Purple Care TM

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

Improvements were required about how incidents of behavioural distress were analysed to ensure learning opportunities were not missed. The management team were aware of this and were working with external professionals. The provider had recently appointed a behavioural specialist to join the management team, they were in the process of reviewing people’s positive behavioural support plans and taking a lead on analysing incidents. Staff were trained and understood their responsibilities to safeguard people from the risk of abuse. Risks posed to people were overall, effectively assessed and managed. Whilst we found guidance could be more detailed in some places, staff were knowledgeable about people’s individual needs and potential risks and how to manage these safely. Systems were in place to ensure people were supported to maintain a safe environment. People received their prescribed medicines when required and had their medicines reviewed. Infection prevention and control policies and procedures were in place to protect people from the risk of infections.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Overall relatives were positive about how well staff supported their loved ones during times of increased anxiety and behavioural incidents of distress. Relatives confirmed they were informed when incidents had occurred and of actions taken to reduce further risks. A relative said, “Yes, I’m informed when incidents occur, I see [name] most weeks and they [staff] update me all the time. They call me as well to let me know if anything happens when I’m not there.” The provider was aware of some relatives concerns and were working with relatives and external professionals to address these.

Staff were positive about the learning culture; they felt well supported by the management team and confirmed training they had received, including from external professionals, that had been beneficial and supportive. Staff confirmed there was an open and honest culture amongst the staff and management team. A staff member said, “Yes, the office here is open for us. I will always seek advice. The app (electronic care record) has all the ABC charts and incidents we complete, the families have access to the app so they can see what happened.” Another staff member said, “Management and colleagues share issues openly and this includes with outside professionals. We also have close involvement with relatives."

External professionals were consistently positive about the learning culture, communication and partnership working with the management team and staff. A professional said, “Management at Purple Care are very willing to work collaboratively with us as a team and recommendations we provide have been acted on to the best of my knowledge. Communication is frequent and comprehensive updates are provided for all people.” Another professional said, “I have provided training sessions for the staff team regarding a named individual. The whole team were attentive and raised poignant questions to provoke discussion within the group. This allowed me to facilitate a very cohesive training session, and the team were able to share the challenges they have come across while working with this individual and thus problem solve these as a team to create a very holistic approach to their support methods."

Systems were in place to monitor accidents and incidents, and the registered manager reported notifiable incidents to the relevant agencies. However, improvements were required about how incidents of behavioural distress were analysed to enable further understanding and learning opportunities. Actions following incidents such as de-brief meetings and information sharing with staff also needed to be strengthened. The management team were working with external professionals to make improvements and these needed time to become fully embedded.

Relatives were overall positive about how their loved ones transition plan was planned and organised. This included how external professionals supported them and their loved one, in making decisions about their care and support needs. Whilst 1 relative told us they had concerns how the transition for their relative had been managed, others told us this had been a positive experience and well planned. A relative said, “We had conversations with Purple Care manager and provider who shared extensive information and provided reassurance. We asked a lot of questions. The managers were very open and very helpful. We went to visit with family member, they liked it straightaway. I have no concerns about their care. We have noticed their progressing. The family are shocked at the progress."

Staff were aware of the importance of sharing information between services, including when a person transitioned between services. A staff member said, “I supported a person during their transition to the service over 5 to 6 weeks. This included shadowing staff at the previous placement and receiving specific training from the intensive support team. The process was good, organised and structured."

External professionals were extremely positive about how well the management team worked with them, relatives and people in ensuring people transitioned to the service safely, and took account of people’s individual needs, preferences and routines. A professional said, “One of my service users moved into Purple Care with a very robust planned transition, Purple Care were flexible, worked with multiple agencies and achieved a perfect transition for this service user. Since moving in they have settled very well, and have reduced incidents, less behaviours of concern, more access to the community, and it is less restrictive than the residential placement where they lived previously.” Another professional said, “The assessment and transition process with Purple Care has been thorough, with Purple Care always being open to work with other professionals. They take the time to get to know each individual, ensuring that all their needs are accounted for before a plan is put in place. The team demonstrates exceptional professionalism and care in making the transition as smooth as possible, which is crucial for individuals with complex needs."

The provider had systems and processes that supported continuity of care. Pre-assessment and transition pathways were planned and bespoke to people’s individual care and support needs, and developed with external professionals, including relatives. The management team considered people’s suitability to share communal spaces and safety of the environment. Information sharing procedures were in place, this included the use of hospital passports and grab sheets used to ensure others, such as ambulance and hospital staff were aware of important information.

Relatives confirmed they were aware of safeguarding procedures and overall relatives told us they had no safeguarding concerns. A relative said, “Yes, we have been informed about safeguarding procedures, but we’ve not had any safeguarding concerns.” The provider was aware of some relatives concerns and were working with relatives and external professionals to address these.

Staff had received safeguarding training and had access to the provider’s safeguarding and whistleblowing procedures. Staff understood their role and responsibilities in keeping people safe from harm and abuse. A staff member said, “My responsibilities is to safeguard people who use our services from suffering any form of abuse or improper treatment while receiving care and treatment. Improper treatment includes discrimination or unlawful restraint. It’s protecting every individual from neglect or abuse, making sure everyone receives support in their everyday needs and making sure their wellbeing is promoted."

Observations were limited, however, people appeared relaxed in the company of staff and interactions were positive. Staff clearly knew people well including their routines, preferences and what was important to them. Staff picked up on and responded effectively, when people required assistance and or reassurance.

The provider had policies and procedures that supported safe practice. This included staff receiving refresher safeguarding training in how to spot potential abuse, and the actions required of them to report any concerns. Systems were in place to monitor safeguarding concerns, and notifiable incidents were reported externally as required. The registered manager monitored community Deprivation of Liberty Safeguards application submissions and authorisations granted.

Overall, relatives were confident risks were assessed and managed well. A relative said, “Yes, everything is fine with how risks are managed, they [staff] always tell me if things happen.” Another relative said, “They, [staff] know [name] very well, [name] is very complex, staff can tell their mood and can minimise any behaviours well.” The provider was aware of some relatives concerns and were working with relatives and external professionals to address these.

Staff confirmed guidance about how to manage and mitigate risks were sufficiently detailed. They were positive about the support provided from the management team and they reflected on the support they received from external professionals. A staff member said, “The intensive support team is involved and have provided training, support and guidance with how to support [name]. There is a MDT (multi-disciplinary team) approach before final decisions are made."

Observations concluded staff knew people’s individual care and support needs, routines and preferences well. We saw staff were able to anticipate potential risks and how they were able to effectively manage these using a calm manner and approach. Staff’s approach to distraction techniques in response to an increase in a person’s anxiety, reflected their care plans and risk assessments. We saw people had access to all parts of their living environment. People were offered choices to access the community with staff, staff were organised and planned for any potential risks.

The provider had systems and processes to assess, monitor and review risks, this included positive risk taking. Staff had received accredited training in positive behaviour support (PBS) and in restrictive physical intervention (RPI). Care plans and risk assessments provided staff with guidance of how to manage known risks safely. Overall, guidance was detailed and person centred. We identified some guidance that could be more detailed, and the registered manager took immediate action. However, staff were knowledgeable about people’s needs meaning this was a recording issue. Care records confirmed the use of RPI was low level interventions and were infrequently used and as a last resort. The provider had emergency plans to support staff such as managing fire risks.

Overall, relatives told us how their loved ones were supported to maintain their tenancy, to report any repairs and manage environmental health and safety. Where concerns were raised, the registered manager and provider were working with relatives and external professionals.

Staff told us how they supported people to maintain health and safety. A staff member said, “Staff complete daily cleaning, laundry, every Tuesday we check fire alarms, the management team carry out their check monthly. Food stocks are checked; fridge / freezer checked. We also check dates on foods."

We observed a safe environment, clean and in good repair.

Purple Care TM is a supported living service, CQC do not regulate the premises. Premises are the responsibility of the landlord. Systems were in place to ensure the premises were safe and procedures to report any housing repairs. The provider had a business continuity plan that detailed how the service would respond to untoward events, impacting the safe running of the service.

Overall, relatives were positive and complementary about the staff that supported their loved one. Relatives confirmed their loved one received the staffing levels they had been assessed as requiring. Positive comments were shared about staff’s competency and approach. A relative said, “Staff are brilliant, they’re very calm and they’ve been with [name] for 8-9 years.[Name] likes the staff, they trust them.” Another relative said, “Yes, [name] always got 2 staff with them all the time, and 3 staff when they go out in the car because of their condition, they’re very nice. I have no concerns or complaints about staff.” The provider was aware of some relatives concerns and were working with relatives and external professionals to address these.

Staff confirmed what recruitment checks and procedures were completed before they commenced their role. Staff were positive about their induction, ongoing training, support and development opportunities. A staff member said, “Checks on my employment history, references, DBS and ID were all completed before I started. There’s a lot of training, the management team emphasise it’s very important to complete training and understand it before providing care. Supervision is regular and very helpful; we can ask anytime to meet with the manager. An appraisal is yearly."

Our observations confirmed people had the right numbers of staff supporting them as assessed. The staff rota matched staff on duty. Staff spoke confidently and knowledgably about people they were supporting.

The provider had safe staff recruitment, including an induction, ongoing training and support procedures. The staff training matrix confirmed staff received a wide variety of training and compliance was good. Records confirmed staff received supervision 3 monthly, a yearly appraisal and spot checks.

People were supported to maintain cleanliness and hygiene of their living environment. Relatives overall confirmed staff supported their loved one to maintain a clean environment. Relatives confirmed people wore personal protective equipment (PPE) when required.

Staff confirmed they completed refresher training in infection prevention and control (IPC) and food hygiene. Staff told us they had ample supply of personal protective equipment (PPE) and how they would reduce the risk of infection. A staff member said, “We receive IPC training, and spot checks are completed by the management team. We have PPE and use it when providing personal care and when preparing meals. If there was an outbreak, it should be easy to control as people have their own accommodation."

We observed staff following infection prevention and control best practice guidance, this included wearing PPE as required.

The provider had systems and processes to safely manage infection prevention and control. The provider had an infections prevention and control policy and procedure and ensured staff completed refresher training in IPC and food hygiene. Procedures were in place to monitor staff practice such as staff spot checks and IPC audits were completed.

Overall, relatives told us their loved one received their prescribed medicines safely. One concern was reported, and this was shared with the person’s external professional to investigate, and the provider informed who also followed this up.

Staff confirmed they completed annual medicines training, including having their competency assessed. Staff understood the principles of STOMP (stopping over medication of people with a learning disability, autism or both).

We observed people receiving their prescribed medicines safely.

The provider had systems and processes to order, store, administer and manage medicines. People’s allergies were accurately recorded. When medicines were administered covertly (disguised in food or drink), this was carried out in the person’s best interests with appropriate authorisation and pharmaceutical advice from a healthcare professional to ensure it was safe. Care plans contained information about how people liked to take their medicines, however, was limited in other detail, for example why people were taking their medicines. Staff also did not always understand how to access medicines related information for individuals on their electronic devices. Improvements were required to ensure medicines were consistently stored safely. Whilst this had had no impact on people, we did raise this with the registered manager who took immediate actions.