Seco Support Swindon

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 newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 78 (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 actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

There was a clear process to follow when incidents occurred. This included conducting de-briefs with staff to discuss details of the incident, what worked well, what could be improved, reflections on the incident and any lessons identified to improve practice. For example, some learning included ensuring the service utilised external services to support healthcare appointments. Staff told us they felt incidents were well managed. One staff member said, “These debriefs have been a good opportunity for us to learn and develop how we support [person].”

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.

There was a robust process to follow when people were admitted to hospital. Staff supported people to prepare and understand the steps involved, in a person-centred way.

Staff told us they supported people’s understanding by using social stories or other communication aids where appropriate. One staff member commented, “We take any items required to help the person feel safe and comfortable during their stay, such as communication aids, [electronic aids], or comfort items. A full handover is completed with hospital staff, and the person’s hospital passport is provided so staff understand how best to communicate with and support the individual. The person’s family or next of kin are informed of the admission.”

One relative told us, “[Person] has been admitted to hospital twice. The team have been so supportive when this has occurred. Staff continued to be [person’s] support team when in hospital as a social patient”.

The service used documents called ‘hospital passports’ which contained key information about people and their needs. This included specific details such as, ‘If I am listening to [song] I may be low, if I am listening to [song] I am usually happier.” This enabled healthcare staff to support people effectively.

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.

People told us they felt safe and able to raise any concerns. One person commented they would speak with staff or the service manager if they were worried about anything. Relatives did not raise any safeguarding concerns.

Staff had completed training in safeguarding and had a good understanding of how to keep people safe. Staff commented, “All Seco teams complete mandatory training to recognise signs of abuse. We can capture these across body maps, allegation forms, or ABC charts. Seco also have whistleblowing procedures in place, as well as a ladder of support to raise concerns. All staff are reminded of this; it is discussed within supervisions and annual competencies.”

We saw evidence of safeguarding and restrictive practices discussed in team meetings. This meant the service was continually reviewing whether restrictions needed to be in place for people, which safeguarded them from abuse.

The provider always worked with people to understand and manage risks by thinking holistically. Staff always provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

We observed staff supporting people to take positive risks. Positive risk taking is a person-centred approach that encourages individuals to make informed choices and take calculated risks to enhance independence, personal growth, and quality of life while managing safety.

One person had a restriction placed upon them which was deemed to be in their best interest. Staff told us, “We are slowly trialling [removing this restriction] to see if this is still needed.” We observed this during our visit to the person’s home. Staff told us this was going well so far.

The manager provided further examples of how they had supported people to positive risk take. The manager explained how they had safely removed restrictive practices such as a person’s kitchen being locked because of concerns around access to knives and sharp objects. This enabled the person to begin using their kitchen independently. The manager told us, “Since then, the person has developed food preparation and cooking skills, including making burgers and pizzas from scratch, and can complete everyday tasks such as making themselves a drink.”

One staff member commented, “Positive risk taking must be accounted for within our role at Seco. Each area of the support plan has a risk assessment attached, for example, finance, medication. This outlines risks as well as what is in place to mitigate these risks. It can also set further steps needed and set target dates for completion for this.”

People had detailed and person-centred risk assessments embedded throughout their care plans. Staff told us they had detailed information to support people. Comments included, “Care plans and risk assessments give detailed guidance on how to manage risks for the people we support. Our care plans are very thorough and often include step-by-step instructions for supporting someone in a way that is specific to them. This is particularly helpful for new staff or staff who don't do as many hours as it shows exactly how to provide care in a way that makes the person feel comfortable”.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People’s risks to their environment were assessed. People had detailed risk assessments within their care plans covering the environmental risks and potential hazards. There was also a ‘home risk management plan’ available which was detailed, a service continuity plan and a personal emergency evacuation plan to support the safe evacuation of a person from their home in the event of a fire. Staff told us they completed regular health and safety checks at people’s homes, and we observed records of this. There were no hazards observed during our visit to a person’s home.

Staff had completed mandatory training relating to health and safety.

The provider made sure there were enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together to provide safe care that met people’s individual needs.

Staff were recruited safely and told us they received regular supervision and support. Comments from staff included, “Supervisions are 3 monthly as a minimum. I enjoy my supervisions for the first time ever! Appraisals are annual too. They are open, honest, and set targets and goals. They are supportive and not a ‘tick box’ exercise. My manager has always prepared ahead of the supervision, which really does make me feel valued and part of the team.”

Staff received a range of training to enable them to support people effectively, this included person-specific training. Staff told us they felt this training was thorough, but one staff member said they felt more face to face training was needed. However, there was a range of face-to-face training available.

People and their relatives told us they were supported effectively. However, one relative told us they felt some staff needed more training and understanding around professional boundaries. We raised this with the manager who told us, “In one of the services, this has been a big learning curve and additional support, and guidance has been provided to the staff team around correct processes and communication preferences.” A relative also commented that they felt their family member would benefit from a stable staff team, with less reliance on agency staff. The manager explained the location of the person’s home meant it was difficult to recruit staff due to them living in a rural area with reduced transport links and ensuring they recruited the right staff with “robust experience”. The manager told us the service used regular agency staff to provide some continuity.

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 had received training in infection prevention and control (IPC) and understood how to protect people from the spread of infection. We reviewed cleaning schedules for people’s homes, which included a deep clean twice a year. People’s homes were visibly clean, and food was observed to be in date. Staff told us they had access to personal protective equipment (PPE) and told us this was 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’s medicines were managed safely. Medication Administration Record (MAR) charts showed people received their medicines as prescribed. Medicines were stored safely. During our visit to a person’s home, we were shown how staff check the temperature in a person’s room to ensure medicines are stored within recommended safe temperatures. A staff member showed us how they would keep medicines cool when the temperature exceeded the recommended safe range.

People had guidance within their care and support plans about how they should be supported with their medicines. This included information about what medicines they take, how they take their medicines, and where their medicines are stored. This care plan prompted staff to ask for consent, for example, ‘Ask [person] if they are ready to take their medicines’.

People did not raise any concerns about how they were supported with medicines.

People were supported to be in control of their own medicines. We saw evidence of staff supporting a person with a discussion with their GP which stated the person no longer wanted to take a medicine as they didn’t feel this was effective.

Most staff felt medicines were managed safely. Staff said, “Our medication tool and assessment gives guidance on medication. Everyone completes a medication competency annually.”

However, one staff told us, “There are improvements that could be made surrounding medication. There is a lot of medication in the service which can cause confusion. Medication stock counts often need correcting by the service lead. We also still use a paper MAR which is much more difficult to follow than electronic.” We raised this with the manager, who told us there had been some recent medicine changes for 1 person. The manager explained that although at times there were errors with the stock level amount recorded, there had not been any medicine errors.

Staff worked in line with the ‘Stopping Over Medicating People with a Learning Disability’ (STOMP) initiative, by reviewing people’s medicines regularly and by only using sedatives as a last resort.