Wigan 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 66 (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.

The provider ensured incidents which affected the health, safety and welfare of people were reported internally and to relevant external authorities when required. We reviewed the last 3 incident investigations which the service had completed. We found that incident reports were completed thoroughly and on the day of the incident. These incidents were reported to the CQC and other relevant bodies.

Leaders monitored trends and themes regarding incidents and appropriately investigated them which ensured action was taken to remedy them and prevent further occurrences. Lessons were learned from safety incidents, resulting in changes which improved care for others.

Staff told us they were encouraged to raise concerns and felt confident they would be treated with compassion and understanding if they did. Learning from incidents was often discussed during handovers or in team meetings.

The provider did not always work well with people and healthcare partners to establish and maintain safe systems of care.

The provider did not always engage with services quickly when a person’s needs had changed. For example, a persons’ care plan, with complex needs, had not been updated since 2023 as the matron from an NHS Trust had completed the assessments and they had left the service. Leaders provided evidence of how they had chased this up with the Trust, however this indicated an unsatisfactory pathway for this person. The manager and staff assured us, that despite the reassessment not being completed in a timely manner, this had not impacted on the person’s care.

The provider worked in partnership with other professionals such as GP’s, dieticians and speech and language therapists (SaLT) to support people to access healthcare when they needed it. On each of the care plans, staff had identified a ‘circle of care’ for people which included the key professionals and family members involved with the person. However, we did see some shortfalls in this area. For example, 1 person was not registered with a dentist, despite being with the service for a considerable amount of time whilst other people’s next scheduled appointments with health professionals were recorded in their care records as being 2 years ago which meant the records were incorrect or they had not attended an appointment since 2023.

The provider ensured arrangements were in place to support people who were transitioning in to or out of the service. The provider had a robust process called ‘Go Live’ which ensured leaders had obtained or completed all the relevant information for a new person entering the service.

The provider ensured initial assessments were completed when people first began to use the service. The provider also completed risk assessments when people moved between services. There was a moving into service transition process which included assessments from the Speech and Language Team (SaLT) and occupational therapy.

The provider ensured people had hospital passports in place. A hospital passport is a document or digital tool which provides important information about a person, especially someone with a learning disability, autism or complex communication or health needs.

Staff said they were made aware of new people accessing the service and would be able to read their care plans if 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.

The provider had systems in place which meant people’s human rights were upheld, and they were protected from discrimination. The provider ensured staff had access to up-to-date safeguarding policies and procedures. The provider kept a safeguarding log which provided brief information about the incident which had occurred. The safeguarding log required further information including the safeguarding tier, next steps or outcome, reviewers’ signature and final comments. As a result, we were unsure of the status of the safeguarding incidents reviewed. Following us feeding this back to the registered manager, the log had been updated.

Staff received safeguarding training which was relevant and at a suitable level for their role, 94% of staff were compliant with safeguarding adults mandatory training.

Staff were aware of their individual responsibilities regarding good safeguarding practices. They had a good understanding of their role and how to escalate concerns if required.

Some of the people we visited had an easy read document on how to raise concerns if they did not feel safe. Staff told us it was not suitable for all the people supported, as they did not have the capacity to understand it.

People, their relatives and staff did not raise any concerns about people being unsafe.

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.

The provider ensured people had personalised risk assessments in place, tailored to individual needs. For example, we saw clear guidance for staff supporting someone at risk of choking and aspiration, and staff received extra epilepsy training where needed.

Staff said care plans and risk assessments contained enough detail to help manage risks, and they had time to read them. They felt able to respond appropriately to behaviours which communicated a need, emotion or distress, supported by the communication sections of care records. One example included details of specific songs to help a person manage overstimulation.

Behavioural support sections in care plans were detailed where needed. In one care plan, we saw how risk assessments covered a range of different scenarios with contingency plans for each, and staff used Antecedent, Behaviour and Consequence (ABC) charts to help manage and understand behaviour which was challenging.

The provider had an internal Positive Behavioural Support (PBS) team who provided support for people with an aim to reduce behaviours which were challenging, by meeting the persons underlying needs.

We observed examples of when people were emotionally distressed and how staff responded. For instance, when a person was upset and tearful, the service level manager offered reassurance. Staff also demonstrated good knowledge of people’s nonverbal and verbal cues, helping them identify signs of agitation or calm.

Leaders promoted positive risk taking within the service. One person told us they had begun to self-administer insulin, giving them more independence.

Staff were trained in least restrictive practice and there was an organisational policy on restraint any restrictive interventions. The PBS team held workshops every 2 months to review restrictions.

Relatives felt people were safe, even when their loved one’s needs were complex. One relative said “Even though [person] has poor mobility and is at risk of falling, I have no concerns about the care he receives. I am very happy with this service”. Another relative said “staff are brilliant” and went on to explain how staff were able to recognise their loved one’s behaviours and respond appropriately to any risks.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

Individual supported living houses were managed by separate landlords and housing providers, therefore, Wigan Supported Living were reliant on them for the maintenance and upkeep of the living environment. Repairs were raised with landlords and monitored through health and safety audits.

During observational tours of 3 locations, we found front doors were secure, though some side gates were not; this was raised with the registered manager who ensured this was resolved

Communal areas were mostly appropriate and aligned with guidance. However, in one location, we found a communal toilet contained a large filing cabinet holding items such as paint. The substances were unsuitable for a communal area and posed a risk to people. Following the onsite inspection and us providing feedback about the cabinet, the service removed it.

Most people had access to well-kept garden areas, but one of the communal garden areas we visited was in poor condition, with a fallen basketball hoop and cigarette ends on the ground. Although, the council were responsible for the maintenance of the area, staff and people residing at the property could have taken simple measures to improve the environment. We raised this with the service level manager and when we visited a day later this had been rectified.

The provider ensured fire exits were clearly marked, and fire extinguishers were available. Personal emergency evacuation plans were in place. At one location, a fire extinguisher in the kitchen was incorrectly labelled as dry powder instead of water vapour, this was reported to staff.

People’s flats were adapted to their individual needs, including automatic doors, lowered work surfaces, wet rooms and autism-friendly electrical sockets.

People were encouraged to personalise their rooms, with murals painted by staff, themed decorations, and furniture brochures available for choice.

Regular health and safety checks were carried out, though some logs were incomplete, missing staff initials and dates. We also found a non- working carbon monoxide alarm in a boiler room, which was resolved after reporting.

We saw evidence of safe equipment use. Care plans reflected people’s equipment needs. We found lap straps were in place for people in wheelchairs and wardrobes were now secured following a recent incident.

Safety checks and certification confirmed utilities and equipment were safe. PAT (Portable appliance testing) was up to date and equipment was serviced as required. Facilities, equipment and technology were well-maintained and consistently supported staff to deliver safe and effective care. Regular fire safety checks and fire drills were completed.

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.

The support and staffing needs of each person were assessed on admission, with processes in place to ensure rota's reflected commissioned hours.

Staffing rota's showed sufficient staff levels, which were confirmed by feedback from people, relatives and staff. The provider ensured there was 7-day manager cover.

Managers had access to staffing dashboards and weekly reports to monitor and address potential staffing issues, alongside weekly data collection on staff hours. Agency staff were rarely used, with staffing levels maintained at 110%. Staff felt staffing levels were sufficient to perform their roles effectively.

The induction process was thorough, including site visits, training and shadowing, supported by a probation period of at least 3 months to ensure suitability.

The provider involved at least two people in the selection process when recruiting staff and where practical, the provider involved people and families. There were robust and safe recruitment practices to make sure that all staff were suitably experienced, competent and able to carry out their role. Leaders recruited staff safely, with all necessary checks and documentation in place. UK disclosure and barring service (DBS) checks were completed to ensure staff were of suitable character to work with vulnerable adults.

Staff had access to a range of mandatory and non-mandatory training modules. The overall compliance rate for training for the services was 99%. Relatives told us they were confident in the staff and felt they had been trained appropriately.

Staff completed regular supervisions. Staff told us supervisions were useful and were always completed on time. Annual performance reviews for senior staff were up to date.

The provider did not always assess or manage the risk of infection.

Most areas such as bedrooms and communal areas of the services we attended were clean and tidy. Furniture was well maintained and therefore did not pose an infection risk. However, some low-risk areas were unclean and warranted some further attention. For example, we observed grease and dirt in high areas, rust on a handle in the toilet and dust in an extractor fan.

Service leaders completed a quality assurance audit monthly. There was an IPC section within this audit. The registered manager did a quarterly assurance audit in which they completed a walk around, checking both health and safety and cleanliness of the service. The provider had also launched a quarterly infection prevention and control audit which would be introduced in July 2025. The provider’s quality team also completed IPC audits. An IPC policy and procedure was in place. However, some of the cleaning schedules/records, which a service manager told me should have been on the computer system were not available. We reviewed cleaning logs for one person which were paper based and found some of the entries were missing. The care worker supporting the person was unsure whether the cleaning had not been completed or whether it had not been recorded.

Staff told us they did not have concerns regarding IPC and confirmed they had access to appropriate amounts of personal protective equipment.

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.

The service had systems and processes in place for the safe storage, administration, and use of medicines. People were supported by staff who followed systems and processes to administer, record and store medicines safely. Staff were trained and had their competency assessed.

Staff had information on how people liked to take their medicines and care plans contained person-centred information so that staff could give medicines safely.

People were risk assessed to determine if they could manage their own medicines. In cases where this was not appropriate, capacity assessments and best interest decisions were completed.

Thickening powder used to thicken fluids to stop aspiration and choking was recorded appropriately.

Medication administration records for topical preparations such as creams were completed accurately, and there were body maps in place to ensure staff applied these correctly.

Staff documented the time of administration of time sensitive medicines such as paracetamol so they could be sure that the safe 4-hour interval between doses had been observed.