Specialist Support Services for Younger Adults with Disabilities North improved from Requires Improvement to Good across all inspected key questions (safe, effective, responsive, well-led), having resolved previous breaches of Regulations 12, 17, and 18. The service demonstrated robust risk management, safe staffing, personalised person-centred care, and strong governance systems aligned with Right Support, Right Care, Right Culture guidance.
Strengths
· Risks were comprehensively assessed and regularly reviewed, including beds, bedrails, wheelchairs and hoists, with all relevant safety checks in place.
· Staffing levels improved significantly since last inspection; sufficient staff deployed to cover care calls without management needing to cover care calls themselves.
· Safe recruitment systems in place including employment references, ID checks, and DBS checks.
· Medicines administered safely by trained staff with accurate MAR records and management audits.
· Staff received excellent training including the Care Certificate induction, and felt well-equipped and supported in their roles.
Quality-Statement breakdown (20)
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood
Specialist Support Services for Younger Adults with Disabilities North was rated Requires Improvement overall following a September 2021 inspection, with regulatory breaches identified in safe care and treatment (Regulation 12), staffing (Regulation 18), and good governance (Regulation 17). A significant shortfall of 35 full-time staff drove cascading failures across risk assessment, medicines management, care plan currency, and person-centred responsiveness, while caring remained rated Good.
Concerns (8)
criticalStaffing levels: “The service was running on 35 full time vacancies at the time of inspection. Staff had been asked to work when on annual leave and on days off.”
criticalMedication management: “Transcribed medicine administration records (MAR) had not been signed by two staff to ensure the information recorded was identical to the prescribed dose.”
criticalCare planning: “One person had conflicting information recorded regarding how much thickener was required to mitigate the risk of choking. This put the person at risk of aspiration.”
criticalGovernance: “The provider failed to ensure adequate systems and processes were in place to assess, monitor and improve the quality and safety of the care provided.”
moderateRecord keeping: “Staff had not recorded the duration, time or presentation for one person who had experienced three recent seizures.”
moderatePerson-centred care: “People did not always know what staff were coming to support them or the times they were coming. 'They don't tell me when they are going to turn up.'”
moderateIncident learning: “Not all risk assessments had been updated or reviewed after an incident. One person's falls risk assessment had not been updated after the person had fallen.”
moderateMissed or late visits: “Due to the lack of staffing some calls had to be cancelled, reduced or times changed. A person was not able to return home after a hospital admission.”
Strengths
· Safeguarding systems were in place and staff had a good understanding of how to protect people from harm or abuse.
· Staff wore appropriate PPE and participated in regular COVID-19 testing; an updated infection control policy was in place.
· Safe recruitment practices were followed, including references and DBS checks.
· People described staff as kind, caring and helpful; dignity, respect and independence were promoted.
· Staff received appropriate training and induction including shadow shifts before lone working.
Quality-Statement breakdown (21)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
effective: Supporting people to eat and drink enough to maintain a balanced dietRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement
effective: Staff support: induction, training, skills and experience
Good
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesRequires improvement
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Promoting a positive culture; managers and staff clear about roles and quality performanceRequires improvement
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Duty of candourGood
well-led: Continuous learning and improving care; working in partnership with othersGood