Support for Living Limited - 37 Barlby Road

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 changed to 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 that people could be harmed.

We identified a breach of legal regulations relating to safe care and treatment.

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.

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. Additional training had been sourced in response to specific incidents that had taken place, and this was helpful for staff.

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. Staff told us they found team meetings helpful and discussed how best to support people living at the service.

People living at the service had lived there for many years and felt well cared for. Staff created hospital ‘passports’, a document which included key information about people’s needs and how they communicated. These were shared with healthcare professionals to help them provide safe and person-centred care to people using the service.

Staff undertook training to understand how to recognise and report abuse. They were all confident in how to ‘speak up’ or whistleblow if they had any concerns. Staff were able to tell us about these processes. One staff member told us, safeguarding is “Anything that involves the health, safety and well-being of people we support. We have a responsibility to make sure they are cared for and if we become aware of something that has happened, then responsibility to report it.”

There were systems to safeguard people’s money. Staff had worked with the safeguarding authority to investigate allegations of abuse and protect people from harm.

The provider had requested legal authorisations where restrictions amounted to a deprivation of liberty for people who did not have the mental capacity to consent to their care arrangements. Decisions around these were made in people’s best interests and for their safety.

Staff were trained to support people in a safe way if they became physically distressed.

The provider had systems to assess, monitor and mitigate risks. Staff carried out comprehensive assessments and developed plans to reduce the likelihood of harm. Staff encouraged people to try new things.

Some people expressed anxiety and distress in ways which they found hard to manage themselves. External professionals had developed guidance for staff to help make sure they responded appropriately and helped to reduce risks to people’s wellbeing. We saw insights in how to de-escalate a situation in people’s care records.

The provider had systems to help prevent, detect and contain fires. Staff and people using the service took part in fire drills. There were personalised evacuation plans which described the support each person needed to safely evacuate in the event of an emergency.

The provider made sure people’s home environment was safe and well-maintained, although it would benefit from redecoration throughout.

People had the equipment they needed to stay safe. Staff carried out checks on the environment, equipment and health and safety. Risks within the environment had been assessed and planned for.

People had access to a safe garden space outside.

The provider ensured enough staff were deployed to keep people safe and meet their needs. Recent changes in people’s needs had resulted in increases in staff levels, during both the day and night.

People using the service and their relatives knew staff well. We saw people were relaxed and happy with staff.

The provider had systems to ensure the safe recruitment and selection of staff. These included checks on their suitability and identity. We identified some issues with the recruitment policy in relation to references required. Following a discussion with the provider, the organisation recruitment policy has been updated to ensure full compliance with the regulations.

Staff undertook a comprehensive induction and regular training to help ensure they understood about best practice. Managers assessed staff competencies and skills. Staff had regular individual and group meetings with managers to reflect on their work and discuss the service.

Systems for preventing and controlling infection were not always followed. We found service did not have soap or hand towels in 2 toilets and lacked toilet tissue paper. Although the registered manager had an explanation for this, we found it was disproportionate to the concern identified and encouraged the provider to consider more creative solutions to address the issue identified. Following the assessment visit the provider made improvements to infection control in relation to bathroom hygiene. The measures included handwash dispensers, wipes and cupboards for toilet paper. The provider also accessed external professional support to assist the staff in understanding and working within best practice guidelines for infection control.

Some food was not labelled in line with best practice. This increased the risks relating to food hygiene.

The service employed housekeeping staff for four days a week. Staff assisted with cleaning on the remaining days. We noted the shift allocation system did not always set out specific tasks to be completed by a named worker, so we found not all tasks had been completed the day before.

The service was mostly clean and there were appropriate systems for waste disposal. People using the service were supported to take part in cleaning their rooms and managing their laundry. Staff provided appropriate support and guidance.

Staff undertook training about infection prevention and control. Staff had the equipment they needed to help manage infections. There were regular audits of cleanliness, however, they had not identified the issues found at the assessment.

Medicines were not always managed in a safe way. Medicines were not stored safely in line with best practice as the door to the medicines cupboard was not routinely locked.

We found 1 person who had a prescribed medicines to be taken when required (PRN) for anxiety but there was not a clear protocol for staff to identify when these were needed. This meant that there was the potential for staff to have varying views as to when to give this medicine.

Staff kept records to show when medicines had been administered. They recorded the application of medicated topical creams and patches. We found 1 medicines administration record (MAR) was missing for a PRN medicine which had been administered 3 times that week.

The provider audited records to ensure medicines were managed appropriately. Their audits had not picked up that the medicines cupboard was not routinely locked despite this being ‘usual practice’.

Staff had training to understand how to safely manage medicines. Their competencies and skills were assessed to check they followed procedures. Staff due for checks which fell outside of the 12 month period were removed from the rota until the competency checks were completed.

Staff were aware of the principles of STOMP (Stopping Overmedication of People with a learning disability, autism or both). One person needed medicines to help them cope with distressing or worrying situations. The use of these medicines was limited to make sure people were safeguarded from abuse.

People’s medicines needs and health were regularly reviewed by their doctors.

Following the assessment visit the service introduced more robust systems for medicines management which addressed the concerns raised. The provider also increased support for the staff team related to medicines management