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. This is the first assessment for this service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 81 (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.

When people were considering moving into a shared house, and other people were already living there, staff went above and beyond to make sure everyone had meaningful choice about where and who they lived with. Compatibility between people was carefully considered, ensuring everyone had a voice in the decision. Visits, tea visits and overnight stays gave people time to get to know each other and experience what living together might be like before a decision was made. This helped people make informed choices and ensured moves were right for everyone involved.

The service worked closely with healthcare professionals, including GPs, specialist occupational therapists and speech and language therapists to help people access healthcare when required. Staff liaised effectively with GPs, district nurses and other healthcare professionals to support people's health and wellbeing. Staff incorporated advice and recommendations from healthcare professionals into people's care plans and risk assessments to ensure support reflected current clinical guidance. Each person had a Health Passport and Hospital Passport to support effective communication with healthcare providers. Hospital bags were maintained for each person and included essential items such as health information, toiletries and clothing to support a planned and dignified hospital admission if required. When hospital admissions occurred, staff contacted family members promptly and remained with the person until family members arrived, ensuring continuity of support during periods of anxiety or uncertainty.

Feedback from professionals confirmed effective partnership working. One professional said, “We have developed an excellent working relationship with seven steps over many years. Their team consistently demonstrates a high level of professionalism, compassion, and commitment to the wellbeing of their clients. One of the most striking aspects of their care is their ability to identify health concerns early and respond appropriately. Time and time again, they have picked up on subtle changes in an individual's health and sought timely medical advice.”

Another professional said, “The team really go above and beyond to support people in a person-centred way even at the most challenging of times. Recently, the team were in a difficult situation regarding a client, but the staff team were great and continued to support the person even though it was a very stressful time. They adapted their approach, were incredibly patient and attentive and very responsive but safe.”

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.

Safeguarding systems and processes were in place to identify report and investigate, allegations of abuse. Staff demonstrated they were highly skilled at recognising when people were unsafe and were confident when challenging and reporting unsafe practice. They knew from people's body language and actions if a person felt unsafe or were worried about something. Staff told us they would give people time to talk and were able to recognise if there were any changes in people’s presentation and actions to take in relation to safeguarding concerns.

Any safeguarding concern was investigated thoroughly and learning shared with staff at meetings or during supervision. The provider had logs and records that showed appropriate action had been taken where necessary. Senior leaders and the provider then monitored this information to identify any themes or trends.

People consistently told us they received an excellent and safe service. One person said, “I feel very safe here. I can talk to staff if I have any problems.” A staff member told us, “People are 100% safe. They have a great quality of life.”

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

Staff supported people to take positive risks and achieve outcomes that mattered to them, enabling them to live as independently as possible. They understood the risks people faced and used personalised strategies to reduce the likelihood of harm while promoting choice and independence.

Staff took a strengths-based approach, focusing on what people could do and wanted to achieve. Staff worked with one person to manage risks in a way that promoted their independence, choice and control. One person had begun accessing social care for the very first time. They needed significant support to develop and maintain a safe home environment, and they were suffering ill health from poor nutrition. Rather than imposing solutions or taking control, staff invested time in building a trusting relationship, worked at the person's pace and gained their consent before introducing changes. The person was gradually supported to make their home safer, balance a healthy diet and develop daily living skills. This resulted in significant improvements while ensuring the person retained choice and control over the changes affecting their life.

Staff followed personalised positive behaviour support plans for people who experienced distress. These plans included information about potential triggers and effective ways to provide reassurance and support. Records showed staff used these approaches successfully to help people remain calm and reduce the impact of distress. As a result, people experienced improved emotional wellbeing, greater opportunities to participate in meaningful activities, such as attending community events, practising their faith, developing independent living skills and pursuing personal interests, which increased their confidence, sense of belonging and independence, alongside support that maximised their comfort, dignity and quality of life.

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.

The service provided support in people’s own homes, and they were not responsible for the upkeep of these premises. However, risk assessments were in place to ensure the environments in people’s homes were safe to protect people and staff from harm. For example, there were effective arrangements in place to manage risks associated with fire or slips, trips and falls. Staff told us they were aware of safety procedures and ways to reduce risks to people, such as checking equipment is safe before using it.

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.

The provider followed safe staff recruitment procedures. Disclosure and barring service (DBS) checks were completed, references obtained from previous employers and any gaps in employment explored. This helped ensure only people of good character were employed.

People supported were involved in staff recruitment. This included sitting on interview panels and asking interview questions. This gave them the opportunity to influence who the service recruited.

People were supported by teams of staff who knew them well. There was good continuity of care. Gaps in the staff rotas, due to sickness or staff leave were filled by members of the staff team. During the inspection it was clear there was sufficient staff on duty to respond to people when required. Each activity or community outing had been risk assessed to determine the number of staff that would be required to support people safely. Rotas demonstrated that people were supported by a regular team of staff who were familiar with people, their needs, likes, dislikes and preferences. One person told us, " I like the staff and know if I am feeling anxious, they will listen to me."

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.

The service assessed and managed the risks associated with infection prevention and control. Infection control audits were completed and staff had access to infection prevention training and competency assessments. Relatives described people’s living environments as clean and well maintained. Staff told us they wore protective equipment such as gloves, followed cleaning schedules and involved people in maintaining their homes where appropriate.

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.

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.