Advance Healthcare (Pine Court)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment under the previous provider, we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 66 (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 ensure action was taken when concerns were identified, and lessons were not always learnt to continually identify and embed good practice. Where concerns were identified with medicines administration and care recording there was no documented action taken and no lessons learned. However, people and their relatives told us they felt able to raise concerns about safety. Staff could describe how incidents were documented and reported. The provider had a system in place to examine incidents and safety events to consider any learning which could be applied to people’s care plans or shared with staff to make improvements.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. People told us they were supported with the transition to using the service. People told us when they started using the service, a full assessment was carried out and a care plan was completed. Partners told us the provider worked with other professionals to support commissioned packages of care, implementing a care plan after a referral was made. The registered manager told us people were supported to work in partnership to design their care plans.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. People told us they felt safe using the service and relatives shared this view. The registered manager understood the local safeguarding procedures and could describe how they had made referrals to the appropriate body when incidents occurred. Staff had been trained in safeguarding procedures and understood how to recognise abuse and report concerns.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. People’s risk assessments were not always in place to guide staff on how to support people with risks to their safety. One person required support from a district nurse with managing their diabetes. There was limited information in the persons care plan about how risks relating to diabetes should be managed. However, staff were able to describe the actions they would take to support the person and were able to tell us how they would escalate any concerns about the person. The registered manager told us they were aware some of the risk assessments and management plans were not fully reflective of people’s needs and person centred. They told us they were planning improvements to start the following month.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People and their relatives told us staff helped to ensure risks in people’s homes were minimised. One relative told us, “[Person’s name] flat is left as the staff find it and they always make sure that [person’s name] has no obstacles in their way.” The registered manager told us they had systems in place to assess risks in people’s homes, records we saw supported this. Risk assessments included environmental risk assessments which supported and guided staff on how to keep people safe. The provider completed a personal emergency evacuation plan for each person and staff were familiar with these in case of emergencies.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. People told us staff were well trained and there were enough staff, and staff had plenty of time to do things with people without them feeling rushed. One relative told us, “One of the best things is the staff always have time for a chat. This is one of the best things they do.” Staff told us they had an induction into their role and regular updates to their training and they felt there were enough staff to support people safely and had plenty of time in the calls to support people. The registered manager shared the recruitment policy with us and records showed staff were recruited safely.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. People told us staff wore gloves, aprons and masks when they supported them. Staff told us they had received training in infection prevention control procedures. The registered manager shared a policy with us which set out how staff should work to reduce the risk of cross infection and told us how risk assessments were completed to support reducing the risk of cross infection. Records we saw supported this.

The provider did not always make sure that medicines and treatments were administered as prescribed. Where people had medicines which needed to be given on an ‘as required’ basis, there was not enough written guidance available for staff on how to administer these for people. Medicine administration records showed 1 person had not had their medicine for over 1 month as there was a supply issue. There was no evidence that action had been taken to address this. This meant we could not be assured people had their medicines administered safely. However, people told us they received the support they needed with medicines. One person told us, “The staff apply cream prescribed by the doctor and this is recorded on a chart to say they have done it.”