Cherish UK Ltd Supported Living

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• 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

Appropriate systems were not in place to ensure risks to people were properly mitigated. Improvements were also required to mental capacity act processes. The registered manager responded immediately to these concerns and ensured any missing documentation was put in place.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Where people had an accident or incident, this was recorded, monitored and action taken to address concerns. Individual incidents were recorded within people’s support plan information. Analysis of incidents was also undertaken so that any trends could be monitored. Following 2 serious incidents at the service, learning had been taken so that improvements could be made to ensure people’s safety. For example, where a person had absconded from the service, the possibility of adding coded locks to doors was being looked at so that the risk of people being harmed could be reduced. A full audit of staff recruitment records had also been done to ensure any potential risks were identified and that nothing was missed.

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.

All of the relatives we spoke with said they felt the service was safe. One told us, “(Person) is very safe and is well looked after by the staff.” There was a safeguarding policy and procedure in place which was in date and provided an overview about what people could do if they experienced any abuse. A safeguarding log was maintained, with details about any incidents reported to the local authority for further review. Staff had completed safeguarding and understood about abuse and how they would report concerns. One member of staff said, “Safeguarding is about protecting people and reporting any concerns. An example of safeguarding could be physical abuse and hitting a person, or mental abuse.” Another member of staff said, “A medication error may need a safeguarding alert depending on the seriousness.” People’s mental capacity was kept under review regarding decisions they may or may not be able to make themselves. Best interest decisions were not always clearly recorded however, where certain restrictions were in place. For example, where door alarms were used on people’s doors to alert staff when they left room, we found this process had not been followed. The registered manager arranged for these to be completed immediately.

In response to 2 serious incidents which had occurred, we look at how risk was managed within the service. We found risk assessments were not always in place for certain areas. For example, where potential risks had been identified during local authority assessments or people’s individual support plans, appropriate risk assessments had not been implemented by Cherish UK. This related to risks presented by eating certain foods, burns/scalds, broken glass and access to hazardous chemicals. Support plans weren’t in place for some people where they experienced pain, particularly where they were non-verbal. Another person had previously had epilepsy and experienced seizures, although not for many years. An epilepsy care plan was not in place for this person. This person has also displayed recent Antecedent, a Behaviour, and a Consequence, although a PBS (Positive Behavioral Support) plan was not in place. Care plans did not capture all areas of known risk or contain appropriate guidance to direct staff on how to manage them. This meant there was a risk staff may not have appropriate available to them about how to keep people safe. We raised this with the registered manager, who immediately arranged for any missing support plans and risk assessments to be put in place following the assessment feedback to prevent anyone from being harmed.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

Everybody we spoke with including staff and relatives said there were enough staff to care for people safely. Relatives felt staff had the correct skills to carry out their roles effectively. One member of staff said, “I feel there are enough staff on duty. We are able to meet people’s care needs.”

Staffing rotas were in place and this demonstrated how many staff were required to care for people. A dependency tool was also used to determine how many staff were required. Staff were recruited safely with the necessary pre-employment checks carried out. This included application forms, job interviews, DBS checks, references, any gaps in employment and right to work in the UK. Staff told us they received enough training to support them in their role. One member of staff said, “We are given plenty of training and can request more if we feel it benefits the work we do.” A training matrix was in place which showed the different courses staff had completed. Some of these included moving and handling, infection control, and health and safety. Learning disability/autism training had been completed, as well as Oliver McGowan which has been a CQC requirement since 2022.

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.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.