You First Support Services CIC

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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 78 (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 positive learning culture where staff and managers were open about safety issues and used feedback to improve practice. Staff and managers reflected on incidents and used them as opportunities to identify what could be done differently. One staff member told us, “We have regular team meetings to discuss care planning, what is working and what isn’t working [in terms of the support provided to people].”

A health professional described a “No blame culture”, explaining that incidents involving a person with highly complex needs were always reviewed to understand what happened and how the person and staff could be better supported next time.

This professional said management “Were on site immediately” after a serious incident and ensured staff received emotional and practical support. Staff also learnt from patterns in behaviour, adapting their routines and shift lengths to reduce staff fatigue and improve how people were supported. These examples showed an open culture where learning was embedded in everyday practice.

The management team 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 provider had safe systems to assess and respond to people’s changing needs. Care plans were detailed, person centred and regularly reviewed with families and professionals. A health professional described the care plan for one person as “One of the best [they had seen] in a learning disability service”, explaining it clearly captured how the person communicated, their routines and the support they required.

Staff recognised early signs of distress, and managers ensured prompt involvement of external professionals when required. Families reported that concerns were acted on quickly, including when housing-related issues created risks within people’s homes. People were supported safely during health appointments, with staff or family attending as needed to maintain consistency and reassurance.

At the last assessment we found 1 person had not always been kept safe in line with the provider’s policy and procedures.At this assessment we found significant improvements had been made.

The management team 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 and avoidable harm. Relatives said their family members were safe, and staff understood people’s vulnerabilities well. One relative said, “[Name] feels safe, and knows that carers support her. It is as good as it can be.”

Staff told us people were safe and protected from abuse. One staff member said, “I do feel that the service provides and prioritises safety for [name], within her home, her support and her daily activities.” Staff were trained in safeguarding and knew what signs may indicate potential abuse. Safeguarding concerns were reported and taken seriously by the management team and staff team.

Staff anticipated behaviours that may place people at risk and acted early to prevent escalation. One staff member said, “The team are very highly tuned to the varying level of the support required and provide excellent care over a 24hr period. To satisfactorily meet [name’s] needs requires a very high level of skill, empathy, kindness, ability to “read the room”, interpret gestures and body language.”

Families said managers were accessible and responsive when concerns were raised. One relative described being notified immediately when a safeguarding issue came to light and said managers handled the matter appropriately, confirming steps were taken to prevent it recurring. A health professional reported strong management oversight and praised the team for their skill in supporting a person with a history of trauma, neglect and self‑harm, ensuring they now felt “Happy, relaxed and content."

The management team and care staff worked with people and their relatives to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive, and enabled people to do the things that mattered to them. Staff supported and encouraged people’s independence by promoting positive risk taking.

People’s care records included information about individual risks and how staff should work to minimise risks to people. People and relatives said staff worked in a safe way, in line with people’s risk assessments.

People and relatives were consistently involved in decisions about risks and how support should be delivered. Families described how staff listened to them and adapted approaches, such as reducing the frequency of eating out or planning healthier meals. People were offered choices about daily routines, activities and personal care.

Staff used their knowledge of each individual to identify when they might be at risk before risks escalated. A health professional described staff as “Very skilled at identifying triggers” and supporting people to cope when they became distressed.

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

People lived in safe environments that met their needs, and risks relating to their homes were monitored. One person said, “I like my house. My bedroom is just about big enough, though I would like a bigger bathroom.” A staff member told us, “The person I support, their home is maintained well and is clean and tidy and if any equipment is in poor condition or broken it is reported appropriately and shared with the team through the [provider’s] communication channel.”

Relatives said staff responded quickly when environmental issues arose, such as damp and mould in one property. When a mattress became wet due to the conditions, the provider purchased a replacement immediately and helped the person raise the mould issue with their landlord as they were responsible for the property, not You First.

People could move around their homes with support where needed, and staff helped them access the bathroom, kitchen and community safely. Relatives said staff understood how different environments could affect people’s levels of anxiety and tailored support accordingly. This included using more appropriate places, such as quieter cafés, or supporting people to access their communities in ways that reduced stress.

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.

There were enough staff with the right skills to meet people’s needs. People and relatives described staff as experienced, consistent and knowledgeable about learning disabilities, autism and behaviour support. They said staff anticipated triggers, de‑escalated effectively and were “the best” staff some people had ever had.

Staff received appropriate training, support and supervision. Formal supervision meetings with staff, observations of staff practice and regular staff meetings were held. Records of staff meetings showed these were well attended, covered a range of topics and staff were encouraged to raise any issue they wished to discuss.

A health professional said the staff team supporting 1 person with very complex needs were “small and dedicated” and worked exceptionally well together. Staff received management support promptly during incidents. Relatives also said new managers were visible, approachable and listened to concerns.

People were supported by staff who had been recruited safely. Appropriate checks were carried out on all new staff to ensure they were able to work in the UK, of good character and safe to support vulnerable people. This helped to ensure people’s safety.

The management team assessed and managed the risk of infection. Infection prevention and control measures were effective.

Staff maintained clean and hygienic environments and supported people with personal care in a respectful and enabling way. Staff had access to appropriate protective equipment and used it safely. Relatives said people were supported to maintain good personal hygiene, including with washing and dressing.

A health professional described significant improvements for 1 person who had been neglected before being cared for by You First. Now this person “Looks clean, is well kept, wears clean clothes, has lovely skin and hair and looks really well in herself.”

Staff followed consistent routines and monitored the environment, ensuring hygiene risks were identified and addressed.

Medicines were managed safely and aligned with best practice, including a national approach to reducing unnecessary medicines. A health professional described the medicines management work as “Amazing”, confirming 2 successful reductions had already taken place for 1 person with complex needs who was taking “An extremely high dose of medicine”. They said decisions had been made collaboratively during reviews and changes were paced carefully to ensure safety and stability.

Guidelines for medicines taken ‘as and when required’, had been very well developed. One professional praised a protocol written by a manager as “beautifully” completed with no amendments required.

Staff monitored the effects of medicines closely and worked with professionals to ensure people received only the medicines they needed.