Advantage Healthcare West Midlands

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 remained Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider had effective processes in place to assess people's needs prior to care commencing. Assessments were completed with people and their families who helped develop care plans and risk assessments that were individual to them. Families told us they valued the opportunities to discuss their needs before support started.

For people with complex healthcare needs, assessments involved nurses and other professionals to help ensure care packages reflected clinical requirements. Care plans contained sufficient information to guide staff in delivering safe and person-centred care.

The provider also considered communication and accessibility needs during assessment, using tools such as the "Little Blue Book" for children and translation resources where required to support involvement in decisions about care.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Care records consistently reflected current treatment guidance and practice. We identified examples where medication information was inconsistent across records, treatment instructions were not always clearly documented and some care plans lacked sufficient detail regarding medicines and clinical interventions. This reduced assurance that staff were always working from accurate and up-to-date information. During our assessment the management team took action to improve records.

Policies and procedures reflected relevant legislation and guidance, including safeguarding, mental capacity and accessible information requirements.

People with complex needs were supported through input from nurses, case managers and multidisciplinary professionals where required. Care plans and risk assessments provided staff with the information needed to deliver care in line with people’s assessed needs.

The provider demonstrated a commitment to learning and improving practice through the sharing of clinical updates, medicines safety alerts and lessons learnt from incidents and safeguarding concerns.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

We found evidence of effective multidisciplinary working across the service. People and children were supported by a combination of care professionals, nurses, case managers and office-based staff, helping to ensure care was coordinated and responsive to changing needs.

Staff had access to clinical support and clear escalation pathways, including nurse advice, management oversight, an on-call system and an internal Rapid Response Team for people with complex needs. Regular team meetings were held to discuss service developments, staffing and operational issues, with the registered manager actively involved.

Communication systems were in place to share important information with staff, including lessons learnt, medication safety updates and clinical guidance. The provider also worked alongside families and external professionals to support care planning and decision-making where required.

Feedback and records reviewed showed collaborative working generally supported positive outcomes for people. However, some relatives reported that frequent changes in carers, nurses and a new manager had affected continuity and communication. Further improvements to workforce stability would help strengthen consistency of care and partnership working across teams.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The provider supported people to maintain and improve their health through personalised care planning, clinical oversight and partnership working with families and healthcare professionals. People with complex health needs had access to support from nurses, case managers and multidisciplinary teams to help ensure their changing health needs were identified and responded to appropriately.

Staff received specialist training and competency assessments to enable them to safely support people with a range of clinical needs, including complex healthcare interventions. Care plans contained information relating to people's health conditions, equipment needs and ongoing treatment requirements.

Staff worked with families and external professionals to promote positive outcomes and support people to remain as independent as possible. Families spoke positively about staff who knew people well and understood their individual needs.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The provider had a range of quality assurance systems in place to monitor performance, identify learning and drive improvement. These included audits, improvement plans, team meetings and oversight from the provider’s Head of Quality and Compliance. Performance data was reviewed centrally and analysed at branch level to identify trends and areas requiring further support.

There was evidence that learning from incidents, complaints and safeguarding concerns was shared across the organisation and used to inform service improvements. Regular clinical updates and medicines safety communications further supported staff to deliver safe and effective care and ensure positive outcomes for people.

Positive outcomes for people were evident through feedback received from relatives and examples shared by the service. Families described improvements in confidence with staff and management, engagement and trust, particularly where consistent staff teams were in place. We also saw examples of people developing positive relationships with staff, improved family engagement and care being adapted to meet individual communication and support needs.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The provider had systems in place to support lawful and person-centred decision-making. A Mental Capacity Act (MCA) policy was in place and reflected the five statutory principles, providing staff with guidance on gaining consent and supporting people who may lack capacity to make specific decisions.

People were encouraged to be involved in decisions about their care. We saw examples of children being supported to participate in care planning through the use of accessible communication tools. Where appropriate, families and other professionals were involved in discussions regarding care and treatment.

Mental capacity assessments were completed when required and generally demonstrated consideration of decision-specific needs. However, further improvements were needed to ensure records clearly evidenced the role and authority of family members involved in decision-making. For example, one assessment referred to family involvement in best-interest decisions, but the legal basis for this involvement was not clearly documented. The manager and quality lead informed us they would review mental capacities currently in place and amend information to ensure all detail was captured.