Wigan Supported Living

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This is the first assessment for this service. This key question has been rated Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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 did not always make sure people’s care records were up to date and consistent with their current presentation.

We reviewed care plans and found them to be extremely detailed; however, we did see some inconsistencies which meant the assessment process was not always effectively informing the care plan. A care plan outlined how a person required an epilepsy mat under their bed; however, we found this piece of equipment not to be there. We saw evidence this meeting had taken place to assess the person’s needs, but the care plan had not been updated.

Another person’s care plan outlined how they were unable to reposition themselves and was at high risk of pressure sores. We did not see evidence that repositioning was being documented and therefore could not be confident it was taking place. However, we did see evidence of their skin integrity being checked daily. The same person had not received a full assessment with a clinical professional (matron) since 2023 meaning clinical aspects of their care plan had not been reassessed or updated. The leaders had attempted to follow this up. The care plan also outlined how the person required hourly checks at night which we could not find. When we raised this with the registered manager it was discovered the person no longer required hourly checks as a member of staff always supported her. This change had occurred 18 months ago but staff had not been updated the care plan.

We found other issues with care records as well including statements being repeated in the same sections, some further clarity required in sections and an example in which the wording implied an individual living with complex needs may make false statements which could potentially impact staff’s response.

Most staff felt the care plans accurately reflected the person who they were supporting but some did acknowledge some amendments/updates were required. Support staff were adequately trained to undertake care assessments and reviews.

Assessments of people’s care were undertaken when they first began using the service and people and relatives were involved with these if they were able to. A relative said how they felt very involved with what was a “well managed move.”

Relatives told us they were involved in meetings about their loved ones and received appropriate communications from the service when needs changed or an assessment was due.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Leaders evidenced how they kept informed of the latest good practice and legislation related to the care and support they delivered. The leaders were signed up to CQC newsletters, the ‘skills for care’ mailing service and the provider ensured there were weekly communications in a ‘managers digest’. Managers also attended a provider forum where all managers were kept up to date with regulatory requirements and changes.

Provider policies were regularly reviewed and closely aligned with latest legislation and other good practice. Staff told us they knew how to access policies and were kept updated when polices were amended.

Care plans and risk assessments regarding conditions such as epilepsy and Percutaneous endoscopic gastrostomy (PEG) feeding were detailed for staff to follow. PEG feeding is a way to give food, fluids and medicines directly into the stomach by passing a thin tube through the skin into the stomach.

The provider assessed people’s nutritional needs and ensured they had detailed eating and drinking care plans which aimed to meet their nutritional requirements. There were some issues with the recording of fluids in a person’s care plan which we reviewed. They should have been offered 2000mls of fluid per day and this had not been achieved in June 2025 and on 3 occasions the record stated they had been offered 200mls or 400mls of fluid. The person had not come to apparent harm and the registered manager agreed to highlight to staff the need to record fluid intake more accurately.

People and relatives were happy with the food being provided. One relative said, “Staff are good at cooking and [person] has a varied diet including fruit, vegetables and meat.”

Staff had a good knowledge of the specific food textures and drink thicknesses for the people they were supporting. They told us they involved people with their own cooking of meals as much as possible to promote their independence.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The service worked in partnership with other professionals such as GP’s, dieticians and teams such as the learning disabilities team. Leaders invited district nurses and social workers to meetings. We saw evidence of multidisciplinary team (MDT) meetings taking place where people’s best interests were considered. The management team and staff demonstrated how when a person's needs had changed, they had promptly engaged with several services to ensure the person's needs were fully met and understood.

Staff established direct and meaningful relationships with relevant healthcare professionals and other services.

Staff safely shared information amongst themselves via internal processes such as handovers.

Staff told us there were clear escalation procedures and knew who to contact if they needed support.

Staff said the team worked well together and despite there being several locations, they felt like a team and would support one another when required. For example, when we attended one of the locations, the service level manager was on leave and another service level manager attended and it was clear they had good relationships with staff and people.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The provider empowered people to maintain good health and wellbeing. Where capacity permitted, people were encouraged to take an active role in monitoring their own health. The provider was involved in local sports and community events including with the local rugby team. The service had also signed up to a local run in which 5 members of staff and 5 people would be taking part.

The care records provided a useful insight into how staff successfully supported people to manage their own health and wellbeing and how they communicated effectively with relatives who made any major decisions regarding heath. The care records also provided updates regarding the status of people’s health and well-being, for example a person’s care plan indicated they were currently having medical examinations to try to identify a medical problem. However, another care plan had not been updated and referenced medical appointments from 2023.

We reviewed a care record and progress notes and found staff had supported a person with diabetes to maintain their blood sugar levels with appropriate foods.

People were supported to maintain good physical and mental wellbeing by having regular access to meaningful activities and wider community engagement. We were sent photographs of people attending a local gym. However, there were some examples in which people had been offered to engage with activities but had refused, despite encouragement from staff.

Staff were mindful of how important maintaining good health and wellbeing was. A staff member explained to me how they do not drive the person to places as they enjoyed walking and using public transport.

We observed staff supporting people to engage in physical activities such as a game of boccia.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent.

The provider evidenced progress for some of the people supported via case studies. One person had been supported to improve their diet, their community involvement, they were now completing their own shopping and washing and were now able to board public transport. Another person had started choosing their own outfits and incidents involving them had significantly reduced.

The registered manager told us they completed monthly checks of the daily records which ensured people were completing the health-related tasks they wanted to do.

Staff told us people improved when they came to the service. One staff member explained how the person she supported had come to the service with very little belongings and had lived in an unsatisfactory environment. They explained how much they had progressed and how they had become much more independent and how the service was continuously learning about the person and adapting their care to meet their needs.

People’s care plans had a section for goals and aspirations. We found that most people had achieved or were in the process of achieving these goals. We suggested that the service considers updating these goals and outcomes when they are achieved as recording on the electronic system was not clear.

Relatives we spoke to told us their loved ones emotional and physical wellbeing had improved since starting at the service. One person said, “They are on an even keel now since moving here and they are much happier.” Another relative said “Staff and management have saved our lives as a family” as they felt confident in the care being provided.

There was ongoing work by one of the managing directors to introduce a framework for measuring outcomes for people using the service.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People had capacity and consent support plans in place which provided information about their decision-making abilities.

Staff understood about the Mental Capacity Act (MCA) and deprivation of liberty safeguards (DoLS) and what the legislation entailed.

Assessments of people’s capacity were completed if people were unable to make their own choices. We saw family members were involved in this process to ensure decisions were taken in people’s best interest. DoLS applications were submitted to the local authority as required.