The examples below provide insight into how other Good or Outstanding rated services are succeeding in this area of inspection.
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Using an internal team of positive behaviour specialists
The provider had employed an internal team of positive behaviour specialists that worked closely with people and their families to ensure support was safe and achieved excellent outcomes for people.
For example, people had dramatically increased their day to day freedoms, by staff understanding the purpose of behaviours and supporting people to communicate any distress in different ways. Senior managers and leaders continued to be visible in settings and staff were confident they could speak to any leaders about any ideas or concerns.
The CQC received excellent feedback from people and relatives about the support provided. Where any concerns were raised these had been addressed openly and positively by leaders through engaging with people and relatives.
Read more about this service here.
Care provider: Avenues South East
Date published: November 2022
Technologies to build confidence when travelling independently
In their inspection, the CQC saw numerous examples of people using public transport with assistive technology to help them remain safe. This included technology to summon assistance if needed, to track people's location with their agreement and examples of arrangements for people to build confidence by travelling independently and being met at their destination. This meant people had more freedom and independence whilst remaining safe at all times.
Care provider: Shared Lives Service - West Northamptonshire Council
Date published: November 2022
Working closely to manage risks around consensual relationships
Areas of vulnerability were identified and carefully assessed on an individual basis. Supportive and sensitive work was undertaken by carers and staff to support people to increase their awareness, knowledge and safety skills.
When a person told their carer they would like to have an intimate personal relationship in future, the carer undertook regular work with the person to help them understand about consent and consensual relationships, to help reduce the risk of the person's vulnerability being exploited and reduce the risk of potential abuse.
Care provider: Shared Lives Service - West Northamptonshire Council
Date published: November 2022
Using NICE guidance to manage risks
This service implemented specialised risk assessments based on NICE guidance for oral health, falls, pressure ulcers, diabetes, epilepsy and more. Implementing the people's experience in adult social care services guidance also supported risk assessments to be person-centred, recognising each person individually.
See also: NICE social care quick guides
Improving oral health for adults in care homes
Helping to prevent pressure ulcers
Care provider: Anonymous
Date published: January 2022
How we developed Positive behavioural support skills
In this three-minute audio clip from the Care Exchange podcast, Joseph Hughes explains how they identified the appropriate training and developed expertise.
You can listen to the full podcast here and access our latest episodes of The Care Exchange here.
You can read more about this service here.
Care provider: City Care Partnership
Date published: March 2021
Supporting people to take positive risks
Shortly before the COVID-19 pandemic started, we helped support a person to obtain a phone contract. He doesn’t have money himself because he’s very vulnerable, but as a service we worked closely with him and the company that manages his financial affairs, to risk assess this need and provide support.
We developed easy-read resources so that he could understand the financial implications of taking on a mobile phone contract and how this may impact his money to spend on other things. This support enabled us to facilitate him to have capacity around that decision. This documentation was important in convincing those managing his finances that the phone contract was his choice.
The benefits of the phone contract were considerable. He was a big football fan so it meant he could use his phone to watch the football, and he was able to contact his girlfriend more. Even before COVID-19 it made a difference to his life, but as we went into the pandemic it helped him to keep connected throughout the lockdown and beyond.
It sounds like a small issue, but for him, the impact it’s had and the things it’s enabled him to do are amazing. While you may not think people can have this sort of thing because they don’t have capacity, if you work through the right processes, you’ll find that they can have them.
Read more about the service here.
Care provider: Castle Supported Living
Date published: December 2020
Assessing risk from the start
The process of assessing and managing risks to people living at Davers Court began before they moved into the service. As part of the pre-admission assessment, people were asked what they’d like to do to maintain their independence. This was incorporated into the care plan with relevant risk assessments.
People were always actively involved in managing their own risks along with their relatives. For example, one person wanted to go to the local shop on their own but there were concerns as to whether they’d be able to find their way back to the service. Staff began by walking to the shop with the person. As they got more confident in their route, staff would follow them rather than walking with them. The person is now able to walk to and from the shop on their own.
The service had procedures in place to pro-actively manage the ongoing risk, for example using the Herbert Protocol. This is a national initiative which contains vital information about the person should they not return to the service. The person is now able to engage in an activity which they enjoy, with the risk being effectively mitigated.
Read more about the service here.
Care provider: Davers Court (Care UK Community Partnerships Ltd)
Date published: March 2020
Imaginative approaches to keeping people safe
The service worked creatively with people using imaginative and innovative ways to understand their wishes. Staff invested time in educating and reminding people what being safe really meant and this contributed to people's wellbeing.
For example, staff and people at one property had a discussion and interactive roleplay around stranger danger. This posed questions and scenarios which people were involved in, learnt and benefitted from.
Read more about this service here.
Care provider: Creative Support - Doncaster Personalised Services
Date published: February 2020
Living restriction free
The service actively sought out technology and other solutions to make sure that people lived with as few restrictions as possible. For example, one person had a voice reminder sensor installed.
The person needed reminding to wash their hands after using the toilet, but they’d become frustrated at being reminded which had led to becoming a trigger for challenging behaviour. The voice reminder was installed and delivered a message regarding hand washing when the door was activated. On hearing the message, the person will now turn around, wash their hands and continue with their day, without frustration and raising anxiety from staff intervening.
Read more about the service here.
Care provider: Creative Support - Doncaster Personalised Services
Date published: February 2019