Manu Integrity Services Limited

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 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.

People and relatives did not raise any concerns about incidents happening or how these were managed. The management team reviewed all safeguarding, accident and incident records to identify any responsive action required. Any lessons learned were shared with the team and discussed in staff meetings.

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.

People felt involved in their care and relatives felt staff engaged with them and other professionals when needed. The service worked in partnership with other professionals such as GP's, specialist occupational therapists (OT) and speech and language therapists (SaLT) to support people to access healthcare when they needed it. Staff told us they received information about people before going into their homes and this helped them understand people’s needs and preferences. An electronic records system was in place, enabling staff, people and their relatives to view up‑to‑date information and understand any changes in assessed needs.

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 and relatives told us staff helped to make people feel safe. The provider had systems in place to safeguard people from the risk of abuse including the training of staff in how to recognise and report abuse. One staff member said, “I keep people safe by following our safeguarding policies and procedures, completing regular training, and being alert to any signs of harm or abuse. I treat everyone with respect, listen to their wishes, and report any concerns straight away to the safeguarding lead or manager.” The registered manager ensured any incidents were reported to the appropriate body and had a system in place to share any learning from safeguarding incidents with staff.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In supported living services, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that staff and management worked within the MCA. At the time of our assessment no one using the service had a DoLS authorisation in place. The provider understood their responsibilities to apply for DoLS authorisations and people’s capacity was assessed in relation to making specific decisions. People were not subject to unlawful or excessive restrictions they had choice, control and freedom over their lives. Staff received training related to the MCA; they respected people’s decisions and promoted their human rights.

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 with the staff who supported them. People and their relatives felt staff understood people’s needs and managed risks to their safety. The registered manager told us they assessed risks to people’s safety and used this information to put plans in place to minimise the risks, and regular reviews were in place. Records showed people had risks to their safety considered. For example, moving and handling, skin integrity, falls and mobility risks were considered, and plans put in place to meet the individual needs and reduce these risks. Staff could access information about how to support people and manage any risks on the provider’s electronic care planning system and an app on their phone. There was also an on-call system so staff could seek advice or raise and concerns out of normal office hours.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

In supported living settings, CQC does not regulate the environment in which people live; however, providers are expected to help individuals identify and understand potential risks within their surroundings. Where people experienced issues with neighbours, for example, the provider supported them to raise concerns and seek appropriate resolutions. Overall, the provider had worked with people to address challenges within their living environments, helping to ensure these remained safe and suitable for their needs.

We visited people’s accommodation and found people had been involved in decisions about the décor of their home and were supported to live in a clean environment. Where required, people’s home had been adapted to meet their physical and sensory needs.

The provider had ensured equipment, facilities and technology supported the delivery of safe care in all the supported living households.

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 and their relatives told us that staff arrived on time, stayed for the full duration of visits, and had the experience and training needed to support them safely and effectively.

Safe recruitment procedures were followed and the provider completed appropriate pre-employment checks. The provider had introduced a new system within the last year for completing and recording these checks, which the registered manager told us was working more effectively.

Staff completed training and shadowed experienced staff before working on their own. The provider also completed competency checks and observations of practice. Staff were satisfied with the induction, training and supervision they received. One relative said, “Their [staff] training is very good and they clearly know what they’re doing.”

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 were involved and supported by staff to maintain the cleanliness of their home and communal areas.

Infection prevention and control policies and procedures were in place, and staff completed training in this area. Staff had access to personal protective equipment (PPE) and knew when and how to use this. The provider completed competence checks to ensure 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.

The registered manager told us staff were trained annually and had their competency checked every 3 months, records we saw supported this. A policy was in place which set out how staff should administer medicines safely in line with national guidance and all medicines administration was recorded in an electronic records system.

Medicines policies and systems were in place. Information was available in each person’s care plan about any support they required with their medicines, and any preferences or special instructions. This included instructions about when to use medicines prescribed for use ‘as and when required’. Staff recorded on the provider’s electronic system when they had assisted someone with their medicine. We found records were appropriately completed, and showed medicines had been given in line with people’s prescription.

The provider and staff were aware of the STOMP principles (Stopping Over Medication of People with a learning disability, autism, or both, with psychotropic medicines) and worked with people and staff to ensure people were not over prescribed with medicines which negatively affected their well-being.