Advent House

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation good governance.

This service scored 43 (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 have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion.People’s choice had been taken away without any consultation or engagement with people. We received consistent feedback from staff that there recently been a big focus on reducing costs which was impacting the quality of care being provided, for example, people were not being supported on as many activities. One staff member told us, “We don't do anything with people anymore, we used to take people out on day trips to the beach or the fayre or bowling, now we don't do anything. We are told that we don't have the money to spend on days out or even on activities we could do in the house with them, we very rarely take them out anywhere because we don't have enough staff to provide the safe level of support.” Another staff member told us, “We have people who have a preference to go out or do certain activities but that has all been stopped due to budget cuts."

Leaders could not demonstrate they had the skills or knowledge to lead effectively. Staff did not feel managers at the service were supportive, especially around difficult incidents. Examples were shared with us of when staff sought support, but none was provided. We received feedback from relatives that they did not feel registered manager had good knowledge of their loved ones, what their needs were and how they should be cared for. The registered manager also did not always have the knowledge or understanding to ensure the service provided safe and effective care in line with best practice guidance. The provider could demonstrate that people had the right support, right care and right culture, which is highlighted in this report. The registered manager did share a weekly report to the area manager updating them of different areas of the service.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.We saw results from the last staff survey that was completed, but we found no actions were set following the concerns raised in relation to communication and staffing. Even though the provider had a freedom to speak up policy, majority of the staff we spoke with did not feel like they could speak up as they felt like they would not be heard.

The provider valued diversity in their workforce. They worked towards improving equality and equity for people who worked for them. The provider had policies in place to guide staff to make sure equality and diversity were considered in all aspects of their work. This included ensuring recruitment processes did not disadvantage different groups of people. Staff had received training in equality and diversity and knew how to put this into practice.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. Audits were being completed at the service but they were not effective. Audits did not find issues we found in medication, care records, lack of activities, use of bed rails and incident reports. Not all seniors who administered medication had competencies completed. During the site visits, we were not assured relevant staff had their competency assessed to support people with medicines. The provider did not provide assurances that they completed competencies appropriately and in line with the competency assessment. Not all seniors who administered medication had competencies completed. The registered manager informed us they had only received 1 complaint since they had started in October 2024. However, we received feedback from 2 relatives that they had raised concerns in relation to their loved one’s care, it was unclear if these had been reported as complaints, but there were no records of these concerns. The service had failed to act on feedback about staffing levels which staff had shared on numerous occasions. Relatives had also raised concerns about staffing. According to the rotas, the service is rota’d in line with commissioned hours, however the deployment of staff was not effective to ensure staff feel safe supporting people. Five residents had DoLs authorisations in place which deprived them of their liberty. We had not received any notification for these. The registered manager confirmed these had not been sent.

The provider did not always understand their duty to work in partnership with other agencies. Even though we were advised that appropriate referrals had been made to external health and social care professionals, there was not always evidence that contact had been made with other professionals to provide valuable input and help resolve issues for a person. We received no feedback from any professionals regarding the provider’s engagement with them.

The provider did not focus on continuous learning, innovation and improvement across the organisation. They did not encourage creative ways of delivering equality of experience, outcome and quality of life for people. There were gaps in systems which prevented leaders from having full sight of the right information about risks, performance and outcomes, this meant the service did not have an effective learning culture.Whilst there were regular meetings held with people living at the home, there were no action plans to show staff had responded to ideas and suggestions made.