Wansbeck Supported Living Service

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

People were kept safe and protected from bullying, harassment, avoidable harm, neglect, abuse and discrimination. They were respected and their freedoms protected in line with legislation. When people raised concerns about safety and ideas to improve, they were listened to and the registered manager, and other staff, took action. Staff protected people from the risks they faced and also displayed a positive attitude towards risk taking. The registered manager ensured there were enough skilled people to meet people's needs and preferences. One person said, “They are always here to help,” and a relative said, “I have no concerns about levels of staffing. They’ll always let me know if staffing has had to change for any reason.”

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.

People felt listened to and were included in how the service was run and how improvements could be made. People and families were involved in discussions when staffing or other matters needed to change.

The registered manager ensured lessons were learned from incidents. Staff felt confident raising any issues and that they would be dealt with appropriately. The registered manager welcomed additional scrutiny from regional management and external partners as a way of identifying improvements.

The service worked with external professionals to continually learn and reflect on practice. Incidents and accidents were reflected on as learning opportunities. External professionals felt the service had worked well with them to improve the service. One said, “They took on board that our advice and continue to work well and support client with this.“

The provider had improved their approach to analysing care information and aligning it to national good practice. Record keeping was generally good and allowed for analysis.

People felt their needs were well supported by staff and had confidence in the service to escalate any changes or to seek help when required. They received regular optical, dental and other check-ups.

The service sought advice and support from external partners and explored ways of meeting people’s needs. They ensured people had access to the right short and long-term care. Staff went out of their way to ensure people’s anxieties about accessing external health services were reduced. For instance, getting the flu jab at the same time as people, or lying down on a stretcher to demonstrate to them how it worked. The service had regularly sent additional staff to hospital with a person to ensure their communicative needs were met – they had communication documentation in place but previous experiences meant they wanted to be completely assured the person received the care they needed, so staff attended on a rota.

Staff had built up mutually respectful and trusting relationships with external professionals. The latter worked openly with staff to help people get past any barriers between them and accessing healthcare.

Policies and processes were aligned with good practice. People received a consistent, compassionate and informed approach from the service.

People felt safe, at home, and trusted staff to keep them safe. They had the confidence to try new things with the staff team and there was a shared understanding and embracing of positive risk taking by people and staff.

Staff received regular safeguarding training. They were aware of their responsibilities and reported changes proactively. They understood the subtle indicators that may mean a person was struggling or needed additional support. External partners had confidence in the ability of staff to keep people safe. They said, “Staff are always welcoming to professionals and will voice any concerns acting in client's best interests,” and, “In my experience the staff team are open and honest and report all concerns to the wider MDT, relevant safeguards are reported as required. Appropriate medical attention is also sought where appropriate.”

Staff interacted calmly with people. We observed no safeguarding concerns on our visits, or in any of our interactions with staff.

Safeguarding processes and policies were clear. The registered manager was responsive to opportunities to update these with the most recent areas of practice/research, and to opportunities to work with external partners.

People were involved in risk planning and had experienced greater independence through being supported to understand and reduced risks. Risk taking was positive and balanced with people's right to choose.

Staff understood the risks people faced. Many had worked with people for a number of years. Newer staff were given the time to gain an understanding of the risks people faced. People and their relatives were involved to identify the best ways to reduce risk. The service sought information from a range of sources, and took the time to understand people’s preferences and routines to inform their approach.

We observed staff working with people to plan the best ways to manage the risks they might encounter.

Care plans and risk assessments were reviewed regularly. We identified a small number that did not adequately described the risk presented to people, particularly with regard to one specific condition, and diabetes. The registered manager reacted immediately to improve these risk assessments and we were assured that current staff had a strong understanding of how to reduce these risks.

People did not raise any concerns about how staff supported them to remain safe in their home environment. People had a sense of pride in their homes. One relative said, “It’s always clean and tidy.”

People’s bungalows were well maintained. The provider advocated robustly for people where there were any issues or delays. People were supported and encouraged to take responsibility for keeping their homes clean and tidy.

People took pride in showing us how well they kept their homes, and how they had personalised them, for example with their own artwork, and the gardening they enjoyed. They helped maintain and enjoy communal spaces. The atmosphere was therefore welcoming and communal where people wanted it, and they had their own individual spaces to enjoy their independence.

Policies and procedures helped ensure people were not put at undue risk through poorly maintained surroundings.

People felt well supported by enough staff to keep them safe and meet their needs. One person told us they could always go and ask a question of any senior staff. One relative said, “I have no concerns about levels of staffing. They’ll always let me know if staffing has had to change for any reason.” Another said, “They all work in a cohesive manner.”

The registered manager had reviewed staffing arrangements and brought in an additional care supervisor, as well as changing shift times to enable people to continue to be less restricted. Staffing arrangements worked for people who used the service. Staff also recognised the improvements. One said, “It means [person] not waiting around in the afternoon; it means they can do more full days out and about.” Staff were also supportive of the change in shift patterns.

Staff responded to people's needs promptly and there were sufficient staff on duty. There were on call systems in place and staff worked flexibly when unexpected scenarios occured, which needed them to provide additional cover.

The provider had auditing and governance systems in place to identify where staffing redeployment may be beneficial. This included internal quality audits and surveys. These helped contribute to the positive changes in staffing arrangements.

People and relatives raised no concerns in this regards. They had confidence in the standards of hygiene maintained by staff.

The registered manager ensured there were ample supplies of appropriate PPE and related equipment available for staff. Staff supported people to maintain their own homes. There were two IPC champions in place.

People's homes were well maintained and the provider ensured specific infection control risks were well managed. Partners raised no concerns regarding infection control. Signage was helpful, as was guidance and reminders given to people around helping maintain their own good standards of hygiene.

IPC policies and processes were up to date and in line with current practice. Staff were regularly reminded of their obligations and we observed staff to be bare below the elbow during inspection.

People gave positive feedback about this aspect of care, as did their relatives. One said, “The carers are very aware of his medication.”

Staff checked for medicines errors and did take action where there were shortfalls with record keeping. The approach to auditing and governance of medicines was not fully effective nor clear. Improvements were needed in this area to include staff and to make audits more focussed on good practice, rather than merely stock checks. Staff had been trained in medicines management and had their competence assessed regularly, through formal review of unannounced spot checks. Where errors were noted or improvements required, this was shared with staff. The service acted in line with STOMP (stopping over medication of people with a learning disability, autism or both with psychotropic medicines) and looked to the least restrictive, least medicinal options to support people to be safe. Staff demonstrated a good knowledge of when and how rescue medication should be used.

We did not observe medicines administration but discussions with staff and external partners gave us assurances about their confidence and competence in administering medicines.

There had been some improvements in how medicines were reviewed, such as more consistent stock checks. These were not always well documented. The registered manager was responsive to feedback and shared documentation on day two of the assessment setting out how they would improve medicines auditing. The registered manager was aware of national good practice, such as the National Institute for Health and Care Excellence (NICE). They were responsive to feedback about the need to continually review and improve practice.