Creative Support - Blackburn Services

Updated 3 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 comprehensive inspection took place on 13 and 14 November and was announced. The provider was given 48 hours' notice because the location provides a domiciliary care service to adults with a learning disability or mental health needs. We needed to be sure people who used the service, staff and the registered manager would be available to speak with us. The inspection was completed by one adult social care inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

We used the 48-hour notice period to speak by telephone with four relatives of people who used the service. This was to gather their views and opinions of the support their family members received.

Before our inspection we reviewed the information,we held about the service. This included notifications we had received from the provider,about incidents that affected the health, safety and welfare of people supported by the service.

We also checked to see if any information concerning the care and welfare of people supported by the service had been received. We contacted the Local Authority safeguarding team, the local commissioning teams and the local Healthwatch organisation to ask them about their opinion of the service. This helped us to gain a balanced overview of what people experienced accessing the service. Prior to our inspection of the service, we were provided with a copy of a completed provider information return (PIR); this is a document that asked the provider to give us some key information about the service, what the service does well and any improvements they are planning to make. This provided us with information and numerical data about the operation of the service.

On 13 November 2018, with permission, we visited five properties where people were receiving 24-hour support in a group living situation. We contacted three people who used the service,via telephone interviews and spoke with three people within their own homes. We also observed care practices and how staff interacted with people in their care. This helped us understand the experience of people who could not talk with us. We also spoke with the registered manager the service manager and six support workers. On 14th November 2018 we visited the registered office and spent time with the registered manager and service manager. We also contacted a selection of staff members by telephone and email to ascertain their views on the service and professionals involved with the service.

During the inspection we looked at care records of three people who were supported at the service. We looked at seven staff personnel files and reviewed a range of records relating to how the service was managed. This included recruitment records, staff training records, medication administration records, quality assurance systems and policies and procedures.

Updated 3 January 2019

This was an announced comprehensive inspection which took place on 13 and 14 November. At the previous inspection which took place on 10 and 11 February 2016, the service was rated as "good" in all five key areas (safe, effective, caring, responsive and well-led.)

Blackburn with Darwen and East Lancashire Domiciliary and Supported Living Scheme is part of Creative Support Ltd. The service is registered to provide 24-hour care and support to adults who have learning or physical disabilities or mental health needs. People using the service are tenants who live mainly in a variety of shared houses across East Lancashire that are staffed on a 24-hour basis. People's care and housing are provided under separate contractual agreements. The care quality commission does not regulate premises for supported living. This inspection looked at people's care and support. The service has been developed and designed in line with the values that underpin Registering the Right Support. These values include choice, promotion of impendence and inclusion. People with learning disabilities and autism using the service can live as ordinary life as any citizen.

At the time of this inspection there were a total of 47 people using the service.

The service had a registered manager in place. 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 service had built on their previous success and sustained the good model of support provided to people living within the service. Significant improvements since last inspection had been made and an outstanding rating in effective had been achieved. This was achieved by improving outcomes for individuals. The person-centred vision and the values of the service had been further developed and embedded into the culture of the service.

People told us they received personalised support which was responsive to their needs. Care plans were well written in a person-centred manner detailing how people wished to be supported. People's independence and choice was promoted. People who used the service were involved in regular person-centred reviews, in a format enabling them to be as fully involved as possible.

All staff we spoke with told us they loved their job, felt part of a good team and felt valued by their managers. The service had implemented Achieve Q awards which recognise and reward staff achievement. Staff told us they felt able to raise any issues of concern.

Comprehensive information and training was in place to guide staff in the most effective approaches which included positive behaviour support.(PBS) The service had supported people effectively and the number of people who required PBS interventions had reduced.

People who used the service had health action plans, hospital passports and dental passports in place. Records we reviewed showed that people were supported to attend health appointments where necessary. Staff were confident in challenging professionals if they felt people's health needs were not being met.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff had followed the code of practice in relation to the Mental Capacity Act 2005. (MCA)

People who used the service told us they felt safe with the staff who supported them. People told us there were always staff available to support them.

Systems were in place to record safeguarding concerns, accidents and incidents and appropriate action was taken when required.

Recruitment processes were robust and were carried out to ensure suitable people were employed to work at the service. The service made sure that people being supported were included in the interview process to recruit the most appropriate staff.

Potential risks to people's welfare had been assessed thoroughly and procedures put in place to minimise these. Risk assessments were holistic, robust and person-centred with the least restrictive option being considered.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. Staff told us they had received the appropriate training and support they needed to carry out their role effectively. All new staff received a comprehensive induction to the service.

Systems were in place to ensure the safety and cleanliness of all the premises where people who used the service lived. Systems were also in place to ensure that people's nutritional needs were monitored and met.

We observed positive interactions between staff and people who used the service. People told us the staff who supported them were kind and caring and enabled them to maintain their independence as much as possible.

Staff were empathetic and passionate about the people they cared for and treated them with dignity and respect.

All the people we spoke with told us they would feel able to raise any concerns with the managers in the service and were confident they would be listened to. An easy read complaints and compliments policy was in place.

The service was underpinned by a person-centred ethos and this was demonstrated throughout the service.