Aiding Independence

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 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 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.

Systems were in operation to record any accidents or incidents and these were reviewed by the leadership team. Where necessary action was taken to learn lessons and prevent similar accidents or incidents occurring again. Staff told us they reported any concerns to the registered manager or person on call. They were informed of the outcome of reviews and any changes made to people’s support.

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.

Effective systems were in place to share information with other services to ensure people received consistent support. For example, when people moved to other supported living services the leadership team worked with the new service provider to plan a transition which suited the person’s needs. This included meeting with the new provider and sharing support plans and risk assessments, involving health care professions such as a learning disability nurse and taking people to see the new services as many times as the person wished. The registered manager told us a person who had moved continued to have positive relationships with staff and previous housemates when they met at community events.

Staff told us they had information about people before they began to use the service, including their support plans and hospital passports. Handovers were completed between staff at the beginning and end of their shift. These were recorded and accessible to staff and leaders. Communication books were also in place which staff signed to confirm they had read them.

The provider worked with people and 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.

When an incident occurred the registered manager had informed the local authority safeguarding team and worked with them to identify what had triggered the incident. They had worked with the team to look at how everyone could be supported to remain calm and protected in the future. The person’s relative told us they had been kept informed of the investigation and their loved one had moved house. They told us, “Since they moved not one incident has happened”. A safeguarding representative told us leaders had shared information promptly and had been open and honest about any concerns.

People and their relatives told us they felt safe when staff supported them. One relative commented their loved one was “100% safe”. Staff knew the signs people may be at risk and were confident to share their concerns with leaders. They were assured leaders would act to keep people safe.

The provider had effective systems in place to protect people from the risks of financial abuse. Relative’s comments included, “They have all the finances on a sheet. I cannot fault them in any way at all. Receipts are given to me” and “They write everything down. It’s all listed. I can look at internet banking anytime to see what has been spent”.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided support to meet people’s needs that was safe and enabled people to do the things that mattered to them.

The registered manager and staff described a culture of positive risk taking, where people were supported to try new things and develop their independence. A staff member told us, “We look at how we can mitigate the risk without reducing independence”. People explained to us how they were supported to live busy fulfilled lives and take risks to develop or maintain their independence. For example, they explained how staff supported them to remain safe in the kitchen while preparing their meals including using a microwave to cook porridge rather than the hob. A relative explained their loved one ran their own bath and staff checked the temperature before the person got in, to prevent them being scalded. Another relative told us, staff prompted their loved one when they had a shower, “hovering” to make sure they were safe and washed properly without doing it for them. Staff had time to read and understand people’s support plans and were confident to support them to take identified risks as safely as possible.

The provider detected and supported people to report potential risks in their home. They made sure equipment, facilities and technology supported the delivery of safe support.

Staff supported people to raise any concerns they had about their home with the landlord. For example, some people told us the shower at their house had been faulty, staff had reported it to the landlord and it had been replaced. A relative told us, “There are no issues on the upkeep of their home”.

When a landlord had served notice on people’s tenancies staff had looked for alternative house rentals that met people’s needs. People were involved in viewing the houses and choosing if they wished to move in.

The provider did not always follow safe recruiting practices. They made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe support that met people’s individual needs.

References from staff’s last employer had been obtained but checks on staffs conduct in previous care roles had not always been completed. The provider amended their recruitment process to include this following our inspection. Disclosure and Barring Service (DBS) checks were completed before staff worked with people. DBS checks provide information including details about convictions and cautions held on the Police National Computer. A risk assessment had not been recorded for a staff member with a historic disclosure on their DBS check. This had not impacted on the quality of support people received and the provider sent us a copy of the completed risk assessment after our site visit.

The provider deployed enough staff to meet people’s needs and the support commissioned by the local authority. Where possible a team of staff worked with people to provide consistency, however there was flexibility to ensure unplanned absences were covered. Relatives told us, “The most prominent staff stay. They have been there a long time. They are consistent”, “They are all competent and well trained in everything they do” and “They have had the same carers for all these years. They dress them well, help them to phone us. I can approach the staff at any time. They are happy”.

Staff completed an induction when they started working at the service, which included shadowing experienced staff. They told us the training they had completed was good, had developed their skills and supported them to look at things in different ways. Staff received regular supervision which they found supportive.

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 described to us how they worked with staff to keep their home clean and tidy. They told us how they vacuumed and mopped the floors and did their own laundry with support. Relatives told us, “Their home is lovely and clean” and “They help to hoover and clean”. Staff confirmed they had the equipment they needed to protect people from the risk of infection, including disposable gloves and aprons.

The provider made sure that medicines were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Staff supported people to manage their medicines as independently as possible. Some people used dosset boxes filled by the pharmacy to remind them what medicines to take and when. Staff described how people sat at the table to open the box and take their medicine with staff present to help if needed.

Staff supported other people to take their medicines from the original packaging. Guidance was in place around how people preferred to take their medicines and when, including the drinks they liked to take them with. A relative told us, “Staff administer it. My loved one knows what it’s for and knows what time they should have it”.

Clear records were maintained showing when staff had supported people and people signed these where they were able to confirm they had taken their medicines. Processes were in place to make sure people ordered their medicines in good time and had their medicines when they were away from home, such as on holiday or visiting relatives.

People’s medicines were reviewed each year with their GP to make sure they remained necessary and effective.