Maximus Support Services Ltd

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 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. Incidents, accidents and safeguarding concerns were reported, reviewed and analysed with management oversight. Post‑incident debriefs were routinely used to support staff wellbeing and identify learning, and adjustments were made to staffing, guidance or risk management where needed. Systems such as medicines audits, incident audits and daily record audits were used to identify themes and drive improvement.

Staff described feeling able to speak up about concerns, incidents or errors without fear of blame, and told us that learning rather than criticism was the focus. One staff member explained, “It’s OK to get things wrong as long as you tell them (managers) – it’s about keeping people safe.” External professionals described confidence in the provider’s approach, with one stating that management went “above and beyond” to reflect, learn and improve practice following incidents.

The provider worked closely with people, families and professionals to establish and maintain safe systems of care, including during complex transitions. This included supporting people to move from hospital or other restrictive settings into their own community‑based home. They made sure there was continuity of care, including supporting staff to work with the person in previous settings to enable them to become familiar with staff prior to the move. This helped to reduce anxiety for people when they moved between different services. Transition planning involved relevant professionals, people and their families.

People were supported by a consistent team of staff who they had got to know and who understood their individual needs. Staff demonstrated detailed knowledge of people’s histories, needs and risks, supporting continuity of care.

The provider worked with people, social 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 and families told us they felt safe and trusted staff to protect them from harm. One person told us, “I feel safe; the staff look after me in the best way.” A family member said their relative was “very much safe because there is such good communication,” noting how trust had been rebuilt following poor experiences with a previous provider.

Staff were able to clearly explain how to recognise and report safeguarding concerns and knew who to contact if they had worries. Systems were in place to report safeguarding concerns to the local authority, and records showed that concerns were escalated appropriately, including where incidents involved medicines or restrictive practice. External professionals reported confidence in the provider’s safeguarding responsiveness and practice.

However, documentation did not always clearly evidence that all ongoing restrictive practices were supported by up‑to‑date mental capacity assessments and best interest decisions, particularly following moves or changes in people’s circumstances. Despite this, there was no evidence that the missing documentation would have altered the care people received or that any restrictions were not appropriate to reduce risk and promote safety.

Some people supported by the service were subject to restrictions in the community where they lived, such as continuous supervision or not being able to leave their home safely without support. In these situations, known as community Deprivation of Liberty safeguards (community DoLS), legal authorisation is required to ensure people’s rights and freedoms are protected where they may lack capacity to consent to their care arrangements. The provider had appropriately identified where community DoLS applied and had worked with the local authority and Court of Protection to ensure the necessary applications and authorisations were in place. This demonstrated an understanding of safeguarding responsibilities and a commitment to ensuring restrictions were lawful, necessary and in people’s best interests.

The provider worked with people to understand and manage risks in ways that balanced safety with independence. Risk assessments were detailed and individualised, and staff demonstrated good awareness of how risks should be managed in practice. Staff were confident in supporting positive risk‑taking and explained how they adjusted support to respond to changes in people’s presentation.

People and families described being involved in reviews and changes to care. One family member told us they had helped write the care plan and felt fully informed, while another said staff encouraged independence. During our visits to their homes, people appeared relaxed and comfortable with staff, and interactions supported choice and control, even where risks were present.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The provider identified and managed risks within people’s homes and made adaptations to support the safe delivery of care and promote people’s independence. Environmental risk assessments were in place, and staff demonstrated familiarity with people’s homes and safety arrangements. People and family members told us homes were respected and kept clean and tidy.

Observations during home visits showed environments that were personalised, well maintained and adapted to individual needs. Where environmental risks existed, staff were knowledgeable about how these were managed, and people were supported to live safely within their own homes.

There were sufficient suitably skilled, trained and experienced staff to meet people’s assessed needs safely. This included where people required enhanced or continuous support to meet complex individual needs. Staff’s skills and experience had been matched to the needs of the person to enabled people to work towards and achieve their aspirations and potential.

Recruitment processes included appropriate checks, and new staff spoke positively about their induction and support. One new staff member said, “No question was a stupid question – I always felt supported.” Staff described feeling supported through supervision, spot checks and post‑incident debriefs, which helped promote wellbeing and safe practice. They worked together well to provide safe care that met people’s individual needs.

The provider had assessed and managed the risk of infection appropriately. Staff had received infection control and food hygiene training, Personal protective equipment (PPE) was readily available and people and families confirmed it was used where required. Infection control was monitored through spot checks and audits, and homes visited were clean and well maintained.

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. Systems were in place to support safe medicines management. Staff received medicines training and competency assessments, supported by regular audits. Staff understood what action to take if a medicines error occurred and could give clear examples of seeking advice, monitoring people’s wellbeing and reporting incidents appropriately.

Family members and people using the service did not raise concerns about medicines administration, and external professionals confirmed confidence in the provider’s approach to medicines safety.