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 requires improvement. At this assessment the rating has changed to inadequate.

This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

This service scored 33 (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 because they did not check and discuss people’s health, care, wellbeing and communication needs with them.

At the last inspection we found care plans had a good level of detail, at this inspection we found the same. However the provider could not demonstrate tools they used to support people to communicate.At this inspection we found the same. Staff told us they would communicate with people verbally, however, upon our observations, we observed most people’s verbal communication was limited and they would benefit from communication tools. We found there was no easy read signage to assist people to navigate them 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.

People had care plans in place however, these did not always reflect the needs of people. This meant there was a risk that people’s needs were not always met. For example, bowel monitoring, continence monitoring and weight management were all areas which were not regularly monitored.

Staff worked closely with other agencies and professionals to ensure people received the appropriate care and treatment. However, the service did not always embed information from other agencies to make changes to peoples care and treatment. Staff had an informal communication process they used to communicate with each other regularly. Staff used handover documents between shift changes however these were not always fully completed. Daily record entries for people were not completed regularly which meant information was missing.

The provider did not support people to manage their health and wellbeing, so people could not maximise their independence, choice and control. Staff did not support people to live healthier lives, or where possible, reduce their future needs for care and support. There was no documentation or care plans to support people to live healthier lives. We did not receive any evidence of staff promoting healthier eating, diet or exercise for people using the service.

Some relatives we spoke to had concerns about weight management for their relative. People who required regular weight monitoring did not receive this. For example, we reviewed information between the service and other specialist services such as the dietician. However, staff did not always implement recommendations made to support people to live healthier lifestyles. It was unclear how the provider supported people with regular exercise or encourage them to live healthier lives.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

There was a lack monitoring related to physical health which included weight monitoring, bowel monitoring and continence monitoring. The service did not complete consistent monitoring which meant there was limited oversight in monitoring and improving outcomes for people who used the service. Staff told us sometimes people were taken to be weighed but this was not always documented.

Staff were observed to gain implied consent to day to day activities however this was not always explored more formally for specific tasks. For example, one person could sometimes become distressed when supported by male members of staff in personal care. The registered manager had not explored consent around this care intervention. The service was not always able to demonstrate that residents had been consulted in aspects of their care planning when changes had been made to their care and treatment. One person receiving covert medication had processes completed in line with national guidance.