Archived: Turn Up Care 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 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 in relation to people’s safe care and treatment and the management of their 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 had a positive culture of safety, based on openness and a willingness to learn. Staff reported concerns about people’s safety and reported any incidents to the registered manager who investigated the concerns. Lessons were learnt and the action needed to prevent further incidents were shared with staff. This was confirmed by key health care professionals who visited people being supported by the service.

The provider met with people and key professionals before people transferred into the service to ensure the staff could meet people’s care and support needs. People were given opportunities to view their rented accommodation and to understand their tenancy agreement and the separate care support they would receive from the care provider.

People reported their transfer into the service had been disorganised and confusing at times. They reported their personal needs and compatibility with other people who used the service had not been fully considered. However, the provider had recognised they needed to further develop their assessment processes to ensure they had all the information they needed to safely meet people’s needs in a shared housing environment. This would ensure staff had information to help with people’s continuity of care when they moved between services. Further time was needed to ensure effective systems would be implemented to assist with a smooth transfer of people’s care moving forward.
 

The registered manager and staff had a good understanding of their role and responsibilities to safeguard people and report any concerns to the appropriate authorities. Staff had been trained in safeguarding and were aware of the provider’s safeguarding policies. One staff member said, “I would report any safeguarding to my manager, they will take action. We don't speak to people with any leading questions, let them disclose what they want to, recorded straight away tell the registered manager.”

The provider was in breach of the legal regulation relating to safe care and treatment. The provider had identified people’s individual risks; however, they had not consistently worked with people to understand and manage their risks. The detail of the management of people’s risks and how to recognise and escalate concerns had not been explicitly recorded in people’s care plans. For example, the care and risk management plans relating to people’s health, emotional and social needs were not detailed. Whilst staff were aware of people’s needs, comprehensive care plans would enhance their training and provide additional person-centred guidance. Records of how staff had supported people with their physical and mental health were not always detailed. This meant the registered manager could not always be assured people had received the support they required.
 

The provider had worked with private landlords to secure accommodation with tenancy agreements for people. People reported some restrictions had been put into place on how they wished to live in their home. Reasonable adjustments of their home had not been made to assist them to overcome personal barriers. This was raised with the registered manager who explained they were addressing people’s housing needs as a matter of urgency. However, further time was needed to ensure people would live in a safe environment in the future.

Staff reported they had received mandatory training as required by the provider. The provider had ensured all staff had received training in how to interact appropriately with people with a learning disability and autistic people, at a level appropriate to their role. Whilst staff had a good understanding in the management of people’s needs; the provider had not ensured staff had received training in all areas relating to people’s risks and needs, such as epilepsy. Staff reported they felt supported, and their practices were checked by the registered manager. However, the records of staff’s supervision, competencies and spot checks were not always detailed to evidence staff support and the assessment of their skills.

Staff rotas were in place to ensure staff were available to support people. However, the provider had not considered the impact of staff working arrangements on their well-being and whether their working hours were in line with employment legislation. There was limited evidence that people had fully received the individual hours of support they were funded for or declined this support.

Safe recruitment practices were being used. The registered manager agreed to review their recruitment systems on how they would manage any potential risks when they had insufficient information about staff conduct during their recruitment process.

People were supported to maintain a clean home. However, people expressed challenges in keeping up with their personal hygiene due to the inconsistent availability of instant hot water. This put people at risk of potential infections.

The provider was in breach of the legal regulation relating to safe care and treatment. The assessment of the level of support people required with their medicines had been recorded. However, the management of their medicines and potential risks were not clearly documented or reviewed to guide staff on people’s preferred methods of supporting them with their medicines. For example, the systems used to monitor and reorder people’s medicines were known by staff but not recorded.

The registered manager and staff understood good medicines management practices and described safe processes when supporting people with medicines.