Advantage Healthcare - South Coast

Advantage Healthcare - Southcoast is a domiciliary care service providing the regulated activities of personal care and nursing care to people in their own homes. The service supported children, young people and adults of all ages who required support with a range of care and health needs. Some people were supported with 24-hour care provision. At the time of our inspection there were 10 people receiving personal care or nursing care.

Not everyone who used the service received personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

We have made a recommendation about the recording of medicine management. We have made a recommendation about the recording of mental capacity assessments and best interest decision making.

Audits of care records did not always identify areas for improvement or gaps. A new online care record system was being introduced to give managers improved processes to review and audit records.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. We found mental capacity assessments and best interest decision making was not robustly documented.

Staff were safely recruited to their roles. There were safeguarding policies and processes which staff followed to keep people safe and report any concerns. Staff were trained to manage infection prevention and control and had access to the personal protective equipment (PPE) they needed.

People’s nutritional and health needs were managed effectively with them. Professional advice and guidance was followed when people required healthcare and nursing support. People’s needs were regularly reviewed, and referrals were made to health professionals when required.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 31 December 2019).

The provider completed an action plan after the last inspection to show what they would do, and by when, to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations, however, the service remains rated requires improvement.

Previous recommendations

At our last inspection we recommended the provider made checks to ensure all staff completed training required by the provider. At this inspection we found staff training had been completed and was monitored appropriately.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions of safe, effective and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Advantage Healthcare – Southcoast on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Interserve Healthcare South Coast is a care at home agency that provides personal care to people, including adults, children and infants, in their homes. Interserve Healthcare South Coast provides support for people across the south coast who require a range of personal and care support. Staff provided bespoke care depending on the person’s need. Personal care or support was bespoke, ranging from four hours every other day to 24 hours a day 'live-in' support for people who have more complex needs such as long-term health conditions. At the time of the inspection, 18 people were receiving personal care.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People's experience of using this service and what we found

We received mixed feedback about staffing levels and staff deployment from people, relatives and external professionals. Relatives told us they and people were not always informed about changes to their visits. At this inspection, we identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2004 regarding Staffing.

Medicines were handled correctly and safely, staff were trained to give medicine safely. Despite this, we saw gaps and errors in recording of medicine administration. Audits used to monitor medicines identified these gaps, but the provider did not always take action informed by these audits to improve record keeping and ensure compliance with all the fundamental standards.

At the time of our inspection, there was no registered manager. The manager was very newly in post and was well regarded by office staff. Staff told us they had already made improvements such as holding team meetings. Office staff told us that during the transition between managers, an interim manager continued to support them. Staff told us they had supervisions and appraisals however they told us there had been a gap in team or peer meetings since the change in manager.

Recruitment processes were robust and made sure staff were employed who were suitable to work with adults and children and in the care sector.

People were protected from the risks of abuse and said they felt safe with the staff providing their support and care. Staff were trained to identify safeguarding concerns for adults and children.

People received bespoke care and support that was personalised to meet their individual needs. Records showed that people received care and support from staff who were trained. Despite this, we received mixed feedback about staff knowledge and competency. We recommended that the provider checks that all staff have completed their training and competency checks as required by the provider.

Staff monitored people's health and wellbeing and took appropriate action when required to address concerns.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People, relatives and staff had mechanisms to give their feedback about the quality of the service. We saw that formal complaints were recorded and investigated. People were consulted about their care and support.

People were treated with care and kindness. People's diverse needs were identified and met and their right to confidentiality was protected.

This service met the characteristics of Requires Improvement. More information is in the ‘Detailed Findings’ below.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

This service was registered with us on 23 October 2018 and this is the first inspection since the provider made a change to its registration. Newly registered services are assessed to check they are likely to be safe, effective, caring, responsive and well-led. The last rating for this service was Good (published 10 August 2016). Since this rating was awarded the provider changed its registration as the service moved premises. We have used the previous rating of Good to inform our planning and decisions about the rating at this inspection.

This was a planned comprehensive inspection that was scheduled to take place in line with Care Quality Commission (CQC) scheduling guidelines for adult social care services.

Follow up

We will review the service in line with our methodology for 'Requires Improvement' services.

We will continue to monitor information we receive about the service until we return to visit. If we receive any concerning information we may inspect sooner.

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.