Archived: PICAS Also known as Pathway Independent Care and Autism Services

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 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.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Safeguarding systems were in place. A safeguarding policy had been completed that detailed the types of abuse and how to escalate concerns if staff suspected or saw abuse to ensure people were protected. The registered manager told us, “I hold regular staff meetings where we look at the various ways of reporting [safeguarding] concerns. Staff know what to do. Through the training, staff know what abuse is, we have policies, which shows staff on how to report concerns. I also carry out spot checks too where I check staffs’ knowledge and understanding regarding safeguarding”.

Observation showed that people felt safe and comfortable at the supported living premises and had a positive relationship with staff.

People and relatives told us people were protected from abuse and felt safe. A person said, “I feel safe living in my home, staff are good to me.” A relative told us, “I am happy, [person] is safe. [Person] been there since 2008 and been very well cared for and is happy in environment. [Person] got the best quality of life.” A person said, “I like it here. Staff are nice.”

Staff knew about safeguarding processes and had received training in this area. Staff were able to tell us the importance of reporting any concerns to the management team. Staff also felt they could be open to the management team if they had any concerns. A staff member told us, “We can report abuse by calling 999, [informing my] line manager, family or other professionals.”

People had risk assessments in place describing the support they needed to keep safe. There were risk assessments to ensure people were safe when being supported such as on falls management, epilepsy and nutrition.

During our assessment, we saw that staff were engaging with people appropriately and had a good awareness of people’s likes and dislikes. Staff were clear on how to avoid known risks to people, and this was recognised by people’s body language and verbal communication if somebody was to become anxious about something, which helped keep people safe from avoidable harm.

Relatives told us that staff looked after people well, which included minimising risks to ensure people were safe. A relative told us, “[Staff] interact with [person] really positively and understand [person]. They manage [persons] emotions effectively. They communicate with us well and send us pictures of what [person] is doing, which is lovely. We can visit whenever we want to, and they are very respectful towards us.”

Staff received appropriate risk management training, which helped them develop their skills. Staff were able to tell us how they supported people with their identified risks. A staff member told us, “To identify the risks for individuals, it can be done through risk assessments, health awareness, financial review, social interactions, past experiences, knowing the hazards, healthy lifestyle choices and information. To minimize risks, we have to consider proactive and reactive measures, professional advice, healthy lifestyle choices through information, manager consultation and monthly audit review.”

The registered manager was able to show us evidence that risk assessment was reviewed on a regular basis and told us, “I review risk assessment monthly, as part of my quality audits; we discuss them in staff meeting and staff supervisions. I review risk assessments after any incident or concerns and from investigations that have been completed.”

Each person lived in their own supported living accommodation, where the premises and environment were adapted to meet people’s individual needs.

We saw evidence that staff conducted health and safety checks, which also included fire safety audits and checks to ensure the premises was safe for people to live in.

The registered manager told us about the systems that were in place to check the environment was safe for everyone who used the service. This included daily, weekly and monthly audit checks completed by all staff.

Staff supported people to report maintenance issues with their landlord when repairs were identified. This helped to ensure that the environment was well maintained.

There was enough staff to support people safely. A relative told us, “Yes, it is always the same people, and they have their own agency. [Person] has key worker as well who has always been the same.”

There were appropriate numbers of staff on duty to support people safely at the supported living sites. We saw staff were available when people wanted them. Rotas confirmed there were enough staff to support people safely. Records showed relevant pre-employment checks, such as criminal record checks, right to work in the UK, references and proof of the person’s identity had been carried out.

Staff had completed key training such as on learning disabilities and first aid to perform their roles effectively. A training matrix was in place to ensure management had oversight of staff training. Staff had also received induction when first employed by the service. A staff member said, “I received an induction, and it was useful to have an understanding with company policies. It outlines our work or job description and responsibilities.” Another staff told us, “We get regular training and can ask or request for training.”

Relatives were positive about staff support. A relative told us, “They’re amazing. They completely changed our lives. Staff are knowledgeable, educated and up to date with everything. They also feel like family.”

Regular supervisions and appraisals had been carried out to ensure staff were supported. A staff member told us, “I have opportunity to meet for supervision with my line manager every 3 months for supervision.”

During our assessment, we observed staff supported people safely and knew them well.

The provider had an infection control policy in place and staff had been trained on infection control. Personal Protective Equipment (PPE) was readily available at the supported living sites we visited, and staff confirmed they had access to PPE when needed.

We observed the supported living sites to be clean and tidy. We saw a staff supporting a person to clean their home and there was a cleaning rota in place. Staff were observed to wear personal protective equipment such as gloves and aprons when needed.

Systems were in place to prevent and minimise the spread of infection to ensure people experiences was safe.

Staff was positive about the service and how they worked as part as a team. One staff told us, “We work well together as a team and the communication is very good. We discuss any concerns regarding infection control issues, as it is important to support [people] to keep their home clean.”

The registered manager told us they worked with external partners and organisations to help ensure infection control systems were robust. This included working with environmental health team as well as external contractors.

Medicine Administration Records (MARs) showed that medicines had been administered as prescribed. Medicine audits were carried out to ensure people received their medicines safely. Staff had also been trained in medicines management and had competency assessments to ensure they were competent to manage medicines. We observed medicines were securely stored in medicine cabinets in people’s homes.

Relatives told us medicines were managed safely. A relative told us, “Yes, they support [person] and I’ve got no concerns [with medicines].” Another relative commented, “Yes, I’ve got no concerns. They’re very up to date with it and even transferred [person] pharmacy close to them so they can manage it rather than me.”

Staff told us they were confident of managing medicines. The registered manager was able to demonstrate the process in ensuring medicines were managed safely such as training being delivered to staff, competency assessments being carried out and regular checks made on medicine administration and records. A staff member told us, “I received medicines training. This training included what to do if a medicine fell on the floor or if a [person] refused to take their medication.”