Union Supported Living

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 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.

Effective systems were in place to identify any trends or patterns in accidents and incidents so actions could be taken to mitigate emerging risks. Processes ensured any learning was shared with staff through handovers and staff meetings, to ensure they had up to date information to support people safely.

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.

People’s needs were fully assessed before they were supported by the service. This information was used to develop care plans and risk assessments to ensure staff had the information needed to provide safe, personalised care.

Staff knew the person well and demonstrated a good understanding of their needs. During our visit, we saw staff quickly understand and respond to changes in their behaviour when they were unable to express their needs verbally. For example, when they indicated they wished to leave the office. Staff quickly responded and supported them to say “bye”, waving as they left.

Staff worked closely with health and social care professionals to ensure people achieved good outcomes. One staff member said, “The care plan is constantly reviewed to make sure it is up to date with any changes.” Another staff member told us, “[Person] does communicate if they are not well through facial expressions and gestures, and if we (staff) feel something is not right, we will make sure an appointment is made."

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.

People felt safe with staff. During our visit, we observed relaxed and positive interactions, with the person appearing to enjoy the company of staff, joking and initiating playful banter. A relative told us, “I believe [Person] is safe, the staff do a good job looking after them.” Another relative said, “[Person] is safe, I’m really happy with the care they receive.”

Staff had received safeguarding training and understood their responsibilities to keep people safe. One staff member told us, “If I had a safeguarding concern the first thing I would do is report it to my manager, and obviously document everything I felt was out of place.”

The registered manager understood their responsibilities and how to refer any safeguarding concerns to the Local Authority (LA) and to the CQC appropriately.

The management team and staff understood the importance of consent and assuming people had capacity to make decisions about their care and support under the Mental Capacity Act 2005 (MCA). Staff confirmed they had received training about the requirements of the MCA and demonstrated an understanding of its principles. One staff member told us, “I encourage [Person] to do things for themselves and respect their choices. It’s not for me to tell them what to do or make decisions for them."

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.

Relatives felt staff supported them well to manage any risks of potential harm or injury. One relative told us, “[Person] has very complex needs and the staff are very aware of these and manage them well.”

Risk assessments were in place to guide staff on how to support the person safely, to mitigate risks associated with for example, choking, behaviours which may challenge and their mental wellbeing. Records confirmed staff had followed these instructions.

Care records and risk management plans had been regularly reviewed and updated where needed.

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

Processes were in place to ensure the home and equipment were regularly checked and maintained in a good working order. Staff understood their responsibilities to maintain a safe environment which was free from trip hazards to reduce the likelihood of potential falls as the person moved around their home.

Improvements were required to the provider’s recruitment processes to ensure they could demonstrate a full employment history had been sought. 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.

During our inspection, we identified improvements were needed to ensure the provider could demonstrate they had taken all reasonable steps to gain a full employment history for all staff. The provider had a risk assessment in place, sought references and completed Disclosure and Barring Service (DBS) checks which provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. We found no evidence people had been harmed and the registered manager took action to address this shortfall during the inspection.

Relatives were happy with the support their loved one received from staff. A relative told us, “I have no concerns about the staff team, who all have good relationships with [Person]. Their personality has really developed over the last couple of years, and these positive changes are down to the staff.”

Rotas demonstrated staffing levels were maintained and the person was supported by a consistent staff team. New staff received an induction which included training and working alongside more experienced staff to learn about their role and the person’s individual needs. One staff member said, “I did my induction with the team leader, and they gave me as much information as possible about [Person’s] communication, needs and activities. They introduced me to the team and the policies for the company.” Another staff member told us, “It was great, I learnt so much during my induction."

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.

Staff had received training in infection prevention and control (IPC) and demonstrated an understanding of how to reduce the risks of infection. One staff member told us, “I ensure I wash my hands regularly and wear personal protective equipment (PPE) as needed to reduce the chance of infections.” Another staff member said, “We do use gloves (PPE) when needed, like handling waste and putting on [Person’s] topical creams."

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.

Records showed the person received their medicines as prescribed and the care plan detailed their preferences on how they liked to be supported to take them. Staff handling medicines were suitably trained and had their competency to administer medicines safely assessed.

Protocols for medicines prescribed ‘as and when required’ (PRN) included guidance in terms of medicine to be administered, reason for administration, and the maximum dose to be taken in 24 hours.

Staff told us their competency to administer medicines safely was assessed by senior staff and records viewed confirmed this.