Midlands Supported Living

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 66 (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 positive learning culture that supported openness, reflection and improvement. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

There were systems in place to record incidents, complaints, compliments and concerns, and managers reviewed these to identify learning. Where an incident had occurred prior to the inspection, staff and managers worked together to reduce the risk of reoccurrence and keep people safe. Minutes from staff meetings showed learning was shared and discussed. This helped staff understand how to improve practice and maintain people’s safety.

The provider did not always make sure there was continuity of care, including when people moved between different services.

The provider had systems in place to support people during transitions, including pre-admission assessments and hospital passports. Inspectors saw that hospital passports had recently been updated and improvements were underway. However, some passports were not fully personalised, and further work was needed to ensure information consistently reflected people’s individual needs. This meant systems were in place but not always effective in supporting safe transitions for everyone.

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.

The provider had effective safeguarding systems to help protect people from abuse and harm. Safeguarding policies and logs were in place, and where incidents had occurred, staff acted promptly to safeguard people. Staff understood their responsibilities and worked with others when needed. Relatives expressed confidence in safeguarding practices, with one relative saying, “[Person] feels safe there’s always enough staff and (they are) never left on (their) own”.

The provider did not always work well with people to understand and manage risks.

Risk assessments were not always in place or regularly reviewed. This meant people were not consistently involved in discussions about risks that affected them. Leaders were aware of these gaps and had begun making improvements. Staff knew people well and understood their needs, and inspectors were not aware of any harm occurring because of any omissions. One person told us “(they) felt safe at night as security doors were locked”. However, we saw no risk assessment for this. Further work was needed to ensure risks were assessed, reviewed and managed consistently with people’s involvement.

The provider did not always detect and control potential risks in the care environment.

Environmental risk assessments were in place, but these were not always consistent across locations. Some assessments showed risk ratings without clear actions or evidence of sharing information with staff. In one location, risk assessments contained inconsistent scoring. These concerns were raised during the inspection, and leaders took action to address them. Relatives described the environments positively, telling us “The place is always warm, lovely and clean”. However, further improvements were needed to ensure environments were consistently assessed and managed safely.

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.

The provider ensured there were enough suitably trained staff to keep people safe. Rotas showed consistent staffing levels, and recruitment processes were safe and thorough. Employment checks were completed, and training records showed improvements in compliance. Staff received service specific training, including the Oliver McGowan mandatory training and medicines competencies. A relative said “they really do help [Person] to keep calm, they know him well”.

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.

Infection prevention and control practices were in place. Staff had completed relevant training, including Control of Substances Hazardous to Health training, and PPE use. Inspectors did not identify infection control concerns during site visits, and environments were clean and maintained.

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.

Systems were in place to support the safe management of medicines. Inspectors reviewed medicine administration records, competency checks, risk assessments and ‘as required’

protocols. We found no concerns. A relative told us, “[Person’s] medication is effectively managed”.