Healey Supported Living Service

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. At our last assessment we rated this key question good. At this assessment the rating has remained 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 strong proactive and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice.

Staff described regular team meetings where they were actively involved in discussions about people’s care, the service and wider organisational updates. Meetings included reviewing each person’s needs, addressing any issues and exploring scenarios to support learning and development.

Staff told us they felt able to share their views and contribute ideas, with one describing the team as “like a close-knit family” and stating, “I feel listened to and heard.” Feedback and suggestions were discussed, documented and followed up, for example proposing fundraising activities people using the service were also encouraged to take part in. Staff told us if they were unable to attend the team meetings face-to-face, they could attend remotely and would receive the minutes via email following the meeting, to ensure learning was shared.

The provider worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services. People had a detailed hospital passport which was readily available and in place to support people who had to move between different services. The passport included people’s communication methods, their likes and dislikes in relation to food and drinks, their family history and contact details of relatives. All passports were readily available and written in an easy read format to ensure it was accessible to people who used the service.

The service operated a person-centred approach to admissions and transitions, working in partnership with external professionals to assess suitability and support people to move at their own pace. Where placements were identified as no longer meeting people’s needs, the provider worked collaboratively with multidisciplinary teams to review and identify more appropriate options.

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.

Safeguarding concerns were reported appropriately, including to the local authority and care quality commission (CQC), with follow-up actions and multi-agency discussions to reduce the risk of recurrence.

There was evidence of financial oversight, including regular audits, and appropriate arrangements in place where individuals lacked capacity, such as the involvement of an appointee. However, some capacity assessments had not been reviewed in line with expected timescales due to a backlog with the local authority. The provider told us they had been completing reviews internally.

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.

Care plans were in place to support health and wellbeing and described the level of support required, including personal care. These reflected people’s aspirations to maintain and develop independence, with structured routines and regular opportunities to review wellbeing with staff. Health information was recorded, including relevant conditions, and risks. Assessments were in place in relation to risk, for example for falls, people who were at risk of choking. Personal emergency evacuation plans (PEEPs) were in place so staff knew how to respond in the event of an emergency evacuation. Staff told us people were supported to review their care and treatment plans regularly and could request a review when they wanted.

People were supported to take positive risks and make choices about their lives. For example, one person who had not previously travelled was supported to build their confidence through gradual steps, including visiting the airport, discussing preferred destinations and undertaking shorter journeys. Staff provided appropriate support to enable the person to safely develop independence and pursue their goals.

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 service carried out weekly fire alarm testing to help ensure people’s safety. Audits were also in place to monitor and confirm that fire safety systems and checks were completed consistently. People had a personal evacuation plan in place in the event of a fire or emergency to ensure staff knew how to support people out of the building safely.

Some relatives raised concerns regarding the environment, including delays in repairs and maintenance. For example, a relative reported a maintenance issue with a bathroom which had “been going on for about a year” without resolution. These issues were managed by an external organisation; however, the provider had escalated concerns appropriately and maintained regular communication with the relevant teams.

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.

Records reviewed over a four-week period demonstrated people received support in line with their commissioned hours, with flexibility to increase provision where required, for example when people remained at home. Systems were in place to monitor delivered hours against commissioned support, including the use of timesheets and clear recording of cancellations initiated by people using the service. Funding arrangements supported the provision of core staffing, including 24-hour support where required.

Staff ensured people who used the service knew the staff on each shift, for example, a visual staff board displayed photographs of staff on duty, which people were supported to update, promoting involvement and familiarity.

Staff received an induction to the service, including agency staff. This helped ensure staff were familiar with people’s needs, care plans and the provider’s policies and procedures before supporting people. Managers maintained up-to-date competency assessment records for staff, demonstrating that staff were competent in areas such as personal care and medicines management. Staff involved people in the recruitment of staff.

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

Staff were trained in the safe use of personal protective equipment (PPE), including how to apply and remove it correctly. PPE was used in line with individual risk assessments and specific care situations to help reduce the risk of infection and promote safe care practices. The provider had a policy on PPE accessible to staff.

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.

Medicines were generally managed safely, with records indicating administration in line with prescribed guidance and appropriate documentation for specific situations, such as periods away from the service. Staff observed people taking their medicines and recorded this on the medicines administration records (MARs), providing assurance medicines were taken as prescribed and in line with guidance.

Topical medicines and prescribed treatments were recorded as administered. Supporting documentation, such as medicines support plans and risk assessments (including for flammable creams), were in place.

Staff completed MAR charts to ensure medicines were administered safely. Where people had allergies, these were documented on the charts, however staff did not document if people had no allergies. The National Institute for Health and Care Excellence (NICE) guidelines emphasise the importance of noting allergies for people on MAR charts, even where people had none. However, the provider made changes immediately following the inspection to rectify this.