Seven Steps Support Limited

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 good. At this assessment the rating has remained 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. Accidents and incidents were thoroughly investigated, used to inform any changes to the service, and the provider apologised when things went wrong. The provider captured lessons from incidents, and they encouraged members of staff to use reflective practice to improve delivery of care and support. Lessons were learnt to continually identify and embed good practice.

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 service worked in partnership with other professionals such as GP's, specialist occupational therapists (OT) and speech and language therapists (SaLT) to support people to access healthcare when they needed it. Records detailed how staff worked effectively with GP’s, district nurses and other external healthcare professionals. Families described staff as knowledgeable and competent in supporting complex health needs, including a percutaneous endoscopic gastrostomy (PEG) is a procedure to insert a feeding tube through your skin and into your stomach.

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.

People were protected from abuse because staff knew how to respond to concerns about abuse, mistreatment, or neglect. There was a safeguarding policy in place, and this was followed by all staff. The manager was aware of their responsibilities under safeguarding and referrals had been made appropriately. Staff spoke confidently about reporting concerns to the management team and felt assured the registered manager and provider would act promptly. Staff understood whistleblowing and felt protected if they raised issues.

People and relatives consistently told us they felt safe receiving support. One relative said, “100% safe. They keep us informed every step of the way. They never let us down.”

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 and their relatives felt staff understood people’s needs and managed risks to their safety. A relative told us, “Staff follow care plans, use appropriate documentation and communicate any concerns promptly.” Records showed people had risks to their safety considered. For example, moving and handling, skin integrity, falls and mobility risks were considered, and plans put in place to meet the individual needs and reduce the risks.

Risk assessments were regularly reviewed and updated to reflect people's changing needs and circumstances. The manager monitored incidents and risk information, and care plans were updated when required.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People and relatives raised no concerns with how staff supported them to maintain a safe environment. The registered manager told us a risk assessment was in place which considered environmental risks. For example, outside the house, driveways, lighting, key safes, stairs, and equipment. Staff confirmed they had access to this information to support them with providing safe care.

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 and their relatives told us staff arrived on time, stayed for the full duration of visits, and had the experience and training needed to support them safely and effectively. The provider carried out checks on new staff to ensure they were suitable to work. Relatives praised the continuity of care provided by consistent staff teams who understood people's health conditions, communication methods and support needs. Families also described effective induction and shadowing arrangements for new staff, ensuring people continued to receive safe and appropriate support.

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.
People and their relatives told us staff used personal protective equipment (PPE) when attending calls. Staff told us they always had access to PPE and could describe how they used this. Staff told us they received infection prevention control training.

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.

People received their medicines as prescribed. Training and competency assessments ensured staff were confident in managing medicines. Medicines administration records were accurate and complete. The provider followed guidance for the receipt, storage, administration and disposal of medicines. Regular audits were completed. Where people received support with medicines they raised no concerns. A relative told us, “[Person’s name] is peg fed and all medication goes through their peg. We have never had any issues.”

The provider and staff were aware of the STOMP principles (Stopping Over Medication of People with a learning disability, autism, or both, with psychotropic medicines) and worked with people and staff to ensure people were not over prescribed with medicines which negatively affected their well-being.