- Homecare service
LDC Supported Living
Report from 19 February 2024 assessment
Contents
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
The service had improved. Staff were now confident in the safeguarding systems and kept people safe from abuse. The systems now effectively supported this process. Risks for people were managed by staff and people were involved in their support. There were enough staff to support people as required and staff were now recruited safely. The service had safe systems for appropriate and safe handling of medicines.
This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.
Learning culture
We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.
Safe systems, pathways and transitions
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
People were supported to be safe from abuse and neglect. People had a lot of staff around them whom they were able to approach if they had any concerns about their care. Relatives said that people were safe and that they trusted staff with their loved one’s care. One relative said, “Yes absolutely safe. [Loved one] has been at this place for a year. I managed to get [loved one] moved from the place where [they were] before that I wasn’t happy with.”
Staff we spoke to knew the signs and symptoms of potential abuse and told us they felt confident to raise any concerns and felt that their concerns would be acted on. Staff knew they could escalate concerns to the local authority safeguarding team or the Care Quality Commission. A member of the management team told us feedback from safeguarding was shared throughout the team through debrief sessions.
We saw that people were familiar with staff which helped them to relax and feel safe. Staff supported people with their emotional well-being by reassuring people when they became anxious.
Operations managers had responsibility for the safeguarding of people in their patch, this was regularly discussed at team and management meetings. Safeguarding concerns were logged on a tracker with relevant actions taken and followed up. Safeguarding training was up to date and staff had received additional training such as trauma informed care which supported staff to make sure people felt safe while receiving their support.
Involving people to manage risks
People and those important to them were involved in managing risks where appropriate. People were informed about any risks to themselves and how to keep themselves safe. Relatives felt they were kept up to date about their loved one’s care and any risks as appropriate. A relative gave an example of a risk for their loved one and how staff encouraged the person to use strategies and equipment that worked for them to reduce the risk of harm. People were encouraged to pursue their interests, create, and maintain relationships and be a part of their community through positive risk taking.
There was a culture of kindness and respect. Feedback from partners was positive about the care and support LDC Supported Living provided people with. Feedback illustrated how LDC Supported Living through the management and staff team embodied kindness and compassion to support people in completely person-centred ways which impacted positively on people and those important to them. One professional shared, ‘Person’s family have been very thankful for the support and have said that they really appreciate the contact from LDC and the photos. They were able to enjoy a holiday without worrying about their [loved one] for the first time in years and have commented that they can now see [loved one’s] personality returning.’ Another professional fed back, 'it was lovely to see how you all got to know [person] and all of [their] quirks and personality, to see the relationship developing between you and the jokes you would have with [them]. Doing things like buying [them] a gazebo and getting [pets] for [their] home showed us how much you care about what makes [person] happy…'
We observed staff supporting people to manage and mitigate risks for them. For example, we saw staff explaining to a person the use of a lid on a hot drink was to help keep them safe from being hurt. We saw staff be compassionate and offer reassurance to people who needed it.
People and those important to them were involved in risk assessments and support planning as far as possible. People had comprehensive risk assessments in place which contained information about how to minimise their specific risks, for example, where people were at risk of having seizures or at risk of self-harm. Daily records of care reflected staff delivered support in line with people’s risk assessments and support plans to good effect.
Safe environments
We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.
Safe and effective staffing
People benefitted from being supported by staff who genuinely cared for them and knew them well. People we spoke with were happy with their staff. One person said their member of staff was “good” and another gave a thumbs up. People were asked about satisfaction with their staff team through the service’s processes and we saw that when people had given negative feedback about staff this had been acted on. Relatives told us their loved ones were supported by the right number of staff and felt staff had the skills needed to support people safely. One relative said, “They are very, very competent, well trained, nothing fazes them. They instill confidence.”
Leaders told us they based people’s staffing levels on their initial assessed needs when LDC Supported Living began providing support and staffing was regularly reviewed. Staff gave examples of where staffing levels had been reduced as people’s independence grew. Staff told us they were introduced to people before starting as a member of their care team to ensure staff were the right fit. Where possible staff told us continuity of the staff supporting people was maintained. Staff received specific training based on the needs of the person they were supporting.
People were supported by their assessed number of staff and there were extra staff available on our visits to enable us to speak to staff without impacting on the support available for people. We observed that staff knew people well and interacted with people in a positive way to ensure people received good quality care that met their needs.
Staff were recruited safely. Appropriate checks were completed to ensure there was full employment history and appropriate references were reviewed. Disclosure and Barring service (DBS) checks were also undertaken. 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 the skills to support people and meet their needs. Staff training was monitored by the management team using performance reports and was discussed during team meetings to maintain training compliance. The majority of staff training was up to date. The quality and compliance manager told us they were changing their system to support better monitoring and clearer reporting of staff training compliance. People received the support they were funded for. Leaders monitored staff support that was delivered for people and analysed any discrepancies. For example, where a person received less support than usual because they were with family or had required additional support to go somewhere they wanted. The analysis was used to assess whether people were receiving the right amount of support or whether they needed more or less support.
Infection prevention and control
We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.
Medicines optimisation
Most people received their medicines as they were prescribed however, some people had not received their when required [PRN] medicines as per their PRN protocol. Records showed staff had either not followed the protocol or responded to the person’s needs appropriately. We spoke with the provider about this during the assessment and they took action to prevent similar issues in the future. People were supported by staff who had the right training and skills to manage their health care conditions. People were assessed and supported to have their needs met. Care plans were person-centred and people and their advocates had been involved in writing them.
Staff worked closely with people and other healthcare professionals to ensure people’s medicines needs were met. Staff said they received training that was suitable for their role.
People’s medicines were stored securely in people’s homes.
There were processes in place to ensure people received their medicines safely. Staff used a paper-based system to administer people’s medicines and kept accurate records. Risks for medicines that cause bleeding and bruising and those which present a fire risk had been assessed and recorded. There were processes in place to ensure people’s medicines information was transferred accurately between care settings.