Nationwide Supporting Accommodation

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 requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulation relating to safe care and treatment due to the concerns identified regarding the environment, infection prevention and control, and the management of medicines.

This service scored 56 (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 did not always demonstrate a proactive and positive culture of safety based on accountability and expected standards. The concerns identified during the assessment showed that a culture of continuous learning and improvement was not always embedded in practice.

We found several health and safety concerns that posed a risk to people. These were not effectively identified and addressed. The nature and extent of the concerns identified indicated that potential risks were not always recognised at the earliest opportunity, limiting the provider's ability to learn and improve.

However, staff reported accidents and incidents promptly and ensured they were appropriately recorded. These were discussed among staff to reduce the risk of recurrence.

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.

At the time of the assessment, people had lived at the service for several years and had not experienced any significant transitions. Nonetheless, the provider monitored and managed risks to people's health, safety and wellbeing. This helped to inform care planning and identify when additional support or input from external health and social care services was required. People, their relatives and relevant professionals were involved in planning and reviewing care and support to help ensure continuity of care and coordinated access to services.

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 identified concerns affecting people's safety and wellbeing and shared these promptly and appropriately with relevant agencies. Staff were alert to safeguarding requirements and knew how to escalate safeguarding concerns. A staff member spoke to us about the concerns they had regarding a person's finances and the actions they had taken to protect the person from potential financial exploitation.

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 provider assessed risks to people’s health, care and wellbeing. Risk assessments contained clear information on control measures and covered a range of areas, such as epilepsy, mobility, skin integrity and self-neglect. Our observations and feedback from a person indicated staff provided safe care and support to people.

The provider did not always detect and control potential risks in the care environment. They did not make sure that equipment and facilities supported the delivery of safe care.

Fire safety considerations were lacking, placing people at an increased risk of harm. Fire extinguishers had last been inspected in February 2024 and were due for servicing in February 2025, more than a year before our assessment. A fire extinguisher had been removed from the kitchen due to a broken bracket and was being stored in the office on the upper floor. The patio area, which was also used as a smoking area, was not appropriately maintained. There was no ashtray or bin for the safe disposal of cigarette butts, and we observed cigarette butts on the ground. A recent fire risk assessment for the building had also identified some of these issues, as well as additional shortfalls, including a lack of evidence of Portable Appliance Testing (PAT) and inadequate fire safety signage.

We identified several environmental hazards during the inspection visit. Loose wiring was observed in various parts of the service, posing a trip hazard and creating potential ligature points within the environment, which did not reflect best practice for maintaining a safe environment. Water temperature monitoring logs showed shower outlet temperatures exceeded expected safe levels on several occasions.

Other health and safety assessments carried out by external contractors highlighted concerns regarding safe water management and risk assessment of hazardous substances.

However, inspection reports showed other aspects of the physical environment were maintained appropriately, including gas safety, electrical installations, and fire detection and alarm systems. Following the assessment, the provider told us they carried out a review of their water temperature monitoring systems and sought professional advice.

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 carried our safe recruitment checks to ensure only the suitable candidates were offered employment. Staff recruitment files contained a range of checks including DBS checks (police check), staff employment histories, identity checks and employment references.

At the point of joining the service, staff completed an induction programme which helped them to get to know people and company requirements. Staff had access to a variety of regular training courses, including in areas specific to people’s individual needs, such as epilepsy, diabetes and mental health. Staff also completed training in learning disability and autism.

The provider did not assess or manage the risk of infection. They did not detect and control the risk of it spreading or share concerns with appropriate agencies promptly.

The kitchen environment was not consistently maintained to an appropriate standard of cleanliness. The oven contained visible burnt food residue, grease build-up and leftover food debris, creating a risk to food hygiene and safe use. Food items were not appropriately labelled in the kitchen fridge. There was dust build-up on the floor, underneath the oven and on top of the extractor fan. There was a lack of documented evidence of food safety checks, including hot food temperature monitoring and regular kitchen checks.

Some other parts of the service were visibly unhygienic, including bathroom floors and staircase. There was no evidence that staff used area-specific cleaning equipment, such as mops and buckets, to minimise the risk of cross-contamination.

After we raised these issues, the provider carried out a thorough clean of the premises and provided photographic evidence.

The provider did not always make sure that medicines were safely managed.

A person’s prescribed PRN (‘when required’) medicines, such as creams and medicines for constipation, were not recorded on the medicine administration records (MAR). Written guidance regarding when to administer these medicines was not in place. Staff competency to administer medicines was assessed on a one-off basis, instead of regularly as recommended by national guidelines. Staff did not monitor the temperature of the medicines cabinet to make sure medicines were stored at the right temperature.

Following the inspection visit, the provider immediately implemented MAR and guidance for PRN medicines. They told us they had begun monitoring the temperature of the medicines cabinet. Staff completed medicines administration records appropriately. A person told us they received their medicines on time. Care plans contained clear information on people’s medicines, including the reasons for administration.