Salutem Supported Living North

We assessed the service against ‘Right support, right care, right culture.’ This guidance supported judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choice, independence, and access to local communities that most people take for granted. We found the service respected people as individuals and promoted their access to their community. However, we received feedback from some relatives about the suitability of the properties. In the 2 large properties the lounge area was reported to sometimes have up to 15 people present. We were told there was a second lounge in 1 of the properties but found this to contain staff belongings and did not see any tenants using this.

People received safe care because the provider had effective systems in place to safeguard people from abuse and avoidable harm. Staff understood how to identify and report safeguarding concerns.

People were supported to transition safely between services because the provider had robust systems in place to achieve this. This included pre-admission plans and hospital passports.

People had been supported to manage risks in relation to their care and support needs. Risk assessments were included in care records and updated when needed. Not all staff understood how to access these, but we were assured this had been addressed.

Staff had been recruited safely because the provider had followed their own robust recruitment processes. Staff had received mandatory training and bespoke training in relation to people’s specific needs. Staff rotas showed people received the support they were assessed as needing. Staff had regular support and supervision to support them in their roles.

The premises were safely maintained. The provider had systems in place to monitor the safety of the environment. The security of the premises had been a concern for some relatives. We raised this with the provider who addressed this.

Some infection prevention control measures were not fully effective. We received concerns from relatives about out-of-date food, soiled linen and unclean cutlery. Personal protective equipment (PPE) was available for staff to use and was kept in people’s own rooms.

Medicine management had not always been optimum. People ordered medicines individually and on occasions, they had not received them from the pharmacy in time. This was not always in the control of the provider. Systems in place to maintain clear oversight by managers were not always effective. The provider was working with health partners to address this.

People were supported to make decisions in relation to their care and support. Where people lacked the capacity to do this the provider ensured they followed the legal requirements in the Mental Capacity Act and Best Interest process.

People’s needs had been holistically assessed with input from people, their relatives and other professionals. People’s needs were reviewed and updated.

People’s health needs had been assessed with input from health professionals. Where people had specific health conditions staff had received training to support people to manage them. People were supported to attend opticians, dentists and additional routine health screening. People were supported to eat and drink enough. People were able to choose what they ate. Some relatives felt the quality of food available could be improved.

The provider monitored people’s care and treatment and supported them to achieve positive outcomes. This included increased exercise for 1 person and significant reductions in medicines for another.

People were supported by caring staff who understood the importance of kind and respectful support. Care records were person-centred and included detailed information about what was important to individuals. People were encouraged and supported to be as independent as possible. People were supported to interact socially and to maintain long standing relationships with their peers.

Staff wellbeing was important to the provider who had assistance programmes in place for staff. Staff told us they felt valued and respected at work.

People received person-centred care which reflected their preferences and routines. People’s communication needs were assessed, and communication guides were included in care records which helped people express their views. Information was available in easy-read versions. People were listened to and could express their views through meetings and forums. Feedback from relatives identified communication could be better. The provider was in the process of consulting with family members during the assessment. Complaints had been responded to though some relatives were not always confident of the outcome of complaints.

The provider was committed to achieving equitable access and experiences for people. Support plans were highly bespoke and personalised. People were supported to set and achieve goals and maintain access to activities. Some relatives felt these opportunities could improve.

Where they wished, people and their family members were supported to make future plans and consider important life decisions.

The provider had clear values based on creating meaningful and fulfilled lives for people. Leaders sought to embed these values in people’s experiences. The registered manager embodied the values of the organisation and staff praised their skills and found them to be approachable. Comments included, “I feel I can approach the manager, and they will take me seriously.” And, “If you feel disrespected you can raise it with the manager and they will address it; they always speak with you nicely.” And, “My colleagues are respectful and managers value and respect me.”

People were able to speak up about their concerns and said they would be listened to. Some relatives felt communication needed to improve in response to things they had raised.

The provider had a clear governance system in place to consider the quality of all aspects of care and support provided. There was a framework in place to support registered managers achieve good oversight of quality issues. Regional managers visited the service regularly to support the registered manager and team.

Regular audits had been completed but had not identified the concerns raised by relatives. The provider had reinforced expectations with the staff team. The provider ensured staff were clear about their role and necessary tasks were identified.

The provider worked effectively with partners and had been working closely with commissioners and health professionals in relation to quality issues.

The provider encouraged continuous professional development and learning. Leaders and staff were able to attend conferences within the organisation.