ASD Support LTD

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 newly registered service. 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 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.

If a mistake was made staff immediately reported this internally and acted to put things right. For example, following a suspected medicines error, a staff member contacted NHS 111 for advice, informed a person’s relative, and notified CQC and the local authority.

When it turned out the ‘error’ was due to the way the (liquid) medicine was administered, staff implemented a different way of administering it to reduce the risk of any wastage/spillage. The positive steps taken demonstrated the service’s transparent and proactive approach when a safety event occurred .

The provider had systems in place to ensure safety incidents were appropriately investigated and reported. Learning from safety events was always communicated to staff and other relevant persons to minimise risk.
 

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 collaborated with people, relatives, and health and social care professionals prior to people coming to the service. Information was shared so people received the care and support they needed. The service has good systems and processes to manage people’s healthcare needs. They ensured these were met and any risks eliminated as people moved into their new homes.

Relatives told us how well people had transitioned into the service. Comments included: “It was a very smooth transition,” and “[Person] settled in really well.”

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.

Managers and staff knew what to do if they had concerns about the well-being of any of the people using the service. They were trained in safeguarding and followed the provider’s safeguarding policies and procedures to identify, address, and report any safeguarding concerns.

Relatives said their family members were kept safe at the service. They gave us examples of how people were safeguarded and told us they were always informed if a safeguarding event took place. A relative commented, “I have no concerns on the safety side. It’s very good.”

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.

The service involved people, relatives, and health and social care professionals to ensure people had personalised risk assessments. Staff followed these when supporting people to ensure risks were managed safely and consistently. Risk assessmentswere regularly reviewed and updated as people’s needs changed.

The service consistently applied effective strategies to reduce the need for restrictive interventions. Staff received training in crisis safety intervention, non‑abusive psychological and physical interventions, and positive behaviour support. This ensured they were equipped to follow people’s support plans and always use the least restrictive approach if people became distressed.

Relatives told us staff enabled people to live full lives and take positive risks which included taking part in community and other activities. For example, a relative said a person needed extra staff support when they left their home and this was provided in line with their risk assessment. This meant the risk was reduced when the person was out in the community.

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

Relatives told us how the service had adapted people’s homes to make them safer. A relative said, “[Person] has epilepsy and their furniture has rounded edges for safety. There is also a monitor mat by [person’s] bed and an alarm.” Another relative said a person’s garden had been made more secure to ensure it was safe for them.

People were cared for in safe environments that were designed and adapted to meet their needs. Properties and equipment were safety-checked and maintained jointly by the service and the landlord. The service had its own maintenance person so urgent jobs could be promptly addressed.

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.

Relatives told us people experienced continuity of care as they were supported by a regular staff team they knew well. A relative told us, “Staff are consistent. There is a board up showing who is on shift each day. No agency staff are used.” Another relative said, “Staff work well with [person]. It’s the same staff at all times.”

Staff were safely recruited, inducted, and trained to ensure they were suitably experienced, competent, and knowledgeable for their role. They had regular supervision and appraisals.
People had the opportunity to take part in the recruitment process and feedback their views on the candidates.

The service took into consideration people’s needs and preferences when staff were recruited, and what personal and professional qualities staff could bring to their work. Staff had opportunities to provide feedback on the service during staff supervisions and appraisals.

A staffing level risk assessment was in place for each person using the service. This set out the level of support each person required along with the competencies and training staff must have to work with them, and minimum staffing levels in case of emergencies. This ensured people received consistently safe, good quality care that met their needs.

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.

Relatives said people’s homes were kept clean and hygienic. A relative said, “[Person’s] home is spotless. It has to be.” Another relative said the service replaced carpets with hard flooring in a person’s home to make it easier to clean and this was a positive move.

The service followed procedures around infection prevention and control (IPC) that met current national guidance. Staff were trained in IPC and understood their responsibilities to maintain high standards of cleanliness and hygiene. Where necessary, people had care plans to support them to maintain good hygiene and avoid risk of infection.

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

Relatives were satisfied with how staff managed their family member’s medicines. A relative said, “They are on the ball, [person] takes their medication OK, they have never missed a dose.” Another relative told us they had to sign for a person’s medicines when they took the person out and sign them back in when the person returned which was evidence of a safe medicines system.

People had detailed personalised medicines care plans to support the safe administration of their medicines. These included information on what each medicine was for, and potential side-effects. People were involved, where possible, in their medicine’s routines. Staff followed national guidance to ensure people’s medicines were ordered, administered, recorded, stored, and disposed of safely. People had PRN protocols for ‘as required’ medicines which staff followed.

People’s medicines were reviewed every 6 to 12 months by their GPs. However, if a person’s medicine didn’t seem right for them staff acted promptly, contacting the prescriber to discuss their concerns. A relative confirmed this, saying staff were currently liaising with a mental health professional due to issues with a person’s medicine .

The service followed best practice guidance to ensure people were not prescribed medicines unnecessarily. The STOMP (Stopping Over Medication of People with a Learning Disability, Autism or both) initiative was embedded into practice. Records showed clear examples of people requiring less medication after coming to the service. For example, staff used alternatives other than medicine to support people to manage distress more safely and effectively.