Creative Support - Leicester Service

Creative Support - Leicester Service is a supported living service. People live in the community in single or shared accommodation. Staff provide onsite 24-hour care. People receiving support are living with a learning disability, and or autism, and some people have a physical disability and health conditions.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection, 25 people were receiving the regulated activity of personal care.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

Right Support: One Supported Living site provided staffing in accordance with the care commissioned by the local authority. However, we concluded this was not sufficient due to people’s care needs. The provider agreed to immediately increase staffing whilst they completed a review of staff deployment. People received individual care, their independence was promoted, and goals and aspirations were supported. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care: People received care and support that was personalised and provided by a staff team who were well trained and supported. People were enabled to achieve positive outcomes and social inclusion was promoted, enabling people to lead active and fulfilling lives.

Right Culture: There was a shared commitment to the culture and values of the service. Positive staff engagement was observed. Feedback received from relatives was consistently positive about the leadership and management of the service. Staff were equally positive about working for the provider and they felt well supported. The registered manager understood their role and responsibilities. There were effective systems and processes in place to continually review, monitor and improve quality and safety.

People were supported to maintain their tenancy, including monitoring environmental health and safety.

Staff were safely recruited and provided consistently and continuity in care. Staff received ongoing training that included areas of care and support, individual to the person.

Staff understood how to recognise where people may be at risk of harm or abuse and knew what action to take. People received support to take medicines and systems were in place to ensure this was completed safely and effectively.

Staff had received training in the management and best practice guidance of infection prevention and control.

People and their relatives, were supported and invited to share their experience about the service. The staff worked well with external agencies and health and social care professionals, in supporting people with their ongoing care and support needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 5 December 2017).

Why we inspected

Concerns were raised about staffing.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for this service has remained good based on the findings of this inspection.

We found evidence during this inspection that 1 supported living site, did not have sufficient staff. The provider took immediate action and increased staffing. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Creative Support - Leicester Service on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the last comprehensive inspection on 14 July 2016 we rated the service as requires improvement overall. The safe and well-led domains were rated as requiring improvements. We returned to the service and inspected the well-led domain on 13 October 2016 and rated this as good.

Creative Support – Leicester service provides personal care to adults with a range of needs including people with a learning disability living in their own homes. At the time of the inspection there were 29 people using the service.

At the time of our inspection there was a manager registered with the Care Quality Commission. However, they had recently left the service. A new manager had been appointed the week of the inspection and was undergoing pre-employment checks. There was an interim manager in place who had applied to add the location to their existing registration with CQC and who was registered to manage a different location (locality manager). It is a requirement that the service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People and their relatives told us that they felt safe while they received support from staff at Creative Support – Leicester. Staff understood their responsibilities to protect people from abuse and avoidable harm and to remain safe. There were procedures in place to manage incidents and accidents.

Risks associated with people’s support had been assessed and reviewed. Where risks had been identified control measures were in place to protect people’s health and welfare. Checks had been completed on equipment that people used and the environment to ensure they were safe.

There were enough staff to meet people’s needs. They were recruited following the provider’s procedures to make sure people were supported by staff with the right skills and attributes. Staff received appropriate support through an induction and regular supervision. There was training available for staff to provide and update them on safe ways of working.

People received support with their prescribed medicines from staff who had completed training in how to administer medicines safely. Guidance was available to staff on the safe handling of people’s medicines.

People were encouraged to follow a balanced diet. We saw that people chose their own meals and were involved in making them. People were supported to maintain their health and well-being. This included having access to healthcare services such as to their GP.

People were supported to make their own decisions. The locality manager had an understanding of the Mental Capacity Act 20015 and Deprivation of Liberty Safeguards. Staff told us that they sought people’s consent before providing support.

People were involved in decisions about their support. They told us that staff treated them with dignity and respect. We saw that people’s records were stored safely and staff spoke about people’s support requirements in private.

People were supported to develop skills to maintain their independence. Support plans contained information about people, their likes, dislikes and preferences.

People were supported by staff who they knew well and who they felt listened to them. They received support that was centred on them as a person.

People and their relatives knew how to make a complaint. The complaints procedure was available so that people knew the procedure to follow should they have wanted to make a complaint.

People and staff felt the service was well managed. The service was led by a locality manager who understood the responsibilities of a registered manager under the Care Quality Commission (Registration) Regulations 2009. Staff felt supported by the management team.

People and their relatives had opportunities to give feedback about the quality of the service that they had received. Systems and processes were in place so that checks were carried out on the quality of the service that was delivered.

After the comprehensive inspection the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

We undertook this announced focused inspection 13 October 2016 to check that they had followed their plan and to confirm that they now meet legal requirements. This report only covers our findings in relation to the requirement. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Creative Support (Leicester) on our website at www.cqc.org.uk.

Creative Support (Leicester) provider social care services for people with learning disabilities, autistic spectrum disorders, and mental health needs. It is registered as a domiciliary care service and a supported living service.

This was an announced inspection that took place on 14 July 2016. At the time of our inspection there were 48 people using the service.

A registered manager is in post. 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.

Since we last inspected the registered manager had promptly informed us of all changes, events and incidents affecting the people using the service. Appropriate action had been taken following each incident and, where necessary, lessons learnt. This showed the service had an open and positive culture.

Staff had had further training in incident reporting and safeguarding (protecting people who use care services from abuse). They had attended a series of training events, presentations, and workshops to ensure they understood their safeguarding responsibilities and knew how to balance people’s freedom to make choices with the need to keep them safe.

Other improvements had been made to the service. The registered manager had introduced a ‘positive outcome form’ to support people using the service in achieving specific goals. Records showed this had proved successful with, for example, one person facilitating their own care review, and another organising a party.

A new system of audit had also been introduced for the ten houses where staff provided care and support to people. The registered manager visited each residence every three months, checked records, and talked with those who lived and worked at the residence to get their views on the service provided.

Quality assurance questionnaires had been sent out to relatives and staff by the registered manager and ourselves. The responses received so far showed that relatives and staff were satisfied that the service was providing high-quality care.

Creative Support (Leicester) provider social care services for people with learning disabilities, autistic spectrum disorders, and mental health needs. It is registered as a domiciliary care service and a supported living service.

At the time of our inspection there were 48 people using the service.

The service has a registered manager. This 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.

People told us they felt safe using the service. Staff were trained in safeguarding and the provider had safeguarding policies and procedures in place to help ensure staff protected people from abuse. However these hadn’t always been followed and the provider hadn't always notified us of serious incidents involving the people using the service.

There were enough staff employed to meet people’s needs and support them to go out into the community and take part in activities. Staff were safely recruited and people using the service took part in interviewing prospective staff members to help ensure they were suitable to work at the service.

Staff had access to a wide range of training courses to help ensure they had the skills and knowledge they needed to support people effectively. Records showed that good practice and developments in learning disability care were discussed with staff with a view to making ongoing improvements to the quality of the care provided.

People told us the staff were caring, looked after them well, and were kind to them. They told us staff encouraged them to be independent and respected their privacy. One person said they had their own keys to their house and this made them feel happy. Another person told us about the skills they had learnt since using the service.

Care plans were personalised and included individual profiles to help staff get to know people and understand their needs. A number of people using the service communicated non-verbally and staff used a variety of methods, for example pictures and symbols, to help ensure they had a say in how their support was provided.

People took part in a range of activities in their houses and in the local community. The service also put on events, for example an art competition, to get people together and create a sense of community. People’s family members and friends were encouraged to visit people in their houses and attend social occasions.

People were encouraged to make their views known if they had any concerns about the service.

We saw that when a complaint had been made this was dealt with promptly, action taken as necessary, and the complainant made aware of the outcome and what had been done to put things right.

The culture of the service promoted personalised support and involved people in how it was run. The registered manager and service director knew the people using it by name and had a good understanding of their abilities and needs. The service centred on people’s well-being and enjoyment of an active life.

People using the service, relatives, and staff were asked for their views at one-to-one and group meetings and through regular surveys. The provider listened to people and took action to make improvements where necessary. They also carried out audits to help ensure the service was providing quality care and support.

You can see what action we told the provider to take at the back of the full version of the report.