United Support Services

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this service. This key question has been rated outstanding. This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 89 (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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.

The provider and registered manager promoted a positive and inclusive culture which put people at the centre of their care. They modelled this approach to the wider staff team who all spoke of the shared values within the organisation. Comments included, “All staff have the same values, delivering person-centred care”, “The staff team have shared values. Respect is a big one” and “Values are 100% shared by staff. Everyone works to same goal.”
Leaders were committed to the principles of supported living and the importance of creating empowering spaces for people where they could flourish. An external professional commented, “The provider's philosophy that people's properties were their homes, rather than simply care environments, was particularly positive and appeared to underpin its approach to dignity and respect.”
The registered manager described how 1 person had previously lived in a group setting where their choices and ability to control their immediate environment had been limited which had led to them becoming distressed. Since moving into their own flat and being supported by a consistent team who they trusted, the person had become happier, and their opportunities had subsequently widened. They told us, “[Name] has been our inspiration”.
The provider was aware of the difficulties of monitoring culture and had processes to address this. The registered manager told us, “Culture is a huge thing, we know what can happen if bad culture creeps in. Constantly checking on that. If staff don't mirror our values, it will be a blockade.” Leaders recognised the power of language and how poor use of words might indicate a poor culture. Daily records were monitored to check language used was appropriate. For example, staff were guided to avoid saying people ‘refused’ to do things as this could be negatively constructed.
Although the provider and registered manager were related, staff were confident they could raise concerns freely and with confidence to either of them. One of them told us, “I don’t even think of them as being related. They both present really professionally.”

The provider had exceptionally inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They always did so with integrity, openness and honesty.

The provider, registered manager and deputy manager all worked closely with people and staff. This enabled them to model organisational values and behaviours. The strong leadership had a positive impact on people’s experiences. Because leaders had a sound understanding of people’s needs and the challenges they faced they were able to work alongside other professionals to help develop bespoke packages of care.
Leaders were highly reflective about their own practice and continually reviewed what worked well for people. When things had not gone well they were honest about any mistakes they may have made and how things could be done differently in the future. For example, the registered manager described a trip out when they had acted in a way which had annoyed the person. They told us, “I felt awful, I got it wrong.” This approach gave staff the confidence they needed to reflect on their own practice and consider how they could improve the support they provided.
Staff all told us managers were available at all times for advice and guidance. As they had a good knowledge of people’s day to day needs staff were confident they understood their experiences. One member of staff told us they would be “comfortable sharing anything” with their managers. Another told us the provider and registered manager were “spreading a positive culture.” There was an on-call system so a manager was always contactable. Staff told us this worked very well.
External professionals told us they considered United Support Services to be a well-managed service. Comments included, “I have always found management and staff to be very kind, compassionate and motivated to do the best for the people they support. They seek to understand the needs of the people they support and look for ways to develop their own skills to ensure they provide the best possible support.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff were confident raising any concerns without fear of negative consequences. Supervision and team meetings were held regularly to provide a platform for raising any concerns or suggestions. Staff said they were able to approach leaders at any time.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The organisation’s intranet provided a link where staff could apply for free counselling. Staff told us they were treated fairly and managers were understanding of any responsibilities they had outside of work. One commented, “They were really accommodating and covered me when childcare was a problem.” Another told us, “Managers are very approachable, any adjustments I’ve needed have been accommodated.”
Recruitment was focused on identifying candidates who shared the organisational values. Although previous experience was important a lack of experience did not deter the provider from employing candidates. Staff who had not previously worked in the care sector told us they had been encouraged to develop and learn. One commented, “It couldn't have gone any better. I feel like I am making a difference. The first couple of weeks was a bit of an eye opener but I feel I have found the career for me.”
It was apparent leaders valued the staff team. Comments included, “[Name] and [Name] have incredible values” and “[Name] naturally uses an inclusive approach. They are calm and bring a feeling of safety.”

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. They always acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

Leaders were committed to building teams of staff around people so they could have consistent care from staff who knew them well and were able to connect with them. One person had built a strong bond with their staff team who they referred to as ‘the boys.’ The provider told us, [Name] chooses their own team. If someone isn’t working out [Name] will let us know, and has done.”
There were excellent systems for monitoring and collecting data relating to risks and outcomes. Data was analysed regularly and a behaviour analyst, positive behaviour support practitioners, the provider, registered manager and staff at United Support Services were able to respond quickly to any emerging patterns and trends. There was a strong emphasis on using data and experiences to drive improvements and improve outcomes for people.
The provider invested in training which helped staff understand and meet people’s needs. For example, training was provided for Sudden Unexpected Death in Epilepsy, Intensive Interaction (a communication approach) and Active Support. PBS training was spread over 3 days with the first day being focused on why restraint should only be used as a last resort. This investment in expertise meant people received care that was focused on their individual needs putting them at the centre of their care.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The service worked with other agencies in order to provide joined up care across services. Information was shared appropriately and in people’s best interest. An external professional commented, “The Management team invested their time at the training session. They appeared to be welcoming and ready to listen, although they are completely involved in the daily care of the people who use the service and know what is happening on a daily basis.”
Community involvement was promoted with staff taking a pro-active and positive risk-taking approach to supporting people to regularly engage in meaningful activities in the community. We saw an email from an external healthcare professional which stated, “This is a provider who cares and invests in the people they care for and about. They want people to be living and not existing.”

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

There was a very strong emphasis on the importance of learning from events, sharing that learning with the wider staff team and implementing changes to improve people’s experiences. Managers and staff reflected on their practice and spoke of the need to learn from what people using the service were telling them. This was done in various ways, for example 1 person with lived experience was asked how they would feel in a certain scenario. Their response was used to help staff understand how someone they supported might react in a similar scenario, and why. Leaders were also pro-active in identifying different ways of gathering information about people’s experiences. Monitoring records were used to capture information about specific situations. These were analysed with the support of a behaviour analyst. A member of staff explained, “We have weekly meetings when we speak to the behaviour analyst and look at how we can make changes and any lessons learned. We then share that across the team. That needs to be so clear, it effects [Name’s] quality of life, it’s so important that everybody understands [Name].”
Staff demonstrated a professional curiosity about what worked for people. This was an approach to support that had been modelled by leaders. A document shared with staff asked them to question ‘Just because something has always happened, does that mean we should accept it?’ Staff told us this approach had led to positive outcomes for people. One commented, “Over the past year I've seen massive improvements in the trust (between staff and the person), and a willingness to try new things.”