Archived: Hanover 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 requires improvement. At this assessment the rating has changed to 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. The provider had a process for the reporting, investigation and review of incidents, accidents and complaints. Staff completed incident and accident records with details of the issue which were reviewed by senior staff and actions were identified if required. The registered managers told us actions identified following an investigation were discussed with staff through meetings and supervision. Staff confirmed there was a positive behaviour support trainer who worked with them on how to improve the recording of incidents or issues. This meant staff could identify appropriate actions and support for the person to meet their needs. Regular audits of incident and accident and complaint records was carried to ensure the procedures were followed and appropriate action taken.

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. The registered managers explained people were supported through a transition process so they could get to know the people living in the house and the staff. People who were considering moving to one of the provider’s houses would visit the house and meet everyone. There would then be a transition period where staff would spend time with the person in their current accommodation, so they got to know each other. The person’s family would also be involved, if appropriate, to ensure the accommodation met their family member’s needs. Health and social care professionals involved in the person’s care were also invited to visit the house and were involved in identifying any changes required to meet their needs. A healthcare professional explained, “The managers and senior staff attend meetings at the hospital, with the service users (both pre and post discharge), to support staff and patients with a smooth transition to supported living accommodation. They get a better understanding of the presentation, base-line behaviour and daily living needs for the individual.”

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 supported by staff and a relative told us, “There have been no safeguarding issues.” Staff confirmed they had completed safeguarding adults training, and they were able to demonstrate their understanding in relation to the support they provided. A staff member said, “Make sure the person is in a safe environment. For the people we support make sure there is no abuse or anything that could affect them mentally or impact how they live.” The registered managers told us there was a procedure for the reporting, investigating and identifying actions to resolve issues.

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. People told us they felt safe living at the provider’s locations and with the staff who provided their support. A person said, “Nothing to worry about. If I was worried, I would tell the manager.” Registered managers told us they worked with people and their relatives to identify possible risks and develop plans which provided support in the least restrictive way. People were supported to take positive risks such as being more involved in tasks of daily life, different foods and activities. Staff were provided with guidance on how to support the person. Risk assessments had been carried out for a range of risks including malnutrition, refusing care, falls and skin integrity. Risk assessments had also been completed for activities and events the person undertook. Registered managers explained staff informed them if they identified a change in a person’s care needs or a new risk. Risk assessments were then completed to ensure people’s current support needs were reflected and risk mitigation was in place.

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 registered managers explained that environmental and fire risk assessments were completed. A monthly fire safety audit was carried out reviewing if the processes were being followed and regular tests and checks were carried out. Staff were also monitored to ensure they had completed relevant training and understood what to do in an emergency. People had a personal emergency evacuation plan (PEEP) developed to provide guidance on how to support the person in case of an emergency. The provider was not responsible for the maintenance of the houses, but they worked with the landlords to ensure the properties were maintained and safe. Staff members had been identified as champions to support with checks in relation to legionella, health and safety and to act as fire marshals.

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 said they felt there were enough staff working at each house and relatives confirmed they felt there were enough staff to meet their family members support needs. Staff told us there had enough staff. A staff member explained, “If we are going to an activity, we can ask for extra staff on the group chat. There is enough staff to cover.” The provider had a robust recruitment process which enabled them to identify staff with appropriate skills for the role. The registered managers confirmed new staff completed an induction, shadowed experienced staff and worked with the champions to develop their knowledge. Staff completed a range of training which included mandatory courses as well as specialist training for epilepsy, Makaton and autism. Staff received support from regular supervision, team meetings and daily handovers.

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. The provider had an infection prevention and control (IPC) policy which was regularly reviewed. Staff confirmed they completed infection control training and could access personal protective equipment (PPE) when needed. An IPC competency assessment in relation to infection prevention and control was completed as part of staff supervision meetings. Monthly infection control audits were carried out which covered ensuring procedures were up to date, PPE was available for the staff, cleaning schedules were followed and staff followed best practice.

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 care plans identified if they required support with their medicines and medicines risk assessments were completed. Staff recorded the administration of prescribed medicines on a medicines administration record (MAR). The MAR provided staff with information relating to the type of medicine, dosage and how often it was administered. Staff confirmed they had completed training on providing support with people’s medicines. Staff completed medicine competency assessments to assess their knowledge. Where a medicine had been prescribed to be administered as and when required (PRN), staff were provided with guidance on how to administer. Regular audits had been completed in relation to the medicines records to ensure people had received their medicines as prescribed.