Supported Living Services Uxbridge

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. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

At our last assessment the provider was in breach of legal regulations relating to safe care and treatment. Improvements were found at this assessment, and the provider was no longer in breach of this regulation.

This service scored 72 (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 proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Accidents, incidents and safeguarding concerns were clearly recorded. There were regular staff meetings, during which lessons were discussed and staff shared their experiences. Minutes from meetings confirmed this. In addition, relevant guidance was shared with staff to promote learning and improvement.

For example, a person had recently gone missing when staff took a comfort break, whilst on a shopping trip. This incident had been reported appropriately and the registered manager completed an investigation into the circumstances. Notes from a staff meeting demonstrated how there had been reflections on the situation and lessons were learned from the incident. We saw that changes were made, in discussion with the person using the service, to maintain their ongoing safety, as well as ensuring staff’s comfort.

A person using the service told us, “Overall, he is a lot better than anywhere else. Staff learn lessons. They are on the ball to keep me safe. They also keep a good eye on us in the community.”

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.

There were systems to ensure people’s needs were fully assessed before they started using the service. The provider also worked with partner agencies to facilitate a planned transition to or from the service. People’s needs, and how they should be met, were clearly documented within their care plans and risk assessments.

A person using the service told us how they had experienced difficulties with previous providers, as their needs had not been properly understood. This person told us they had experienced situations, which had caused great distress and breakdowns of placements. They spoke positively about the current service and explained how the provider had met with them at their previous placement to discuss their needs. Staff from the new service then shadowed staff in the previous placement to get to know the person and learn about their needs. This person said they felt that, overall, the staff had supported them well.

A second person had recently moved to new accommodation that was located nearer to their family. The person was unable to tell us about their experience of this. However, staff at the person’s day centre told us they felt the move had gone well and the person had settled well in their new home. They said that the person’s family were also very happy to have the person living back nearer to home.

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 and their relatives told us the service provided safe care. A person’s relative said that staff knew [Name] and their needs, including their individual communication methods, well. The person’s relative said they felt their loved one was happy with the care and support they received and was safe. The relative felt that staff were trained appropriately and said they kept in touch and informed them of any issues or concerns.

Staff and management demonstrated a good understanding of safeguarding. Staff explained the different types of abuse and gave examples of signs and symptoms to look out for. There were safeguarding and whistleblowing procedures for staff to follow. All the staff we spoke to confirmed they had completed safeguarding training and would report any suspected abuse.

Information in 1 person’s care plan indicated possible restrictive practice. However, when we checked this, the person using the service told us they fully understood the measures that were in place, such as 15-minute checks day and night and locking the front door. The person explained how that they had consented to staff taking these actions for their own safety.

A person living in another supported living setting told us that if they felt uncomfortable or unsafe about anything they had certain people they would be happy talking to and telling.

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

We were assured that risks to people's personal safety were assessed, monitored and managed effectively. The support plans we looked at contained detailed and person-centred information regarding how to help make sure people kept safe in all areas of their daily lives, such as nutrition, mobility, mental health, finances, activities and medication.

A person using the service explained how staff knew them well enough to recognise signs that indicated they were becoming distressed. They explained how staff would then take action that had been requested and agreed by the person, to minimise the risks they presented to themselves, as well as others.

We also found the service supported people appropriately with perceived risks. For example, 1 person was stated to have a nut allergy, although the registered manager told us there had never been formal confirmation of this allergy from the medical professionals. However, the person themselves believed they had a nut allergy and this had been stated in their discharge notes from a previous placement. Because of this, the registered manager explained, “We do not give nuts or any food item containing nuts. we check all food, including snacks. We also do not prep food near or around other people's food that may contain nuts. When [Name] goes out to eat, we adhere to allergy controls and inform the food provider of the potential risk.”

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

All the people using the service lived in their own homes and had their own tenancy agreements. Staff ensured people’s homes were all clean, hygienic, safe and well maintained. Staff and people using the service told us that any maintenance issues with their accommodation were documented and reported to the relevant landlord. A person using the service praised their landlord for their responsiveness.

We also saw that risk assessments and evacuation procedures had been completed for each person and their individual home environments.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People told us they were happy with the staff who supported them and had built up positive and trusting relationships with them. We were assured that people were supported by enough regular staff who knew them and their needs well.

Staff told us that they had completed inductions and core training in areas such as safeguarding, fire safety, infection control, first aid and food safety. In addition, staff told us they had completed training for supporting people with a learning disability and autistic people, as well as mental health, the Mental Capacity Act 2005, de-escalation and person specific training in respect of people’s individual health conditions.

Staff told us they received regular support and supervision and felt fully supported by the registered manager and other colleagues.

The provider operated safe recruitment processes. People were protected against the employment of unsuitable staff because appropriate checks, such as police checks, identity and right to work in the UK, were carried out before people started working 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 supported people to maintain good hygiene and keep themselves and their homes clean. Staff confirmed they had completed infection control training and had enough Personal Protective Equipment (PPE) to use when needed. The provider had effective systems and processes to ensure infection risks were minimised and saw that prompt action was taken when any concerns were identified.

The provider mostly had effective systems and processes in place to manage and administer people’s medicines safely. However, we identified that improvements were needed in a few areas.

Not all PRN (when required) medicines had clear written guidance available for staff to follow. We also noted that, although people’s medicines were listed on the medicines administration records and in their Individual Support Plans, there was very limited detail in respect of why they had been prescribed or of any contraindications or side effects that staff needed to be aware of. However, all the staff we spoke with knew people well and could tell us the signs and symptoms people displayed when they needed to be offered their PRN medicines

There were no protocols in place for 1 person’s ‘over the counter’ cough medicine. This person’s liquid medicines, including prescribed eye-drops, had also not been dated upon opening. Some medicines need to be disposed of after they have been opened for a certain period of time, to make sure they remain safe and effective.

We discussed our findings with the registered manager who agreed to make the required improvements.

People received their regular medicines on time and these were administered in the ways people preferred. Some people had full knowledge and understanding of the medicines they took and what they were for. One person had also compiled a ‘pain tool’ for staff to follow.

The service ensured that people’s behaviour was not controlled through excessive or inappropriate use of medicines. Staff understood and applied the principles of STOMP (Stopping Over-Medication of People with a Learning Disability, Autism, or Both) where appropriate and ensured that people’s medicines were regularly reviewed by their GP.

Staff confirmed they had completed medicines training and had their competencies regularly assessed. The registered manager also ensured regular checks, counts and audits were completed. All the medicines and associated records we looked at were correct, with no errors or omissions noted.