Social Care Solutions Ltd (Herts & Bucks)

“At the time of this assessment, there was no registered manager in post. The area manager had recently submitted an application to the Care Quality Commission (CQC), which remained under review. During our previous visit, one supported living service was led by an interim manager, while another had no active service manager due to absence. At this assessment, both service manager positions had been successfully appointed, providing greater stability in leadership to embed and sustain improvements with the support of the senior leadership team.”

“We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.”

“The provider had begun to make early, positive progress in stabilising leadership, improving communication, and strengthening daily oversight. Relatives told us people are now more consistently supported, with current staffing levels not impacting essential care such as medicines or health appointments. Leaders had reduced reliance on agency staff and recruited additional permanent workers, including drivers, to improve continuity and ensure people’s commissioned hours are met more reliably. Safe recruitment practices had also been followed.”

“Training completion, induction quality and access to specialist learning had improved, and staff confirmed they now received more consistent supervision, knowledge sharing sessions and competency-based discussions that enhanced their confidence and capability.”

“Although the safe management of medicines showed improvement, we continued to find gaps in PRN protocols, inconsistencies between MARs and pharmacy labels, and 1 instance of expired topical medication, indicating that oversight and stock rotation processes were not yet fully reliable. Recent increases in audit frequency, enhanced training, and better organised medicines files, supported by positive feedback from relatives demonstrated that the service was progressing towards a safer and more consistent medicines management.”

“The provider had strengthened its approach to consent and best interest decision‑making, with relatives being routinely involved where people lacked capacity. However, further work was required to ensure all MCA/BI decisions are decision specific, clearly documented, and that any restrictive practices, have the appropriate MCA and best interest decision processes in place. Evidence showed MCA forms were sometimes combined across multiple decisions or required further detail, and not all restrictions were fully supported by completed best‑interest assessments.”

“Although progress was clear, governance improvements were not yet fully embedded. Gaps remained in the reliability of audits, record ‑keeping, induction…”