

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.

This service scored 39 (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 always make sure people were at the centre of their care. People at the home did not have any activity plans and we were informed staff would decide what people would do. People were unable to share feedback with us about how they felt, but we received feedback from relatives that people were not being supported to complete activities they enjoyed. We reviewed 2 people’s care plan which stated activity plans should be completed for the following month. We also observed people at the home for the majority of the time not taking part in any meaningful activities but being guided back to communal spaces. There was also no plan in place to get people back into activities they used to enjoy or even explore new activities. Each person was given a set amount of money from the provider to spend on activities; there was inconsistencies in how this money and amount was spent. People also did not have any individual menu plans. Menu plans were devised without taking into account people’s individual needs. Alternatives were made for those who could not eat what was on the menu. Even though people’s dietary needs were met, we were not assured people were able to choose what they wanted to eat as. The provider could not evidence or demonstrate how they would involve people to make choices in menu and activity planning and explore new things, we were told they relied on people’s preferences. The provider had recognised the need for personalised menus but were still in the process to implement these. Staff also reported to us people were not doing meaningful activities, some people were being supported to go for drives which met their sensory needs, but a lot of the time people spent time indoors. One staff member told us, “There are some service users who seem to not leave the house for anything but appointments and maybe the odd outing once every few weeks.” Relatives also raised concerns about people no longer taking part in as many activities as they used to.

The provider understood the diverse needs of people at the service. People who lived at the service had a wide range of needs which were covered in the staff training programme. This meant that staff were given the knowledge they needed to support people with diverse health and care needs. To ensure continuity of care, there were a mixture of permanent, agency and bank staff working throughout the service. This helped to ensure there were always staff available who knew people well.

Staff did not supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. For people who had limited verbal communication skills there was no information in care records to show how staff were to gain their views and converse. There were no communication aids in use such as Picture Exchange Communication System (PECS) or talking mats. There were no easy read signage around the building that would navigate people to areas within the home. The provider did share examples of some easy read documents they had in place.

The provider did not always involve people in decisions about their care. Staff told us there was not much involvement from people to plan their activities or meals and the provider did not provide any evidence of how they would do this. Feedback that the provider had sought from a person included that they did not feel involved as it was hard for them to communicate. Staff told us they worked together to share experiences and techniques with each other and get tips from each other of how is most effective to communicate with people and what gets the best results. Staff shared that they had access for specific communication training, but this was not provided, and they relied on using their own ways to communicate.

The provider did not make it clear if people could access care, support and treatment when they needed it. There were not always plans in place for people who had shown interest in achieving meaningful goals. There was a lack of information recorded about what activities people may have completed and how they had progressed in these activities. People had hospital passports in place, but the information was not always consistent and in line with their care plans.

Staff and leaders did not listen to information about people who are most likely to experience inequality in experience or outcomes.The provider could not demonstrate whether people had received their commissioned 1-1 support and how this was provided. Relatives told us they raised concerns on behalf of their loved one as they could not always do so, but these were disregarded.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future. There was no evidence that people had been encouraged to consider their goals and aspirations for the future.Care plans had not considered how to support people to develop their independent living skills or develop goal-orientated plans for their stay at the home.