CQC report explained · a residential care home
What the CQC found at Advent House
Rated Inadequate: inspectors found the home performing badly and the CQC has taken enforcement action.
What inspectors found, February 2020
Rated Good; inspectors found safe, kind and person-centred care, with improvements since the previous Requires Improvement rating.
Inspectors visited the home without notice on 30 December 2019 and 7 January 2020. They observed all residents, spoke with eight staff and reviewed care, medicines, recruitment, training and management records.
The home supported seven adults with learning disabilities, autism or other complex needs. Inspectors found people were happy and settled, staff knew them well, risks and medicines were managed safely, and the home was clean.
Staff supported people to make choices, build independence and take part in activities such as outings, holidays and concerts. Care records were detailed and staff worked well with health and social care professionals.
The overall rating and all five question ratings were Good. The previous rating was Requires Improvement, with one breach of regulation. Inspectors found improvements had been made and the home was no longer in breach.
Staff knew people well
People appeared happy and settled. Staff understood their routines, preferences and communication needs.
“People were very happy and settled, and staff clearly knew them very well.” from the report
Safe medicines support
Medicines were stored, administered and recorded safely. Staff monitored as-required medicines and checked their competence.
“Medication was stored, administered and recorded safely. Records showed time specific medication and how people preferred to take their medicine.” from the report
Meaningful activities
People were supported to access the community and take part in activities, including holidays, swimming and a pop concert.
“People enjoyed many outings and trips including holidays and pop concerts.” from the report
Personalised care
Care records described people's abilities, needs, preferences and goals. Communication plans helped staff support people effectively.
“Care documentation was personalised and contained detailed and relevant information regarding people's specific needs and preferences.” from the report
End of life wishes
needs fixingRecords did not clearly show some people's wishes about end of life care. No one was receiving end of life care during the inspection.
“Evidence was limited as to what people's wishes were for end of life.” from the report
Induction records
needs fixingSome staff induction booklets were not completed fully, so the records did not always show how learning was put into practice.
“However, these were not always completed in full to evidence how this knowledge was put into practice.” from the report
Quality systems
minorThe quality assurance systems were working, but inspectors found them difficult to navigate. The manager agreed to consider an alternative approach.
“Quality assurance systems were in place but hard to navigate.” from the report
- 01How will you discuss and record my relative's wishes about end of life care?
- 02How do you check that every new staff member completes their induction fully?
- 03How do you make sure agency staff understand my relative's needs and communication guidance?
- 04What changes have you made to make the quality assurance systems easier to navigate?
- 05How will you continue the improvements that led to the change from Requires Improvement to Good?
This was an unannounced planned inspection covering all five key questions, including the care and the premises; the report says the previous Requires Improvement areas had improved to Good. This explanation was written from the published report of 14 February 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, December 2018
Advent House is rated Requires Improvement; inspectors found kind, personalised care, but staff training and quality checks were not reliable.
This was an unannounced inspection on 9 and 10 October 2018. Inspectors spoke with people living in the home, relatives and staff. They also checked care records, staff files, medicines records and quality checks.
The home was caring and responsive. Staff were kind, patient and knew people well. Care plans were up to date, people were supported to make choices, and they enjoyed a wide range of activities.
There were important weaknesses. New staff did not have clearly recorded training, induction or supervision. Some risks were managed in practice but not properly documented. The provider's checks did not always find these problems.
The overall rating Requires Improvement means the home was not consistently meeting the standard expected. There was one breach, relating to staff training and supervision. Improvements had been made since the previous inspection in recruitment and notifications to CQC.
Kind and respectful staff
Staff were patient and compassionate. They knew people well and supported their dignity, privacy and independence.
“People were treated with kindness, respect and compassion, and were given emotional support when needed.” from the report
Personalised care
Care plans described people's individual needs, preferences and abilities. People and their relatives were involved in reviews where possible.
“The support plans were personalised and responsive to people's individual needs and preferences.” from the report
Improved recruitment checks
The previous recruitment breach had been addressed. Records showed that references and DBS checks were completed.
“Staff recruitment records demonstrated the service was ensuring staff were subject to the appropriate scrutiny.” from the report
Staff training and supervision
seriousNew staff did not have a clear record of mandatory training, induction and supervision. This was a breach of Regulation 18.
“There was no clear system in place to demonstrate that new staff had received mandatory training, supervision and support during their induction.” from the report
Risk records
seriousOne person did not have a risk assessment for pressure sores at the time of inspection. Risk assessments also combined several risks, which could cause confusion.
“We identified there was no risk assessment in place for one person who was at risk of pressure ulcers.” from the report
Topical medicines records
needs fixingBody maps were not being used for creams and lotions, and instructions did not always explain clearly where or when they should be applied. The manager said these were put in place after the inspection.
“We found body maps were not in use for topical medications.” from the report
Weak quality checks
seriousThe provider's audits did not identify some missing risk and medicines records. There was also no clear structure for making sure induction and staff competencies were completed regularly.
“The provider did not have sufficient systems and processes to mitigate the risks relating to the health, safety and welfare of service users.” from the report
- 01What training, induction and supervision does every new staff member now receive, and how is completion recorded?
- 02How often are staff competencies checked, and can you show me the current training matrix?
- 03How are pressure sore risks assessed, recorded and reviewed for each person?
- 04How are topical creams and lotions recorded, including body maps and instructions about when and where to apply them?
- 05What changes have been made to the provider's audits so that missing records and staff training gaps are identified promptly?
This was an unannounced inspection of the home, its premises and care, and it considered all five CQC questions; the home no longer provided nursing care. This explanation was written from the published report of 20 December 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Advent House
6 rated inspections over 3 years: the service has improved, from Inadequate to Good.
- February 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2017Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2017Inadequatedown from Requires improvementSafe: InadequateWell-led: Inadequate
- March 2017Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- November 2016InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- August 2014
Report published without a new overall rating.
- November 2013
Registered with the Care Quality Commission on 24 November 2013.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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Most charge £980 to £1,260 a week. 79 can care for a couple. 12 years' experience on average.
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