SUPPORTED LIVING ENABLEMENT SERVICES

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 69 (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. Lessons were learnt to continually identify and embed good practice.

The provider had improved its systems for recording, investigating and reporting incidents. The registered manager told us they had reflected from previous incidents and used this learning to help ensure staff appropriately reported and recorded all actions taken in response to incidents. This included notifying relevant stakeholders and updating care plans when risks escalated.

One of the company directors told us they had taken a more active role in supporting the registered manager with incident investigations. They had developed incident trackers to improve oversight and carried out thematic analysis to identify trends and reduce the risk of similar incidents occurring.

The registered manager used staff meetings to discuss incidents and share learning with staff. This gave staff opportunities to reflect on their practice and contribute ideas to improve future approaches to care and support.

The provider worked with people and healthcare partners to help establish and maintain safe systems of care. People told us there was continuity of care, including when they moved between different services.

People and their relatives told us they were happy with how their care had been initially arranged and that the care packages in place were working well for them.

The registered manager told us they had experienced challenges obtaining all the information needed to support safe hospital discharges and new referrals. To address this, they personally attended new and re-started care packages until all relevant information was available. This helped them develop an understanding of people's needs and create care plans based on their direct observations and experiences. They were also developing checklists to track and obtain all necessary information for new referrals. This reduced the risk of failed discharges and disruptions to care provision.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They shared concerns promptly. However, they needed to embed systems to ensure concerns were addressed appropriately with professionals.

People told us they felt safe receiving care from staff and had developed positive, trusting relationships with them.

Professionals told us the quality of provider-led safeguarding enquiries could be improved. We reviewed a recent safeguarding submission to the local authority and found the provider's responses did not always fully address the areas requiring investigation. The registered manager acknowledged improvements were needed in how safeguarding responses were compiled and submitted. They provided evidence of new incident and safeguarding trackers designed to support oversight of incidents and safeguarding concerns.

The provider had policies and procedures covering the management of people's finances and the maintenance of professional boundaries. This included guidance on social media use and contact with people outside of work. Staff discussed these topics during induction and team meetings, which helped ensure they understood their responsibilities. Staff demonstrated a good understanding of safeguarding, including the action they would take to protect people from harm.

The provider worked well with people to understand and manage risk. However, people’s care plans did not always capture how staff should support people to monitor and reduce risks related to people’s care.

Although staff supported people safely, care plans did not consistently reflect current risks for people and the support they needed to manage these. For example, a person's skin integrity care plan did not clearly describe areas at risk of skin breakdown, what monitoring was required, when concerns should be escalated, or the person's ability to manage these risks independently. Following the inspection, the registered manager reviewed the person's needs and provided an updated care plan with more detailed guidance for staff.

A person's moving and handling risk assessment contained conflicting information regarding the level of support required when using mobility equipment. Although staff understood how to support the person safely, the registered manager agreed to review and update the records.

Similarly, 2 people's care plans identified moving and handling risks associated with bed height and the potential impact on staff safety. However, records did not demonstrate how these concerns had been escalated or what action had been taken to reduce the risk. The registered manager told us the risk was currently low but agreed to review the care plans to ensure risks and actions taken were recorded more clearly.

The provider detected and controlled potential risks in the care environment. They made sure equipment supported the delivery of safe care.

The provider carried out assessments of people's home environments. These considered factors such as falls risks, home safety and security, smoking, and the safe use of care equipment. For example, one person had a smoking risk assessment in place which promoted safety within their home and helped ensure staff could work in a smoke-free environment.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development.

People and relatives told us they were happy with staffing arrangements. They said they were supported by a consistent team of staff and were confident staff had the skills and knowledge to provide safe care.

Staff spoke positively about the training and support they received. They completed training relevant to their roles, including a combination of online learning and practical sessions delivered by an external provider. The training programme was based on the Care Certificate, and staff completed regular refresher training to help maintain good practice.

New staff completed a structured induction, during which their competence and performance were assessed. This helped assure the provider that staff met expected standards of practice and behaviour. Staff told us they felt well supported, received appropriate training and benefited from effective guidance from senior staff.

Recruitment processes were consistent with the requirements of the regulation relating to fit and proper persons employed. The provider had systems to monitor compliance with recruitment requirements and assess any risks where recruitment documentation was not immediately available. This supported safe and proportionate recruitment decisions.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading.

People told us staff maintained good standards of cleanliness and hygiene when providing care. They said staff used appropriate PPE, including gloves and aprons, where required to support safe care delivery.

Staff had received training in infection prevention and control and demonstrated a clear understanding of safe working practices. They described how they followed infection control procedures, maintained a clean working environment and took steps to minimise the risk of cross-contamination, helping to protect both people and staff.

The provider made sure that medicines were safe and met people’s needs, capacities and preferences.

People told us they received the support they needed to take their medicines safely and as prescribed.

People’s care plans contained information about their prescribed medicines, and staff administered these as intended. Staff had received medicines training and demonstrated a good understanding of safe medicines management. For example, they explained how they checked medicines administration records against medicines supplied in blister packs to help ensure records remained accurate.

The registered manager carried out weekly audits of medicines records to monitor medicines support and identify any discrepancies. This helped provide assurance that people received their medicines safely and as prescribed.