Dynamic Support

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. Also, they received safe care and support in line with their needs and wishes. 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 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

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 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.

People were supported by staff who knew how to keep them safe and ensure they had a positive quality of life. They were able to tell us who they would speak with if they were worried. Every interaction observed showed how comfortable people were with the staff that supported them; some named specific staff. Other people would get very excited both showing through physical and facial expressions. Relatives told us their family members were kept safe.

Staff knew how to recognise signs of potential abuse. They were all confident if they raised concerns with the management, action would be taken. All staff knew where to raise concerns externally. Systems were in place to manage potential safeguarding including working with external partners such as the local authority.

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.

Positive risk taking led by people’s needs and wishes was part of the culture of the organisation. Where people lacked capacity family and those important were involved. Throughout the inspection people were telling or showing us how they were living their best lives. Independence was promoted and looking at ways to involve the person and family to mitigate risks was an important part of this. Relatives commented they were involved in managing risks although felt staff knew as much as them.

People who could display distress when upset or anxious had clear plans in place to proactively prevent this. Those who were able were aware of their own plans and contributed to them. An example was provided on 1 person newer to the organisation who had significantly reduced their distress since moving into their home. They were now an active part of their local community. Relatives confirmed what we saw and heard. Comments included, “They give him processing time and space. Keep him safe and give space” and, “They are very good with him. Calm him down. They ring the office and get guidance from [staff members].” Staff were aware of strategies to support people and keep them and others safe whilst respecting their quality of life.

Systems were in place to ensure risks to people were identified and ways to mitigate them found. There was oversight to update people’s risk assessments in line with changing needs.

However, records were not being kept as accurately in relation to incidents of distress. The registered manager had already identified this and was carrying out work to improve record keeping, including further training.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

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 were supported by enough staff to meet their needs and wishes. Relatives were positive about the staff numbers and how their family members were supported. They also confirmed when more than 1 staff member was required for support, it was provided.

Systems were in place to ensure staff received enough training to meet the needs and wishes of people. Personal development was encouraged by the management. Some training was bespoke to their service and the people they supported. All staff had received in depth training how to support autistic people and people with a learning disability.

Staff received regular supervision and regular checks of their competency from the senior staff. People were supported by staff who had been through robust recruitment processes. All staff confirmed they had been through an interview process, induction and had shadowing opportunities. Staff from overseas received support on adjusting to living in England and the cultural differences.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

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 were supported by staff who understood their medicine administration preferences. Relatives confirmed people’s preferences were followed and they had choice around their administration.

The staff and management were aware of reducing medicine being administered where possible. This was in line with current best practise for people with learning disabilities and autistic people. Relatives confirmed there were regular meetings with the prescribers. People were kept safe because high risk medicines had risk assessments in place. Topical creams had body maps in place to ensure consistent application. Medicines were stored safely and securely when it was necessary in people’s homes.