Creative Support - Bolton Service

Updated 21 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 25 July 2018 and was unannounced. The inspection was carried out by one adult social care inspector and one assistant inspector. At the time of the inspection the service was supporting ten people to live in their own homes.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and which improvements they plan to make. We checked the information we held about the service and the service provider. This included statutory notifications sent to us by the registered manager about incidents and events that had occurred at the service. A notification is information about events which the service is required to send us by law. We used this information to decide which areas to focus on during our inspection. We contacted the local Healthwatch organisation and the Local Authority Commissioning team to obtain their views about the provider. No concerns were raised about the service.

During the inspection we spoke with the service director, the registered manager, the positive behaviour support practitioner (PBS), six members of staff and five relatives. We spent time

at the office and looked at care records, staff recruitment, staff training and supervisions and records about the management of the service.

We also contacted several health and social care professionals after the inspection visit. They had no concerns to share about the service.

We visited all the supported tenancies to meet people using the service and talk to staff. We looked at medication records for four people and inspected how medicines were managed at each supported tenancy.

Updated 21 August 2018

Creative Support – Bolton Service supports people with Autism Spectrum Condition (ASC) and challenging behaviour, in their own home, providing personal care in line with a supported living model. People who use the service have their own tenancies and receive their support from staff employed by Creative Support.

This inspection took place on 25 July 2018. The provider was given 48 hours' notice of our intention to visit. This was because we needed to ensure there would be someone present at the office to facilitate the inspection.

We were assisted throughout the inspection by the registered manager and three project managers. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager at Creative Support – Bolton Service had been registered since October 2011.

We spoke with a number of people during the inspection including relatives, staff and community professionals. People who used the service had limited means of communication and were unable to share their experiences. People who used the service relied on families or advocates to support them with decision making.

The service was last inspected on 18 May 2017 and was announced. The service was rated as Requires Improvement.

At the last inspection we found procedures were in place to manage people's medicines safely. However, these had not always been followed, which had resulted in some errors being made with medicines on several occasions. Arrangements for the safe recording and administration of people's medicines required improvement to ensure people were protected from the risk of unsafe medicines management.

This was a breach of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At this inspection we found that medicines management had improved and systems were now safe. The service had sought advice around medicines management from a healthcare professional external to the organisation and had incorporated a new system for auditing medicines.

Mandatory training had been completed by all staff.

There were systems and processes in place to protect people from harm. Staff had a good understanding about the signs of abuse and were aware of what to do if they suspected abuse was taking place.

The service had developed positive working relationships with health and social care professionals which led to joint working to expand people's communication skills.

A robust system for staff recruitment, induction and training was in place. This enabled the staff to support people effectively and safely.

People's needs were assessed before using the service and on an ongoing basis to reflect changes in their needs. Clear and well thought out arrangements were in place for people moving into the service which helped to significantly reduce possible anxiety about this change.

There were enough staff so people could take part in the activities they wished and be supported in meeting their individual needs. People had access to activities that were important and relevant to them, both inside and outside their home. People were protected from social isolation because of the support and range of opportunities offered by staff.

We observed positive relationships and observed the management team and staff interacting with people in a caring, good humoured and friendly manner. Management and staff demonstrated insight and understanding of people's personal preferences and needs.

The service had been developed and designed in line with the principles that underpin the Registering the Right Support and other best practice guidance; these values include choice, promotion of independence and inclusion. This policy asserts that people with learning disabilities and autism using a service should live as ordinary a life as any citizen. This policy can be found on the Care Quality Commission website.