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Advance Cornwall, a supported living domiciliary care agency in Truro, was rated Requires Improvement overall at its first inspection, with breaches of Regulation 17 (Good Governance) due to missing risk assessments, absent medicines audit processes, and out-of-date medicines training for six staff not identified by the provider's own monitoring systems. Caring, effective and responsive practice were all rated Good, with people receiving person-centred support from a committed staff team, though inconsistent record-keeping and a transitional management restructure undermined governance and safety oversight.