Taylor Support Hub

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 requires improvement. At this assessment the rating has remained requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed as risks were not always adequately assessed and planned for. Despite this, relatives felt people were safe.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was learning following incidents to reduce the ongoing risk of a reoccurrence. One relative said, “If they’d not told me [about an incident], I wouldn’t have known. We discussed changes to make it safe. They [the provider] have implemented those changes. I’m glad they don’t hide anything from me.”

Staff told us improvements were made following incidents occurring. One staff member said, “If someone we are supporting has an incident we will report it to management. We will always have a debrief and as part of that we will discuss what went well and what didn’t. We can then use that information to update care plan and risk assessments and share that information with the team to avoid it happening again.”

We reviewed an incident where a person was at risk, there was an investigation, and learning had been put in place to reduce the risk of reoccurrence.

Relatives told us people were well supported and the provider worked in partnership with other professionals. For example, 1 relative told us staff often attended joint multidisciplinary meetings to ensure there was holistic support and learning about how to best support the person.

Staff attended meetings to discuss individual’s needs and to speak with relatives. We reviewed the minutes taken in these meetings.

Partners told us the provider worked in partnership with them for the benefit of people. One professional told us how the recordings made by staff could be more detailed to help them make clinical decisions, but generally they had no concerns and felt the management team were approachable.

We were told people’s care plans and risk assessments should be reviewed annually, or if there was a change in a person’s needs. However, it was acknowledged there was a ‘backlog’ and we found reviews were not always happening and care plans contained out of date information. We also saw when new information had been discussed by staff in meetings, this wasn’t then reflected in one central place, for example, in the person’s care plan. This meant there was a risk staff would not always have access to guidance.

People were comfortable and happy in the presence of staff. Multiple relatives confirmed people were happy to be supported by staff. A relative told us, “[My relative] is always really happy to go on a residential break with staff. If they didn’t want to go, I would know that behaviour. My relative asks for staff. My relative is very happy to go.”

Staff understood their safeguarding responsibilities. They knew of the different types of abuse, how to recognise the signs and symptoms and the action needed to report concerns. They told us they would raise these with managers internally first, but they could raise them with the local safeguarding authority, if they needed to.

The provider shared safeguarding concerns with the local safeguarding authority. However, the quality of recording around what action had been taken was mixed. In some instances, it was clear what action had been taken to protect people, but in others it was not always clear. We asked the registered manager about this, and they were able to show us additional evidence about what action had been taken, so we were satisfied people were being protected. However, records around this needed to be clearer.

Relatives told us they felt people were safe with the staff team who supported them. A relative said, “They are thorough at finding the right place, lots of things are considered from a safety aspect. If I ask them a question, they are already ready with the answer.” Another relative said, “Yes, I feel my relative is safe, because we know the staff very well. We can tell what mood my relative is in when they come back. If there is negative behaviour or aggression, we know my relative has not had a good time, but it doesn’t happen often, it’s not happened for years.”

Staff told us they were enabled to get to know people and they were able to tell us about people’s individual needs. Staff became familiar with people’s needs as there was generally a core team of staff supporting each person, with cover only being used when staff from the core team were absent.

People’s care plans did not always contain enough detail about how they needed to be supported. Risk assessments were not always updated in line with the providers own review dates. Assessments were not always completed using the provider’s own method for completing them. We asked them about this, and they explained they had identified this so were going through them to update them. However, the newly completed assessments were also not always completed correctly so we could not be sure action taken would always be effective.

One person’s plan referred to them needing restraint at times, however there was no further clear detail about what this looked like for the person. This meant there was a risk of inappropriate restraint as staff did not have clear guidance. In another example, another person’s plan was missing information about the need for specialist equipment needed when undertaking certain activities so there was a risk this equipment may not be used when necessary.

We did not receive any feedback from people about their experience of their environment and relatives were not present during care and support to observe this themselves. Therefore, we did not receive any feedback about this.

Staff confirmed the environment was assessed prior to people’s arrival at each property. One staff member said, “I will come to office and collect the person’s medication records and review care plan and risk assessments. I am given the information of where we are staying. The property is visited prior to us going there and a risk assessment is done, which we have access to.”

The provider carried out risk assessments of the properties where people would stay during their support, to ensure they were appropriate and risks were managed. For example, if the area was quiet enough, if door locks were secure or whether the layout of the property was suitable.

Relatives felt staff were well trained and knew what they were doing. One relative told us the provider strived to ensure at least one experienced staff member, who knew their family well, supported their relative at all times. However, relatives told us of occasional instances when care was delayed or cancelled due to staff being unavailable and they felt a back-up system should be in place to avoid this. They said whilst cancellations did not happen very often, when they did, they had a big impact of people.

Staff told us they felt well trained. One staff member said, “I had a week’s induction when I started with a mixture of face to face and online training. I then did some shadow shifts observing how staff supported people and getting to know the people I would be supporting. The training was really good and covered all of the topics I needed to support the people I would be working with. I get regular refresher training.”

Staff also told us they felt there were enough staff and they never had to work short staffed. One staff member said, “I have never been asked to work understaffed, if the staff team can’t cover it, then one of the managers will normally help out. We have enough staff, and I think they have just recruited some more staff.”

Staff were recruited safely. Checks were made on staff suitability to support people who used the service such as checks on criminal records, identity checks and references. However, records needed strengthening to ensure checks were robust, such as ensuring there was a full employment history, references were from verified sources and thorough address checks. Staff received training to be effective in their role; however, the monitoring of this was not clear.

People were not able to discuss with us their experience of infection control measures in place and relatives were not present during care and support to observe this themselves. Therefore, we did not receive any feedback about this.

Staff told us they had access to Personal Protective Equipment (PPE). One staff member said, “We always have PPE with us and will also carry a change of clothing for the person if they need it.” Another staff member said, “Staff who do the residential breaks are given a supply of PPE, I have a box of gloves and roll of aprons always in the car. If we are running low, then there is more at the office, and we just have to ask.”

Staff received training in relation to infection control. However, multiple staff had training that was noted as expired or not completed and it was not clear when this was going to be completed.

Relatives felt people were well supported with medicines, when this was needed. One relative said, “They’ve always come back with the right amount of pills missing.”

Staff felt they were trained and supported well to feel confident administering medicines. Staff also knew to report concerns if they felt there had been any errors with medicines. One staff member said, “I do administer medication. I have complete training and after the training I had to observe another person administering before [a manager] came and observed me administering them and deemed me competent. I have not made a medication error but if I did, I would report it to my manager and follow their instructions.”

Medicine processes in place were not always effective to ensure people were always being protected. Some documents referred to people having covert medicines. However, the provider had not verified the most appropriate way of administering this medicine with relevant health professionals. Mixing medicines with incorrect food or drink can change the efficacy so it was important this was checked directly with relevant professionals. Confirmation from relevant health professionals had not been sought to ensure giving a person an over-the-counter medicine was safe.