Advinia Homecare received a Good rating across all five key questions at its first inspection in August 2019, with 48 people receiving personal care and strong feedback from people, families and professionals. Minor issues around medicines recording, rota management and a care plan omission regarding mental capacity were being actively addressed by the registered manager.
Concerns (4)
moderate
Record keeping
: “A recent audit by the local authority had found the recording of staff support with medicines required improvement. The registered manager had put a clear action plan in place.”
minorGovernance: “The registered manager accepted the management of rotas needed to improve before there was an increase in the numbers of people being supported by the service.”
minorCare planning: “One person was not able to make decisions about taking their medicines. Their care plan gave staff good advice...but was not explicit about whether they had capacity. The manager amended the care plan immediately.”
minorMissed or late visits: “Feedback was less positive when usual care staff were not available, and we were told covering staff were less punctual and well organised.”
Strengths
· Overwhelmingly positive feedback from people and families about the quality and caring nature of staff.
· Effective safeguarding processes with good communication between staff and the local authority.
· Person-centred care plans recently rewritten to provide clearer guidance to staff.
· Strong, stable registered manager with excellent feedback from staff, people and professionals.
· Good end-of-life care supported by a hospice-trained staff member and experienced senior staff.
Quality-Statement breakdown (21)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
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: 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: 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: Continuous learning and improving care; Working in partnership with othersGood
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 candour; Engaging and involving people and staffGood
Focused inspection of safe and well-led following concerns about missed/late calls and medication errors found the service remained Good, with safe recruitment, positive culture and effective partnership working. However, governance systems, care plans and medication records were still being developed and needed to be embedded to sustain improvement.
Concerns (9)
moderateMedication management: “Before the inspection we had received information reporting medication errors that had taken place.”
moderateMedication management: “current medication administration records (MARs) were not clear for staff to follow and needed to be more detailed.”
moderateStaff competency: “There had been some concerns with the current agency provider due to inconsistent communication and concerns around agency staff competency.”
moderateMissed or late visits: “We received concerns in relation to missed and late calls, and of people not receiving the correct number of staff to attend to their care and support needs.”
moderateGovernance: “systems and processes were still being developed by the nominated individual and the manager.”
minorCare planning: “Care plans contained basic explanations of the control measures for staff to follow to keep people safe.”
minorLeadership: “At the time of our inspection there was not a registered manager in post.”
minorStaffing levels: “The provider had refrained from taking on any further care packages until they had recruited enough staff.”
minorCommunication with families: “Formal surveys of staff and people had not been carried out.”
Strengths
· People told us staff arrived on time and care was consistent
· People and relatives reported feeling safe with staff visiting
· Staff trained in safeguarding and confident to identify and report concerns
· Safe recruitment processes including DBS checks and references in place
· Staff supported people to take medicines safely with competency assessments underway
Quality-Statement breakdown (12)
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: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
well-led: Promoting a positive, person-centred cultureNot rated
well-led: Duty of candourNot rated
well-led: Managers and staff being clear about their roles and regulatory requirementsNot rated
well-led: Engaging and involving people, the public and staffNot rated
well-led: Continuous learning and improving careNot rated
well-led: Working in partnership with othersNot rated