Transforming Support (Birmingham)

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 75 (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.

Robust accident and incident recording systems were in place, ensuring all events were documented, reviewed, and acted upon. A service improvement plan was in place, with clear actions monitored to reduce risks and enhance outcomes.

Staff were encouraged to discuss incidents transparently through team meetings and reflective practice sessions. This approach fostered a positive learning environment where shared experiences informed improvements in safety and quality of care. For example, the service employed a Positive Behaviour Support (PBS) Practitioner who worked collaboratively with staff and individuals receiving support to develop tailored strategies and techniques. This intervention enabled one individual to better manage their emotions, benefiting from increased structure and routine. As a result, they became more settled, experienced fewer incidents, and were able to spend more time engaging in the community.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored.

Transitions into the service were thoughtfully planned and centred around each individual. One relative described a structured approach, noting there had been a carefully arranged period of visits and information sharing before their loved one moved in. Pre-admission assessments were undertaken to identify individual needs, risks, preferences and desired outcomes, including those related to health, care, wellbeing and communication. However, information relating to sexual orientation and the expression of sexuality was not always recorded. The provider acknowledged this gap and confirmed that it would be addressed moving forward.

There was effective coordination with external services, including hospitals, GPs, dentists and other healthcare professionals. Appropriate information sharing supported continuity of care, and individuals were assisted to access the services they required.

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 using the service, along with their relatives, expressed confidence that staff safeguarded their wellbeing and upheld their rights. One individual told us they felt “safe” because staff consistently supported them. A relative commented, “They do keep [name of person] safe.” Another relative commented, “[name of person] feels safe with the familiar carers. This is important for them, you can tell by their reactions and behaviour. Their environment is safe, on the ground floor with a lovely fenced in garden.

Staff showed a clear understanding of safeguarding procedures, including how to identify and respond to potential concerns. They were aware of their responsibilities to follow appropriate reporting processes to help ensure people were protected from harm.

Community Deprivation of Liberty Safeguards (c-DoLS) provide the legal framework for restricting a person’s liberty in supported living and other community settings. Managers and staff understood when it was necessary to apply for c-DoLS authorisation and how to comply with any conditions attached.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided support to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessments were in place, regularly reviewed, and tailored to each individual’s needs. These clearly outlined the support required to minimise risks while promoting independence. For example, one person’s assessment detailed how they expressed anxiety and frustration, identified triggers, and explained how staff should respond to support them effectively. Risks were managed in the least restrictive way, ensuring a balance between safety and individuals’ rights and preferences. Staff demonstrated a good understanding of individual risks and were confident in supporting people while encouraging positive risk-taking.

Additionally, a clear restraint protocol was in place, specifying the types of restraint that could be used, the duration, and the circumstances in which they were appropriate. It outlined steps to be taken before implementing restraint, as well as actions required afterwards, including debriefs and learning from incidents. All restraint incidents were reviewed by the management team to ensure they were appropriate, proportionate, and carried out safely.

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

The service worked with landlords to ensure people’s homes were safe, well-maintained and suitable for their needs. The Management team carried out regular checks and prompt action supported the ongoing safety and comfort of the living environment. People and staff understood fire safety processes and supported people to stay safe within their own homes.

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.

Staffing rotas were effectively managed, with sufficient staff in place to ensure consistency and continuity of care. Staff completed comprehensive training relevant to their roles, including both mandatory and service-specific topics. Training was regularly reviewed and refreshed, ensuring staff maintained the skills and knowledge needed to support people safely and effectively. Ongoing supervision, team meetings, and additional learning opportunities further supported staff development.

New staff were recruited in line with safer recruitment practices, with appropriate checks carried out to confirm their suitability to work with people. These checks included reviewing employment history, obtaining references from previous employers, and verifying identity.

Relatives consistently expressed confidence in the staffing arrangements. One relative commented, “Staff are friendly when I visit, and do their job. I am grateful to them. This year [name of person] has been going out for chicken and chips and to Morrisons.”

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.

Regular infection prevention and control (IPC) audits were completed, and any identified shortfalls were promptly addressed. People’s personal space and shared areas were seen to be clean, tidy and well-maintained, supporting a safe and hygienic environment. People were fully involved in IPC practices, with staff providing appropriate support and guidance. This included encouraging good hygiene, such as regular hand washing.

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.

Medicines were stored, managed and administered in line with good practice guidance. Staff received appropriate training in medicines administration and showed a clear understanding of their responsibilities. They were also aware of STOMP principles (Stopping Over-Medication of People with a Learning Disability, Autism or both) and supported people to have their medicines reviewed where appropriate.

People were encouraged and supported to be as independent as possible with their medicines. This included involving them in decision-making and promoting understanding, while ensuring the right level of support was in place to keep them safe.