Supported Living West Midlands

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

Staff had received training in safeguarding and knew how to report any safeguarding concerns. Concerns raised by staff were documented to ensure there was a record of appropriate action taken to keep people safe. Risk assessments and management plans were in place and risks to people's safety and well-being were managed through a risk management process. People had comprehensive positive behaviour plans which guided staff on how to support people safely. People received care and support in line with their needs. Staff felt they had adequate training around medicines and regular checks of staff abilities were conducted. Medicines protocols were in place.

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.

Relatives told us that since the current registered manager had been in post they were confident any concerns raised would be dealt with. One relative told us, “[The registered manager] is just brilliant, they gave me so much reassurance and they worked so much with [name of service user] and listened to my concerns. They want the best life for [name of service user]. [The registered manager] has involved me in the care plan and we’ve done it all together, they keep me updated. They’re honest and [the registered manager] doesn’t lie about how hard it’s going to be to get [name of service user] where they need to be. I don’t worry anymore because I trust them.” Other relatives said the provider had responded to them in a timely way.

Staff received training in safeguarding and were able to identify signs of abuse. Staff demonstrated they knew who to report any potential safeguarding concerns to and where to escalate this if necessary. One member of staff said, “Abuse can happen in different forms such as physical, emotional and financial”. Another staff member told us, “If I witnessed any type of abuse, I would ensure the person was safe. I would report the incident to my manager. If I was unhappy with how the incident was managed, I would contact the safeguarding local authority, the Police and CQC”.

We received mixed feedback from partners linked to the service. Professionals told us things had improved since the current registered manager had been in post. Some professionals told us the provider was slow to respond for requests for information. Others told us they had no concerns about the provider and believed the new management structure would continue to improve and develop the service.

The provider had a detailed safeguarding policy and procedure for staff to follow. There were systems and processes in place to report and record safeguarding concerns. Systems were in place to identify any lessons learnt and take appropriate action. The provider ensured lessons learnt were shared with staff and, when appropriate, other services operated by the provider.

The provider was responsive to meeting people’s needs to ensure a safe transition from hospital, a different care provider, or from the service user’s home. Care plans were updated to reflect people’s changing needs. One family member told us, “There was a transition period for [name of service user]. They came to see us and completed an assessment. We were involved in the care plan”.

Staff ensured people were involved in discussions about their care needs and followed their care plans and risk assessments. One staff member told us, “We speak to them and their relatives to get to know their preferences and add this into the care plan, whether that’s routines or choices around food and drink.”

We saw the provider had successfully worked with partners and had been involved in discussions with them about people’s care needs.

The provider had processes to monitor safe systems, pathways and transitions. This included a comprehensive needs assessment which was completed prior to support being provided.

People told us they felt safe with staff and spoke positively about them. A person told us, “I feel safe”. A relative told us, “[Name of service user] seems safe to me, we speak a lot on the phone, and they seem happy. If there was a problem they would tell me.”

The service understood their responsibilities in relation to safeguarding and would report any concerns to the relevant agencies as required. Staff had completed safeguarding training and were aware of the different types of abuse and reporting procedures to follow if they had any concerns of abuse. There was a support structure in place for staff to respond to concerns.

We saw people being safely supported which was in line with their care plans and risk assessments.

There was a process for recording and monitoring safeguarding concerns which provided management with clear oversight to help report potential safeguarding concerns to the relevant agencies, including CQC. Policies for safeguarding, whistleblowing and duty of candour underpinned these processes. The registered manager and provider understood their responsibility under the duty of candour and took responsibility when things went wrong. Records showed safeguarding concerns were investigated which involved people, relatives and other healthcare professionals including the local safeguarding teams. To protect people’s safety and welfare, risk assessments were put in place detailing measures to mitigate further risk to people.

Relatives told us things had improved since the current registered manager had been in post. They said staff understood their needs and provided them with the support they needed to keep them safe from harm. A relative told us, “[Name of service user] is calmer and more relaxed. [Name of service user] knows all their names because it’s always the same people who are spending time with them.” The service adopted a balanced and proportionate approach to risk that supported people but respected their choices about their care and daily lives. People were involved and informed about any risks and how to keep themselves safe. For example, there were measures in place for a person whilst they were out in the community. These had been reviewed and adapted in accordance with the person’s needs and wishes which enabled them to continue doing the things that mattered to them whilst maintaining their safety.

Staff were aware of people’s individual needs and helped ensure people were safe. Risk assessments provided guidance on what action staff should take to reduce risks and maintain people’s safety. Staff were encouraged to report new risks so that appropriate action could be taken to ensure the safety of people. There was a system in place to report, record and monitor incidents and accidents. A staff member told us, “We help to keep people safe and take risks in a safe way. For example, when accessing the community to do activities we put measures in place to keep people safe.”

We observed that risks to people were managed safely by staff.

Risks to people’s health and safety were assessed and person-centred care plans implemented. People assessed as needing a specific number of staff to support them safely received this level of support. Care plans including guidance and strategies for staff on how to manage distress in a person-centred way, based on knowledge of early warning signs for those people. For example, staff used distraction and redirection strategies to support a person who experienced distress. The provider had procedures to monitor risks to people including restrictive practice reduction plans which were audited regularly. The provider considered patterns and trends to minimise risks to people and inform staff how to support people safely. Staff met with healthcare professionals on a regular basis to review people’s risks and take action to ensure people were cared for safely. Risk assessments were regularly reviewed to ensure they remained relevant and help ensure people received safe care.

People were cared for in a safe environment that was designed to meet their needs. People had a range of equipment available to use. Relatives felt the environment and equipment were safe.

Staff received a range of training to support them to keep people safe. The provider monitored and reduced environmental risks and staff had received a range of training to support them to keep people safe. Staff were positive about the changes implemented since the new management structure had been put in place. One staff member commented, “Since [current registered manager] has been in post they have implemented many changes. They visit regularly and conduct spot checks.”

People’s homes and equipment were clean and well maintained.

There were systems in place to monitor the safety and upkeep of the premises. Regular checks were completed by the provider to ensure the environment and equipment was safe for people to use. This included checks for fire safety, legionnaires and moving and handling equipment.

People were supported by staff that knew their needs well. When possible, staff members would support the same people to promote stability and continuity. A relative told us, “The staff are very pleasant now we’ve got to know them and now [name of service user] is very settled.”

Staff told us they felt supported and spoke positively about working for the service. A staff member told us, “Since [registered manager] has been here the service has improved and it’s a great place to work. I can speak to the manager at any time, they regularly visit us”. Staff told us they worked well as a team and shared information with each other, as necessary, to ensure effective care was consistently provided. Staff told us they felt very supported by their team managers who were there for them when needed. One staff member told us, “The team managers are supportive, they work alongside us”. Staff provided safe and effective care to people. Staff received an induction and regular training which included mandatory training to support autistic people and people with learning disabilities. A staff member told us, “I completed online and face to face training. I also shadowed more experienced staff. After my induction I felt comfortable to support people on my own however I was given the option of extending my induction if I didn’t feel ready”. Supervision and appraisals were in place to monitor performance and development. Staff participated in monthly staff meetings where they were able to share information and receive important updates about the service.

We saw people being safely supported which was in line with their care plans and risk assessments.

The service ensured staff had the knowledge and skills required to meet people’s needs. The provider followed safe recruitment practices and had ensured appropriate pre-employment checks were completed satisfactorily before staff were employed. Relatives told us that staff knowledge and skills had improved since the new registered manager had been in post and specialised training was provided. A relative told us, “They have now [knowledge and skills], a lot of that has come from me and it has been a slog, but they have put training on when I’ve asked. For example, they’ve been on a [specific training course relevant to the service user] course this week which was sorted by [the registered manager] at long last.”

Feedback from relatives was mixed regarding cleanliness. One relative told us, “It could do with being better cleaned, [name of service user] can’t do much so he needs them to do the cleaning”. Another relative told us, “[Name of service user] has got a lovely home, it’s really good and quiet. We can visit whenever”.

Staff received training in infection prevention and control and were aware of safe hygiene practices. No concerns were raised about the availability of Personal Protective Equipment (PPE).

Staff followed current practice when supporting people and used PPE when required.

The provider had policies and procedures in place regarding IPC and systems to monitor practices. The provider knew how to respond to risks and signs of infection and how to make sure infection outbreaks at the service would be effectively prevented or managed. There were arrangements in place to make sure the environment was cleaned by staff at regular intervals.

People had their medicines at the right time and in a safe way. Records of medicines administered were accurately recorded, including time sensitive medicines for certain complex health conditions. Person centred care plans were in place for ‘as required’ medicines.

Staff informed us they had a good working relationship with the local pharmacy. Regular medicines audits were carried out and any issues identified were actioned immediately to make improvements. Staff received training in medicine administration and competencies were thorough and comprehensive.

Medicines were stored securely and safely. People's care plans detailed how they preferred to take their medicines including clear protocols for medicines given 'as and when' needed.

Medicines were stored securely and safely. Effective systems were in place to make sure people’s medicines were ordered and accurately recorded to ensure sufficient supplies of medicines were in stock. Staff administering medication were clearly identified and not interrupted by other staff. Staff administering medication were person centred in their interactions.