Active Care Group Supported Services

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• 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 good. At this assessment the rating has remained good. This meant people were generally safe and protected from avoidable harm.

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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

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.

Staff had completed referrals for people when this was appropriate and involved people in the process where this was possible. The service had a business continuity plan in place which included information on local suppliers, emergency contacts and protocols for adverse events.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People and their relatives told us they did not consistently feel staff understood risks in relation to people’s care in 1 of the supported living services we visited. They told us they believed that this was due to a lack of training in specific areas such as effectively managing when people expressed their feelings through an emotional reaction. Relatives told us they were not always involved in assessing risks related to people’s care. When we made the provider aware, they already had an action plan in place which included recruiting an expert by experience to work with people and their relatives and wider changes in the provider’s central support team. However, there was more time required to embed this in the service.

We generally found staff to be knowledgeable about risks associated with people’s care, but we found that this was not always the case in 1 of the services. When we asked staff, they were not always able to demonstrate the specific risks in relation to people’s care. For example, staff were not always able to tell us the reasons people were receiving one-to-one care and the possible risks if they did not receive this despite providing the one-to-one support themselves. When we made the provider aware, they immediately took steps to ensure staff were aware of the specific needs of people.

Care records generally included the information required for staff to support people effectively to manage risks related to their care. In 1 service, we found 1 person’s records contained conflicting information such as the frequency they should be repositioned which could adversely affect the prevention of pressure damage. When we made the manager aware, they addressed this appropriately to ensure it was clearly recorded when people declined to be repositioned.

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

We received feedback from several people and their relatives in relation to the elevator in 1 supported living service as this had not always been operational which impacted on people’s lives. The provider had addressed this in the short-term and had plans for the longer term to ensure there were alternative ways in case of the elevator malfunctioning.

We saw safety adaptations had been made such as ensuring corridors were wide enough for electric wheelchairs, adaptations were made to people’s apartments and rooms, there were hand rails in place where these were required and bathroom floors which meant people were able to use these independently where they were able to. Staff undertook required checks relating to fire safety, water safety and they regularly visited the service to check on the wider safety of the premises.

We did not look at Safe and effective staffing during this assessment. The score for this quality statement is based on the previous rating for Safe.

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

Staff undertook training in infection prevention and control, including for hand hygiene and personal protective equipment use. Staff regularly checked the environment to ensure it was clean and where shortfalls were identified, there were actions taken.

Where we identified areas which could be improved to ensure they could be cleaned effectively, the provider had wider improvement plans in place and we saw that the work had started.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Staff empowered people to take their medicines independently where this was possible. There were effective systems in place to support people with this and decisions were documented in people’s care records.

Staff ensured medicines were stored in line with manufacturers’ instructions and medicines administration records (MARs) were in place for people which included people’s allergies, stock balances and guidelines for ‘as required’ medicines. Where errors had occurred, this was documented but actions taken to prevent the recurrence were not always detailed. For example, in 1 supported living service management had recorded that staff should read the MAR before administering but there was no information recorded to indicate whether the staff member received refresher training or what other systems had been implemented since the error. When we informed the manager, they told us that the actions had been completed and that these would be recorded clearly in future.

Staff had completed regular training and competency checks. Staff understood the principles of ‘stopping over-medication of people with a learning disability and autistic people’ (STOMP). STOMP is a national NHS England work programme to stop the inappropriate prescribing of certain medicines. There were systems in place to ensure alerts regarding medicines and medical devices were shared with each supported living service and action taken to address relevant alerts.