Priory Supported Living London & Home Counties

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.

The last rating for this key question was good. At this assessment the rating has remained good.

This meant people were safe and protected from avoidable harm.

This service scored 72 (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 developed a learning culture, where people using the service, staff and external professionals were involved in learning from things that went wrong. Accidents, incidents and complaints were investigated. Action was taken to make improvements. This included reviewing care plans, risk assessments and processes as well as retraining staff, when needed.

People using the service were invited to take part in debriefs with staff following incidents. This helped them to understand what had happened and be part of planning improvements.

Relatives told us they were informed when things went wrong and they were able to contribute their views about how to rectify problems.

Staff told us there were effective systems to discuss incidents and accidents with each other and managers. They explained this was useful for learning and improving practice. They told us they felt supported by managers during this process. One member of staff told us, “We have a debrief after every incident. Managers check on our wellbeing. We talk about consistency with each other staff to make sure we are providing the right support to service users.”

The registered manager discussed how reflective practice had made a positive difference to people’s lives, reducing incidents and helping people to develop personalised strategies for managing strong emotions.

The provider’s systems ensured people experienced safe transitions and pathways. Managers assessed people’s needs before they moved to the service and liaised with other professionals. They developed personalised transition plans. For example, some people visited the service over a period of weeks or months and had overnight stays before they moved to their home. For others the transition was quicker which reflected their needs and personal circumstances.

Staff supported people to access healthcare and community services. They provided information for other professionals about people’s communication, healthcare and social needs. This helped to ensure everyone involved in their care gave them the support they needed to transition between services.

The provider had processes designed to safeguard people from abuse. People using the service and their relatives told us they were safely cared for. Their comments included, “[Person] is safe with staff” and “[Person] is as safe as [they] can be.”

Staff undertook training to understand how to recognise and report abuse. They were able to describe safeguarding procedures.

Staff and managers had worked with the local authority and other external partners to investigate allegations of abuse and put in place plans to protect people from harm.

Staff assessed risks to people’s safety and wellbeing. Assessments included plans about how risks should be mitigated. People were involved in developing their own risk management plans. They were supported to take risks and be independent when this was appropriate.

Some people expressed their anxiety in a physical way. Staff worked with external professionals to assess and plan for these types of incidents. They monitored incidents and supported people to reflect on their feelings and how they had responded to different situations. Staff were trained to keep themselves and others safe. Staff explained how they worked with people to identify triggers which had upset them. They followed plans to deescalate situations and to help people express their emotions in an appropriate way. Relatives and staff confirmed these processes worked well and they thought people were kept safe.

Careful risk management and involving people in decisions about their care had helped improve their independence and their mental health. Relatives and staff gave us examples of this, explaining how incidents had reduced, and people had increased the amount of time they spent taking part in things they enjoyed.

Staff also assessed people’s physical wellbeing, and any risks associated with this or the care they received. Risk assessments and plans were regularly reviewed and updated.

There were procedures to support people to safely evacuate their homes in the event of a fire. These included individual evacuation plans.

The provider ensured people lived in safe and well-maintained environments which reflected their needs. There were 8 different supported living schemes. Some of these offered shared communal facilities and some were designed as individual flats. People told us they liked their homes. Their comments included, “I love the garden here and being outside”, “I really like my bedroom” and “The place is well-maintained, nice, clean and we all get along.”

The provider worked with landlords and external companies to ensure any repairs or problems were attended to. Staff liaised with healthcare professionals when people needed equipment or a change to the environment. For example, a new ramp had been installed at 1 scheme to make this more accessible for people using a wheelchair.

Staff carried out checks on environmental safety, including fire risks. The service had won an award for an “enthusiastic and proactive” approach to managing safety and ensuring each of the schemes went “above and beyond” with safety checks.

The provider ensured there were enough staff to meet people’s needs and keep them safe. They assessed people’s individual needs and based staffing levels on these assessments. Each scheme had a dedicated staff team who knew the people living there well. People told us there were enough staff and they liked the staff who were supporting them. Relatives explained there was good consistency and staff retention.

The provider had systems to check the suitability, knowledge and skills of staff who they employed. People using the service were involved in staff recruitment to make sure their views were considered when selecting new staff.

Staff completed inductions to the service, which included checks of their knowledge and competencies. They undertook a range of training relevant to their role and attended regular individual and team meetings with managers to discuss their work.

The provider had systems to help prevent and control infection. Staff undertook training in these. Staff told us they had enough personal protective equipment (PPE). People told us their homes were clean. People were supported to be involved in cleaning and managing their laundry. The provider carried out audits of infection prevention and cleanliness. They addressed issues when these were identified.

Some of the provider’s systems for managing medicines needed to be improved. Some people were prescribed ‘as required’ (PRN) medicines. Records telling staff when they needed to administer these were not always detailed enough. Staff knew people well and we were assured PRN medicines were administered appropriately. However, the lack of detailed records increased the risk of things going wrong. We discussed this with the registered manager who agreed to make the required improvements. The use of PRN medicines was monitored to make sure people received medicines only when they needed them.

The registered manager had identified that medicines audits were not always robust enough. They had taken action to improve these and shared their findings with us.

People received their medicines in a safe way and as prescribed. People and their relatives told us they were happy with the support they received with medicines. Their comments included, “[Person] takes their medicines, and this is professionally managed” and “Everything is good with medicines. [Person] gets the help they need.”

There were procedures for managing medicines safely. Staff received training and had information about medicines management. Managers tested staff knowledge and competencies. Managers responded appropriately when things went wrong with medicines, investigated this and made sure systems were in place to safeguard people in the future.

People were supported to manage their own medicines if they wanted to and were able. Risks associated with people’s medicines were assessed. Medicines were stored safely and administration was recorded appropriately.

People regularly met with GPs and other healthcare professionals to ensure their medicines were reviewed. The provider worked with people using the service, their families and other professionals to monitor whether they were prescribed the right medicines. This included working with others to follow the STOMP (stopping overmedication of people with a learning disability, autism or both) principles.