Advantage Health & Social Care was rated Requires Improvement overall at its first inspection, with concerns around inconsistent medicines recording/PRN guidance, inaccessible recruitment records on the day, and governance gaps. People received personalised, compassionate care from a small consistent staff team and effective, caring and responsive services were rated Good.
Concerns (6)
moderate
Medication management
: “we saw there were three gaps on one person's medication administration record, and body maps for creams were not consistently completed”
moderateMedication management: “guidance provided to staff to support the administration of 'as and when' required medicines were not consistently in place”
moderateRecord keeping: “Staff files were not easily accessible on the day of our inspection. The registered manager could not locate staff references and DBS checks.”
moderateGovernance: “we identified some inconsistencies in how the governance systems were working. For example, medication audits had not always identified areas where staff would benefit from further guidance”
minorLeadership: “The registered manager acknowledged they required more time to do administration tasks rather than undertaking care duties.”
minorStaffing levels: “we noted the registered manager was on the rota covering a significant amount of care calls”
Strengths
· People received personalised care from a small, consistent staff team who knew them well
· Staff treated people with compassion, kindness, dignity and respect
· People and relatives felt safe with staff in their homes
· Staff demonstrated a good understanding of safeguarding and had completed safeguarding training
· Risks associated with people's care had been assessed including nutrition, falls and pressure care
Quality-Statement breakdown (24)
safe: Using medicines safelyNot rated
safe: Staffing and recruitmentNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Supporting people to live healthier lives, access healthcare services and supportNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: How the provider understands and acts on the duty of candourNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Continuous learning and improving careNot rated
well-led: Working in partnership with othersNot rated