Advance Cornwall

Updated 30 November 2022

Inspection team

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by one inspector

Service and service type

This service provides care and support to people living in three ‘supported living’ settings. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a manager registered in post.

Notice of inspection

We gave the service three days’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

Before the inspection, we reviewed information we held about the service and the provider which included any statutory notifications sent to the CQC. A notification is information about important events which the service is required to send us by law. We used the information the provider sent us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all of this information to plan our inspection.

During the inspection

During the inspection we reviewed four people's care plans and risk assessments. We reviewed staff training and supervision. We also reviewed other records relating to the management of the service. We spoke with two people who were supported by the service, 10 staff including the registered manager, the head of operations for the South West, who is also a registered manager, and the operations manager for the east of Cornwall.

We spoke on the phone with two relatives of people who were receiving support from Advance Cornwall, about their experience of the care provided. We spoke with three healthcare professionals.

Updated 30 November 2022

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 guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people, and providers much have regard to it.

About the service

Advance Cornwall is a domiciliary care agency. The service provides personal care to people living in their own homes and flats and to people living in a ‘supported living’ setting, so they can live as independently as possible. The service was supporting seven people who received personal care who lived at three different supported living settings, Tolvean, Albi Court and Phernyssick.

People's care and housing are provided under separate contractual arrangements. The CQC does not regulate premises used for supported living; this inspection looked at people's care and support.

Not everyone using the service received a regulated activity; CQC only inspects the service being received by people who are provided with the regulated activity of 'personal care', for example which includes help with tasks such as personal hygiene and eating. Where they do, we also take into account any wider social care provided.

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

The service was able to demonstrate how they were meeting the underpinning principles of Right Support, right care, right culture.

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.

The Right support:

The model of care and setting maximised people's choice, control and independence. The supported living settings had easy access to the local community and amenities. Staff supported people to make choices about their daily lives and engage in activities that were tailored to their individual needs and promoted their independence. People were supported to maintain and develop relationships. Staff understood the importance of respecting people's diverse needs and promoting independence. People received support to maintain good health and were supported to maintain a balanced diet where this was part of their plan of care. Risks were identified and recorded. One person had been identified as, ‘deteriorating” and ‘at risk of falls,’ and another person required two staff to use equipment during transfers. We requested a current moving and handling risk assessment and there was no record of recent review, to respond to reports of deterioration. Staff were not always provided with accurate direction and guidance to help reduce recognised risks. We were provided with the required risk assessments following the inspection visit. The assessments were dated the 24 October 2022, the day of the inspection. People were supported by enough staff on duty who had been appropriately trained. People received their medicines in a safe way. However, there was some staff training which was out of date. People were protected from abuse and neglect. People's care plans were clear and up to date. However, some risk assessments had not always been consistently recorded and regularly reviewed.

Right care:

People were supported by staff who had been appropriately trained and were skilled in their role. People received good quality person-centred care that promoted their dignity, privacy and human rights. There was a strong person-centred culture within the staff team. Support plans had been created for each person to help ensure consistent approaches were used by staff when supporting people. Staff knew people well and demonstrated an understanding of people's individual care, behavioural and communication needs. This helped ensure people's views were heard and their diverse needs met.

Right culture:

The provider was in the process of implementing organisational and management changes. This involved a new management structure, focusing on compliance and standardising record keeping and consistent processes and procedures. New electronic systems were in the process of being implemented. However, we found inconsistencies in how information was currently being recorded, stored and monitored by staff and managers.

The service was working with many different systems and processes and there was not yet a consistent process in place which enabled effective overview and monitoring of the service by the registered manager.

There were sufficient staff to support people. The service was trying to recruit to four posts at the time of this inspection. People always received their planned support with no one reporting any failure in staff being present as expected.

The provider had implemented quality assurance systems to monitor the quality and safety of the care provided. People and relatives had been asked for their views and experiences of the service provided by Advance Cornwall.

Support workers’ managers worked closely with them and carried out supervision to monitor their performance. Staff told us they felt well supported and enjoyed their work.

Staff created an environment that inspired people to understand and achieve their goals and ambitions.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection:

We registered this service on 24 September 2021 and this was the first inspection at a new location. The last inspection of this service, under the same provider, was rated good (published 24 January 2018)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.