Step Up -Domiciliary Care Also known as Step Up Supported Living 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 newly registered service. This key question has been rated good. This meant people were 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.

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.

The provider fostered a supportive and open culture where people and staff were encouraged to raise concerns. People and staff said they felt confident their concerns would be treated with compassion and understanding. Incidents were investigated by the management team, and any learnings were shared with the staff team. The registered manager was aware of their responsibility of duty of candour and to notify CQC of significant incidents.

Staff told us they were updated about incidents and changes in people’s care needs. They told us incidents and accidents were discussed in handovers, meetings and group supervisions. One staff member said, “There is a no blame culture – together we work out want went well, what went wrong and how can we improve and be open.”

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 registered manager and staff worked with people and key professionals to ensure service could meet people’s needs and provide continuity. People said they were fully involved in their initial assessment of needs and decisions about their care requirements.

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.

The provider promoted a proactive and positive culture around people’s safety. The management team thoroughly investigated any safeguarding concerns and reported concerns to the relevant authorities.

The registered manager was the safeguarding lead and had a clear understanding of their statutory duty to notify CQC of safeguarding concerns. People said they felt safe using the service. A ‘safeguarding statement’ was included in the provider’s service user guide which provided people with a summary of the provider’s safeguarding policy and their duty of care to protect people from harm.

Staff had been trained in safeguarding for adults and children and different types of abuse and 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.

People raised no concerns about the care they received. People’s care records provided staff with the information they needed to support people safely. The registered manager agreed to review people’s care records to ensure information about people’s historical risks and health needs were documented. This would assist staff in identifying emerging risks and symptoms.

Staff knew people well and were confident in the management of people’s risks. They had access to an on-call system if support was required out of hours.

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 provider considered the safety of people and the staff who supported them. They carried out assessments of people’s home environment to identify and reduce any risks which could impact on staff and the people they support.

The provider did not always make sure staff recruitment files were complete.

We reviewed a sample of staff recruitment documents. Background employment and criminal checks had been carried out to ensure staff were of good conduct. The registered manager confirmed while previous employment histories were discussed with potential staff during interviews; their conversations were not consistently documented. Following our feedback, the registered manager committed to ensuring all future health and social care backgrounds of new staff are thoroughly investigated and recorded. Further oversight of the recruitment of staff is needed to ensure people are supported by staff of good conduct.

Staff said they felt supported and trained to carry out their role. Training records showed, staff had completed training in most key and relevant subjects for their role. Although we found no impact on people; the registered manager acknowledged and agreed to take immediate action to review and to ensure staff had completed all the training required in line with the provider’s staff development policies.

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 confirmed staff wore personal protective equipment (PPE) during personal care and when carrying out household tasks. Staff understood the importance of wearing PPE and how to manage the risk of infection for people with underlying health conditions. Infection control policies were in place and up to date.

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.

At the time of our assessment, people were not receiving support with the administration or management of their medicines. However, following our review of the provider’s information return, the provider’s policies, procedures and discussions with the registered manager and nominated individual, we were satisfied the service is compliant in this area.