Fanco Ltd (Avant Healthcare Services – Manchester South) was rated Requires Improvement overall at its first inspection, with breaches of Regulation 17 due to ineffective governance systems, unsafe medicines management, and an absent registered manager whose departure left directors without sufficient knowledge to run the service safely. Strengths included kind and caring staff, person-centred care plans, no missed calls, and a responsive provider who took corrective action during the inspection.
Concerns (7)
criticalMedication management: “There were no protocols to tell staff when they should administer 'when required' medicines, and staff did not record what medicines were contained in the blister packs they administered.”
criticalSafeguarding: “The provider was unaware of the correct process for reporting safeguarding concerns to the local authority.”
criticalGovernance: “Effective systems were not operated to monitor, assess and improve the quality and safety of the service. This was a breach of Regulation 17(1) of the Health and Social Care Act 2008.”
criticalLeadership: “There had been no registered manager in post for approximately three months...the provider did not demonstrate the experience and knowledge required to run the service safely.”
moderateCare planning: “In one case we found the provider had not given adequate consideration to the recommendations of a professional...staff were directed to carry out potentially unsafe practices in relation to moving and handling.”
moderateConsent / capacity: “In some cases, it was not clear what decisions mental capacity assessments related to...the provider frequently referred to taking instruction from people's families without consideration of the individual's ability to take decisions.”
minorRecord keeping: “In one case we saw the staff member had been employed before the provider had received written references...there was no record of verbal references.”
Strengths
· People and relatives told us staff were kind and caring in their approach and communicated well with them.
· Care plans were person-centred and provided staff with the information needed to provide care meeting people's needs and preferences.
· Electronic call monitoring was used to alert the provider if staff had not attended a call within 30 minutes; no missed calls were reported.
· Staff received adequate training, support and induction including the Care Certificate and an 'Avant Day' training course.
· Complaints were identified, investigated and used to improve the service, with people feeling comfortable to raise concerns.
Quality-Statement breakdown (19)
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Using medicines safelyRequires improvement
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongRequires improvement
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
caring: Ensuring people are well treated and supported; equality and diversityGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and controlGood
responsive: Improving care quality in response to complaints or concernsGood
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 requirementsRequires improvement
well-led: Continuous learning and improving care; Engaging and involving people using the serviceRequires improvement
Avant Healthcare Services Manchester South improved from Requires Improvement to Good across all five key questions, resolving a previous breach of Regulation 17 (Good Governance) through robust quality assurance systems. People reported consistent, reliable, person-centred care delivered by well-trained staff and a highly accessible registered manager.
Strengths
· People felt safe and received continuity of care from familiar staff; safe recruitment systems were in place.
· Medicines were managed and administered safely, with staff competency in administration checked.
· Staff received comprehensive induction and mandatory training, and felt well supported.
· Care records were detailed, person-centred and reflected individual preferences and needs.
· Robust daily, weekly and monthly quality assurance checks and audits were implemented following previous breach.
Quality-Statement breakdown (24)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving care; Working in partnership with othersGood