Cherish UK Ltd 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 Good. At this assessment therating has remained the same. 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.

There were systems in place to investigate any incidents. Individual accident forms were completed with details about what happened and any immediate actions taken.Incident analysis was completed to ensure any trends or themes could be monitored.

We had undertaken a targeted inspection of Cherish UK in December 2024 in response to two serious incidents which occurred. We saw the service had implemented measures to prevent any future re-occurrences.

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.

The service worked effectively to support people during transitions between services, ensuring these were planned and person-centred. Staff worked collaboratively with individuals, families and external professionals to ensure continuity of care and minimise disruption. People were supported to understand and prepare for changes, helping to reduce anxiety and promote a smooth transition. This approach ensured people felt reassured, supported and able to maintain stability during periods of change. For one person’s transition, we saw staff had completed extra training to ensure they could meet the person’s needs safely.

People had health passports in place which provided an overview of their needs if they were ever admitted to hospital.

People who used the service and their relatives said the service was safe. One relative said, “(Person) is very safe with the staff, they know so much about them and what they need.” Another relative said, “I would definitely say my daughter is well supported and safe.”

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.

There was a safeguarding policy and procedure in place which was in date and provided an overview about what people could do if they experienced any abuse. A safeguarding log was maintained, with details about any incidents reported to the local authority for further review.

Staff had completed safeguarding training and understood how to report concerns. Safeguarding was also a key feature within the staff handbook. A member of staff said, “Safeguarding concerns could be relating to medication errors, or problems with a person’s finances.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes/hospitals, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA).

DoLS are not applicable in supported living services, although the service was working within the requirements of the MCA and understood about the legislation.

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 who used the service had individual risk assessments in place relating to the care and support they received. These covered a range of areas specific to people’s individual conditions including diabetes, physical aggression, epilepsy, choking and weight loss. Where any risks were identified, control measures detailed how these needed to be managed.

People who used the service and relatives were involved with risk assessments where possible and we saw the service were responsive when there were any changes to people’s circumstances. For example, where people made potentially unhealthy choices around the foods they ate and the relationships they maintained through online activity, which may not always have been appropriate.

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

CQC does not regulate the living environment within supported living services as the premises are usually owned by landlords and housing providers, who are not registered with CQC. At some of the properties we visited, the quality of the environments varied, however we saw the registered manager had raised these issues with the housing providers for them to take appropriate action.

Evacuation procedures were in place for people may struggle to evacuate safely in the event of an emergency. Where any equipment was used such as hoists, we saw these were regularly serviced to ensure they worked properly.

Changes were made to people’s living environments where there were any concerns about a person’s safety, or their needs changed. For example, one person had a new wet room installed due to concerns about their mobility.

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.

Staffing rotas were in place that evidenced how many staff were available to care for people. Some people and relatives reported high staff turnover, although felt it wasn’t to the detriment of anyone’s care and support. One relative said, “I am concerned about high staff turnover, but I do ask (person) if everything is ok and she always says yes.”

The feedback we received from people who used the service and relatives was that staffing levels were sufficient. One member of staff said, “I support (person) on my own and feel as though I can manage. We have enough staff.” Another member of staff said, “At the moment we have enough staff and I feel we can meet people’s needs with the current arrangements.”

Staff were recruited safely, with appropriate pre-employment checks carried out before staff started working with the service which included Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Staff had opportunities to learn, and any poor performance was managed appropriately.

Staff told us they received enough training to support them in their role including Oliver McGowan training. This provides staff with additional training about how to support people with a learning disability. Simulation training was also provided in several areas and enabled staff to experience situations practically.

Staff supervisions and appraisals took place where staff could discuss their work in a confidential way. A member of staff told us, “Training is done on a regular basis and I have recently moved into a manager role, so am doing more training for this.”

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.

Staff managed the risk of infection via the use of appropriate personal protective equipment (PPE) such as gloves and aprons, and frequent cleaning and hand washing.

Staff had received training in infection prevention and control, to support their understanding of best practice. Staff had the responsibility of cleaning within the supported living properties and where possible, people who used the service were encouraged to help if they were able. We observed people’s living environments were clean and tidy at the properties we visited.

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.

Care plans contained information staff would need for people to be given their medicines safely. For one person, on a medicine that required regular monitoring, information was available for staff on who was responsible for this and what signs and symptoms would require escalation.

For one person who had their medicines crushed there were instructions available from a pharmacist that ensured that staff could do this in a safe way. Staff had completed capacity assessments and had discussions to ensure this was done in the person’s best interest.

Topical medicines such as creams were documented on the MAR charts and staff had clear body maps available to support correct application. Medication training was part of staff induction and competencies were reviewed every 12 months.

Staff conduct audits of medicines, and when medicines incidents occurred, they were reported and investigations took place. We saw evidence of actions from incidents being taken.