Sheffield 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 remained requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk people could be harmed.

The service was in breach of legal regulation in relation to people’s safe care and treatment and the ways people’s medicines were managed.

This service scored 53 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Overall, 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 told us they had no complaints about the service. People and relatives were confident any concerns and complaints would be recognised and investigated. One relative said, "I have no worries or complaints about them [management team].”

The provider had policies in place which were readily accessible to staff. Staff were aware of how to respond to accidents and incidents which included how to record and report incidents. Accidents and incidents were monitored monthly by the registered manager to ensure any triggers or trends were identified. However, when quality assurance audits identified areas for improvement action was not always taken to address these issues in a timely way.

The new registered manager was working to develop a culture of learning and embed good practice across all the services. However, this needed to be fully implemented and sustained.

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.

Each person had a hospital passport, but inconsistencies and gaps in care records, risk assessments and medicine records meant continuity of care was not always robust.

The service 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 service shared concerns quickly and appropriately.

People we spoke with did not share any concerns in relation to their safety or the quality of the care and support they received. People appeared relaxed in the company of staff and relatives told us their loved ones were safe from the risk of abuse.

The service had a safeguarding policy for both adults and children. People, and those who matter to them, had safeguarding information in a form they could use, and knew how and when to raise a safeguarding concern.

Staff were aware of their responsibility in relation to safeguarding and how to report concerns and escalate outside of the organisation. Safeguarding training was being provided to staff

The service had a safeguarding log with evidence staff reported safeguarding allegations and concerns to the local authority.

Guidance contained in care plans for staff to follow, such as how to support a person safely, was predominantly clear and easy to follow. However, in some people's care plans and risk assessments the information was unclear or lacked the detail required to robustly guide staff on safe and appropriate care. For example, one person's risk assessment in relation to choking needed further person-centred guidance for staff on how to respond if the person did choke.

Risks associated with people's behaviours were not managed safely. Risks had not always been assessed and there was a lack of guidance about how to support people who may require additional support to manage their emotions or underlying health conditions. For example, when people experienced self-harm or anxiety there was no guidance for staff around potential triggers, consequences or outcomes.

We found no evidence this impacted on care delivered and discussions with staff confirmed they knew how to support people safely. The registered manager assured us they will address inconsistencies with people's risk assessments.

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.

People told us they liked their home and were free to decorate their room how they wanted. The service was working with the housing provider to support people to address any issues related to their properties. The service identified areas for improvement and actions were identified to control potential risks in people’s homes.

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 receiving support and their relatives felt staff had the right skills to do their job. They said staff were respectful and caring in their approach. People were supported by sufficient staff in line with their assessed needs. We observed there were the correct number of staff available to support people.

Staff spoken with said they undertook an induction and refresher training to maintain and update their skills and knowledge. However,staff gave us mixed feedback about staff training. Staff One member of staff told us, "The majority of training is e learning which you can skip through without actually learning anything.” Another staff member said," The training covers legal and safety requirements, gives me a good foundation to start supporting people confidently and often refreshed annually.” One staff member said they felt they would benefit from more in-depth training in topics such as diabetes and pressure care.”

The provider operated a safe recruitment process; appropriate checks were undertaken to help ensure staff were suitable to work at the service. A disclosure and barring service (DBS) check and satisfactory references had been obtained for all staff before they worked with people. Disclosure and Barring Service (DBS) checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

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.

We found policies for infection control were in place, so important information was provided to staff. Training records showed all staff were provided with training in infection control. We saw infection control audits were undertaken which identified issues that were then acted upon.

The service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They did not always involve people in planning.

We looked at how medicines were managed in 3 different houses and found they were not always managed consistently or safely. The medicines policy, which set out how medicines should be managed, was not always followed which meant that people may not have had the support they needed with their medicines or had annual medicines reviews with their doctor.

The records about medicines were inconsistent in quality and could not always show that medicines were accounted for or had been safely given to people as prescribed.

When people were prescribed medicines to be taken ‘when required’ or with a choice of dose, the protocols to support their administration were not detailed enough to ensure they were administered safely and consistently. When people were given ‘when required’ medicines there were no records made to show if the treatment had been effective.

Medicines were stored in inconsistent ways and some people’s medicines were not stored safely, including medicines which required cold storage.

Prior to our inspection the management had made checks and carried out audits, on how medicines were managed, and they had found there were shortfalls and concerns about medicines. Actions had been taken to resolve some of the concerns however they had not had time to embed the changes. After the inspection the registered manager gave examples of further actions that had been taken to make the handling of medicines safer.

We found no evidence that people were harmed at the time of the assessment because the harm is not always immediate. However, people were placed at increased risk of harm by not managing medicines safely.