Avant (Sutton)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this service since their registration in June 2024. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a strong proactive and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice.

The nominated individual (who is responsible for supervising the management of the service on behalf of the provider) told us, “That is one of our values and we are very open and transparent and whenever we get issues, we let all our partners know, like the councils. We admit when we have made mistakes and we talk about it with staff in meetings. We take and share the lessons learnt from across all the branches with all staff.” A healthcare professional said, “They keep me informed of any concerns they have and are open about challenges, knowing that I prefer to address problems quickly before they escalate.” Robust systems were in place to support prompt reporting and investigation of safety events. Opportunity to learn from events was integral to the provider’s systems. Safety events, across all of the provider’s services, were reviewed and discussed by all managers as part of ‘lessons learnt’ meetings. Managers identified themes and trends from safety events and the action required to support all staff to learn and improve their working practices, to ensure the ongoing safety of people that use the provider’s services.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider had arrangements in place to obtain information about people, their individual needs and risks to their safety, prior to them using the service. This information was used to develop care and risk management plans for people, which was shared with staff before they commenced a package of care. This helped to ensure people received safe and appropriate care and support from the moment they started to use the service. A relative told us, “At the start, I talked to the hospital people and they asked what we wanted. Avant came…they asked all the questions of what [family member] needed.” The registered manager said, “When we start a package, the person gets a call and introduction email and we go through the support plan from the local authority and make sure people are happy with this and make any changes that are needed. We load this up on our system and then a field worker will go out and set up the care plan and risk assessments. We then start the care and do follow up calls and reviews ongoing after. We will have identified the staff team for the person before we start with the package. We have an application that the carers will access before they go in (via mobile phone or smart device), so they can see the care plans and risk assessments and daily notes and can read up on a person before they go in.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People’s feedback indicated they had no concerns about the staff supporting them with their care and support needs. The provider made sure that the importance of safeguarding people was discussed regularly at individual staff supervision and wider staff team meetings. Staff understood their duty and responsibility to safeguard people and were supported to report safeguarding concerns to the relevant persons and agencies. A staff member told us, “The company has clear policies and procedures in place to protect individuals. We receive regular safeguarding training and I always feel confident that any concerns I raise will be taken seriously and acted upon.” Managers made timely referrals and worked proactively with agencies to ensure people were safeguarded from further risk.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People told us staff supported them to stay safe when being supported with their care needs, for example, when people were moved and transferred using equipment or when being assisted to walk around their living environment. One person told us, “(Staff)) know I have a four wheel walker. They help me up and down the stairs safely. They get me into bed, which is down (lowered), and observe hygiene and safeguarding.” A relative said, “I’m quite pleased with them. [Family member] has had no falls with them. Carers are very good with him and are gentle and kind. They don’t rush.” Another relative told us, “They give [family member] a wash and bring him downstairs. He can’t walk properly. He’s had no falls with the carers. They are careful and walk with him. He’s got no bruises or sores.” Staff understood how to manage identified risks to keep people safe. A staff member told us, “I stay informed about the risks to the individuals I support by carefully reading care plans, following risk assessments, and staying observant of any changes in their condition.” Managers regularly assessed, monitored and reviewed safety risks to people. People’s records contained current information and guidance for staff on how identified risks should be managed to keep people safe from injury or harm.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Staff understood how to manage risks posed by people’s living environment, to keep people safe from injury or harm. A staff member told us, “Anything that could be identified as a potential hazard or danger in the process of providing care to the client, becomes a risk that requires making a safe choice to avoid it.” Managers assessed risks posed by people’s living environment and used this information to put measures in place, to manage these risks and keep people safe. Managers told us identified risks were regularly assessed, monitored and reviewed to make sure the measures put in place to reduce these, remained appropriate.

People had not always experienced safe and effective levels of staffing to meet their needs. People told us, a few months prior to this assessment, they had experienced late care calls, missed calls and lack of continuity of care because staff assigned to the care calls were often changed. Managers were open and honest with us and told us, as soon as these concerns were raised, they identified an issue with the scheduling of care calls. In response, they had taken immediate action to address the concerns and had increased management oversight at the service to make sure the issues were dealt with.

People confirmed there had been recent improvements to the timeliness of care calls. One relative told us, “Things have improved since last year.” Records maintained by the provider showed the number of late care calls in the 2 months prior to our visit had reduced.

People told us they now received support from regular staff. One person told us, “Yeah, I get the same people. All of them are my core carers. I get two carers for a visit.” A relative said, “Now, we get more regular carers. They are wonderful.” We were assured the provider had taken appropriate action to address the concerns identified and reduce risk to people from not having their care and support needs met. It was too early to judge at the time of this assessment whether these improvements could be maintained. We will continue to monitor and use information and intelligence we receive about this service, to check the provider maintains safe and effective staffing at the service.

Staff received relevant training and were encouraged to continuously learn and improve in their roles through supervision. They had opportunities to progress their careers if they wanted this. There were safe recruitment practices at the service and only suitable staff were employed to work at the service.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff used personal protective equipment (PPE) to reduce infection risks. One person told us, “The hygiene is very good. They wear gloves and aprons. They dispose of them in the bins outside when they have finished.” Staff supported people to keep their living environment clean and hygienic to prevent the spread of infection. One person said, “They will clean the bath and toilet if it’s needed. There’s no problems with hygiene.” Another person told us, “I think they are very good at hygiene. I want my commode soaked all day. I tell them if I want it. They clean the place up for me and make my bed. This company are very good at hygiene.” Staff were provided with training, support and resources to help them reduce infection risks. Managers undertook regular spot checks on staff to make sure staff were taking appropriate action to reduce infection risks when supporting people.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

People were supported by staff to take their medicines when they needed these. One person told us, “They give me my medicines. They put them in my hands and I take them. Carers also put some creams on me. Mostly, I have medicines in the evening. There’s no problems and they write down what they’ve given.” A relative said, “The carers give [family member] her medicines and eye drops, for dry eyes. They give them in the morning before breakfast. They’ve not missed any. No, I don’t think there’s any problems with medicines.” Medicines records confirmed people received the medicines prescribed to them. Staff were provided with training and supported to manage and administer medicines. Managers undertook regular spot checks on staff to make sure medicines were managed and administered safely.