ECHO Supported Living 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. 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 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 systems in place to support a learning culture. Lessons were learnt to continually identify and embed good practice. Relatives told us they were kept informed of any incidents which occurred and felt staff and the manager communicated well with them when things had gone wrong. Incidents were analysed monthly to look for trends and enable actions to be taken to make any required changes to prevent incidents from happening again. For example, where incidents of people having distressed behaviours had increased at a particular time during the day, analysis was completed to determine if any changes were needed to people’s individual risk assessments and support plans and if any broader learning had been identified. The registered manager gave the example of how a health tracker had been put in place following learning. Staff were aware of how to report and document incidents and could describe how they received updates on learning from incidents. Staff told us they had an immediate debrief following incidents and how individual plans were updated with learning.

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. Relatives told us they felt people had a good transition into the service and were well supported. A relative told us, “From the day [person’s name] arrived at the service we couldn’t be happier, from day 1 the manager was on the phone, asking what do we need to know and getting all the information needed to make the move work ok and it was all in place when they moved to the service.”Leaders told us they had systems in place to support people to transition into the service. There was an assessment process which included the use of a universal assessment tool to determine whether people’s needs could be met. Once agreed a transition plan was created and relevant people were involved in the transition planning and support plan development. Staff told us the transition period varied depending on individual needs and during this period there were planned and structured visits for the person designed to build trust and reduce anxiety. Staff confirmed as they got to know people detailed support plans were put in place. Support plans were in place and had been developed with people, their relatives and other professionals to ensure peoples safety.

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 told us they felt safe in their home and were happy with the support they received from staff. Relatives told us they were confident staff would report any concerns to the appropriate people, and they felt people were safe being supported by the service. One relative told us, “I am very happy with the provider, [person’s name] is safe, no safeguarding experiences, we get told if [person’s name] stubs their toe even and there have never been any worries, we know how to raise a concern if needed.” Staff told us they understood how to recognise abuse and could tell us how this would be reported to the appropriate person. Staff had received training in adult safeguarding, and this was updated on a regular basis. The registered manager told us, they used root cause analysis when safeguarding incidents occurred and actions were monitored through a tracking system to ensure learning was put in place. The provider had systems in place to ensure all incidents were reported to the appropriate body. We saw incidents were logged and any lessons learned were shared with staff.

The provider had systems in place to assess risks to people’s safety and enable plans to be put in place to reduce the risks. Relatives told us people had risks to their safety considered as part of the initial assessment. Risks were assessed and management plans were put in place to guide staff. Staff understood how to manage risks to people’s safety and could describe how they supported people in line with their risk assessments and management plans. For example, staff could describe how they supported people to reduce the risk of them becoming distressed. We saw risk assessments were in place for health-related risks such as seizures, risks relating to the use of vehicles, mobility and activities undertaken. Staff could describe how they used this information to help them keep people safe. For example, a staff member said, “[Person’s name} is at risk of choking and they have set guidelines on what they can and cannot eat and very specific rules about food preparation which we follow.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Relatives told us people were supported to maintain their homes. A relative told us, “The staff look after [person’s name] home, cleanliness and safety I have no concerns. [Person’s name] has the flat how they want it.” The registered manager told us they had systems in place to support people to maintain their property and keep the environment safe. For example, weekly checks were undertaken and there was a system in place to escalate any concerns and get repairs done where needed. The provider had ensured people had equipment in place to maintain their safety. Staff were aware of how to support people to maintain their environment and relevant risk assessments and care plans were in place.

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. Relatives told us there was always enough staff to support people. A relative said, “[Person’s name] has support 24 hours a day, they have never missed an activity or event due to being short staffed.” The provider worked with local commissioners to determine the levels of support people needed. Most people had support from staff continuously throughout the day and had a core staff team to work with them. Relatives told us staff were experienced in supporting people. A relative told us, “Staff are very consistent and are skilled up by more experienced staff when they first start.” Staff confirmed they received training in their role through an induction and had regular updates, records supported this. The provider had a recruitment policy in place which ensured staff were recruited safely. The registered manager told us there was a system in place to analyse staff training needs and this included consideration of individual needs and the skills staff would need to support people; we saw training had been provided to staff supporting people with specific health conditions for example. The registered manager had systems in place to monitor staff competency.

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. Relatives told us staff used protective equipment designed to prevent the risk of cross infection and helped people to maintain their home environment. A relative told us, “[Person’s name] home is great the staff are on top of it with PPE, cleaning, and maintenance.” Staff had received training in infection prevention control. The provider had a policy in place which was understood and followed by staff. There were regular checks in place to ensure staff followed the right procedures. Staff had access to protective equipment and could describe how they used this effectively to keep people safe.

The provider had systems in place to ensure people had the support they needed with their medicines. Relatives told us people received the support they needed with their medicines. A relative said, “Medicines are reviewed regularly, [person’s name] was on much higher dosages of medicines, but it is well managed now. They share information with me, and it is all in hand, they have an annual review and monitor medicines regularly.” Staff responsible for administering medicines told us they received training and had their competency assessed. The provider had a policy in place to guide staff on safe medicines practice, and this was being followed by staff. Electronic planning and recording systems were in place to enable staff to have up to date information about the medicines people were prescribed and enable medicines administration records to be completed, this included guidance and records relating to medicines prescribed on an ‘as required’ basis. We saw staff followed the guidance when administering people’s medicines and where incidents had occurred with medicines administration there were systems in place to review these and prevent them from happening again.