STANDBY24 LTD

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• 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, which was newly registered on 8 December 2023. 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.

Staff acted quickly and effectively to understand why a person may have become distressed or why an incident occurred. They had meetings with each other, as well as with other healthcare professionals, to help identify what could be changed to prevent repeated occurrences.

A member of staff told us, “When things go wrong, incidents are recorded, reported, and reviewed. The team discusses lessons learned and adapts practice to prevent similar issues in the future.” Another member of staff explained, “When things go wrong, information is shared through [electronic care records], group meetings and phone calls.

Staff identified and understood the risks associated with closed cultures. They ensured people using the service had access to others outside of the service, such as professionals, family and friends, with whom they could raise concerns about their safety if needed.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People using the service had detailed care plans, so staff knew how to support them to have a good day. Staff consistently supported people if they became distressed. They also followed agreed action plans to help people avoid situations that could cause them distress. Staff also followed reactive strategies for people when needed.

A member of staff told us, “The care plans and risk assessments are well documented and provide clear guidance on how to support [the individual] safely.”

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.

Staff involved people and their representatives in all aspects of their care. Staff and leaders had taken active steps to ensure there was an open culture. There was evidence that concerns could be raised safely and poor or unsafe practice was identified and challenged.

A member of staff told us, “I have raised safeguarding concerns in the past and followed the correct procedures to ensure the person’s safety. The issues were handled promptly and appropriately by management.”

People’s representatives confirmed the service had an open culture. They told us they trusted the staff and felt their loved ones were supported safely and appropriately.

A member of staff told us, “For me, safeguarding also means listening to children, valuing their voices, and ensuring that they are involved in decisions about their lives wherever possible. It requires professional curiosity, reflective practice, and a commitment to anti-oppressive values to protect children and promote positive outcomes.”

If restrictive practice needed to be used, it was legally justified, proportionate, necessary and used as a last resort. Staff were committed to minimising restrictive practices and any that needed to take place were recorded in people’s Deprivation of Liberty Safeguards (DoLS) or Court of Protection authorisations.

A member of staff told us, “Safeguarding is about protecting vulnerable people from harm, abuse, or neglect and ensuring they live safely while having their rights and wellbeing respected. I have not had to report one personally, but I know the correct procedures if a concern were to arise.”

Staff and leaders recognised and understood the warning signs that could indicate a closed culture was developing and took prompt action to address these. Staff and people’s representatives confirmed that leaders carried out regular unannounced spot checks. They also told us there was frequent engagement between leaders, the people being supported and their representatives.

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.

Staff understood there were times when people became distressed. They took appropriate steps to understand why this was and learn what support people needed to enable them to express their emotions. Staff spoke in a respectful way with people, and about them, during times of distress.

A person’s representative told us, “They [Standby24] have done wonders. We were having 3 to 4 [serious incidents] a week before Standby24 started supporting [Name], now they are few and far between. Of course, we still have ‘wavy’ times, but staff recognise if [Name] is not in a ‘good’ mood and they react appropriately.”

Staff supported and empowered people to take informed risks in areas they wanted, which helped enhance their lives. Staff reviewed people’s care plans and risk assessments with them when their needs changed, or staff identified changes in their mood or communication styles.

Staff supported people effectively to protect them from the risk of avoidable harm. They followed best practice guidance and identified risks were mitigated, whilst ensuring the person still maintained their independence and dignity.

The provider completed environmental risk assessments for people and their home environments. They made sure equipment, facilities and technology supported the delivery of safe care.

Staff spoke with people about their personal environments and, when needed, made sure adaptations and reasonable adjustments were made to meet their individual needs and enhance their quality of life. Staff assessed each person’s sensory needs, so that consideration could be given to what and how people could see, hear, feel, smell and taste within their environments. Staff understood what could cause people to experience sensory overload and supported them to make changes to avoid this happening, so they could be calm and relaxed at home.

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.

People’s representatives told us people had built up excellent relationships with their support staff.

People were supported by enough staff to meet their individual needs. Staff had completed appropriate training, including how to support people with a learning disability and autistic people. Staff’s competency was regularly assessed to make sure they maintained the relevant skills to support each individual person.

Staff told us they received regular support and supervision and felt fully supported by the registered manager and other colleagues. A member of staff told us, “I feel fully supported by both my managers and my colleagues. I receive regular and consistent supervisions and have an annual appraisal, which I find very supportive for my professional development.”

When people received 1-1 support, leaders tried hard to match staff’s skills and experience to the needs of each person. This helped enable people to work towards and achieve their aspirations and potential. A person’s representative told us, “[Name] has the same staff. [Name] likes all of them and has [pet] names for them. They are a really good bunch.”

The provider operated safe recruitment processes. People were protected against the employment of unsuitable staff because appropriate checks, such as criminal record checks, identity and right to work in the UK, were carried out before people started working at the service.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and, when needed, shared concerns with appropriate agencies promptly.

Staff supported people to maintain good hygiene and keep themselves and their homes clean. Staff confirmed they had completed infection control training and had enough Personal Protective Equipment (PPE) to use when needed. The provider had effective systems and processes to ensure infection risks were minimised and saw that prompt action was taken when any concerns were identified.

A member of staff told us, “I use PPE when required and it is always available.”

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.

People received appropriate support with their medicines. They were also involved with assessments and reviews about the level of support they needed to manage their medicines safely and to make sure their preferences were included. This was clearly documented in their care plans.

Staff completed risk assessments with people about their medicines and supported them to be as independent as possible. People had regular reviews of their medicines, to ensure they continued to be effective and make sure side effects were minimised. People were also able to access appropriate monitoring, when needed, such as blood tests.

Staff followed guidance for giving PRN (when required) medicines and the outcomes were assessed and recorded to ensure they were effective.

Staff had completed training for managing and administering medicines and had their competency checked regularly. Staff read and understood the medicines policy and followed the principles of STOMP (Stopping Overmedication of People with a learning disability, autism or both) and STAMP (Supporting Treatment and Appropriate Medication in Paediatrics).

People’s behaviour was not inappropriately controlled by medicines. The provider worked closely with others to help stop overmedication. This included working with people with a learning disability, autism or both, their families, health professionals, commissioners and prescribers.

Staff were trained and understood how to support people and meet their needs without use of medicines wherever possible.

Staff attended debriefing sessions when medicines were used to calm, control or restrain a person. This helped to identify actions that could be taken to reduce the likelihood of repeat occurrences. ABC (Antecedents/Behaviour/Consequence) charts were used by staff to help identify patterns when people expressed distress or an emotional reaction.

Staff said they would speak up if they had concerns that a person was being controlled by excessive or inappropriate medicines.

All staff we spoke with clearly described the procedures they would follow if there were any concerns or errors with people’s medicines. A member of staff told us, “If a medication issue arises, I follow company policy by reporting it immediately to the appropriate manager, recording the incident accurately, and ensuring the individual is safe.” Another member of staff added, “I would reflect on what happened, follow any updated guidance and take part in refresher training if needed, to help prevent future errors.”