Creative Support - Doseley Road

Creative Support Doseley Road is a care home providing care and support to autistic people and people with a learning disability. At the time of our inspection the home was providing personal care to three people. The service can support up to five people. Doseley Road accommodated people in one adapted building, there were communal rooms and a large garden for people to enjoy.

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:

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.

People received care and support in a safe, clean and well-maintained environment. This met their sensory and physical needs, whilst making it feel homely.

People had choice and control in their living environment. People chose how they wanted to spend their day. Staff encouraged people to make their own decisions and take positive risks.

People personalised their home and bedrooms in their own personal style. Some people chose to have a key to lock their bedroom door when they were in their bedroom. Choices were respected by the provider and staff team.

Relatives told us staff had in-depth knowledge about their family members and developed meaningful relationships with their family member, based on trust and mutual respect.

Staff told us how to communicate with people. They had detailed understanding of the way people chose to communicate. Staff members told us to stop attempting to communicate with people when they saw signs people were becoming anxious. It was clear staff put people’s wellbeing first, above anything else occurring in the home.

Staff supported people with their medicines in a dignified and safe way. They ensured people's privacy was respected when they received their medication.

Right Care:

People’s needs, aspirations and quality of life was the main focus of care and support. Staff members told us they were there to support people to live their own life and visiting health professionals confirmed this, adding how the provider strived to ensure people lived their own lives free from restrictions.

Staff understood how to protect people from poor care and abusive practices. All staff had received safeguarding training and they were confident to raise concerns.

There were enough appropriately skilled staff to meet people's needs and keep them safe. Staff had been recruited safely.

Relatives felt the care received was kind and compassionate. The provider worked with advocacy services to ensure people’s voice was heard.

Visiting professionals told us how the registered manager was driven in proving the highest quality of care which produced the best opportunities for people using the service.

Right Culture:

Staff member's said the registered manager was a great leader. A leader who focused on the rights of the people using the service and acted as a positive role model, leading by example to the staff team.

Staff members told us they felt they worked in an inclusive environment which focused on high quality support for people who used the service.

Health and social care professional praised the management and leadership qualities of the registered manager. Explaining the registered manager works openly and transparently to achieve the best outcomes for people.

Relatives felt included in the service and told us they could raise concerns or make suggestions freely.

The culture of the service was open and transparent. Incidents and accidents were shared with the staff team in order to learn from mistakes and improve the service.

Innovative ideas and suggestions were acted upon to ensure all person's using the service received inclusive care and could access the community regardless of physical difficulties.

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 requires improvement (published 27 November 2020).

Why we inspected

We undertook this inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed to seek assurance about this decision and to identify learning about the DMA process.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Doseley Road is a registered care home for adults with learning disabilities. At the time of our inspection the home was providing personal care to four people. The service can support up to five people. Doseley Road accommodated people in one adapted building.

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

Since our previous inspection significant improvements had been made to the home. We found infection control risks had been mitigated and the premises was well maintained. The kitchen had been refurbished and people were supported to prepare and cook their meals. The provider had made improvements to ensure cleaning chemicals used in the home were risk assessed to ensure people’s safety.

Since our previous inspection the service had made improvements to deliver care in line with the principles of the Mental Capacity Act 2005 (MCA). 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.

Improvements had been made to the governance systems since our previous inspection, which were now effective in identifying improvements to the service. Since our previous inspection the service now had a registered manager, who had made positive changes to the home.

The provider had made improvements to people’s risk assessments and to the management of medicines in line with policies and procedures. Staff received training on recognising and reporting abuse, so people were protected from the risk of potential harm.

People’s needs were assessed, and care was delivered in line with best practice. Care plans were person centred and included healthcare professionals’ input when required. People were supported by staff who were safely recruited, trained and had the skills to care for people’s needs. People were supported by staff to eat and drink sufficient amounts to promote their health. Staff worked in partnership with other healthcare organisations to meet people’s needs effectively. The home was adapted to meet the needs of the people living there.

Staff promoted a positive culture which was person-centred and open. The provider supported staff to be open and honest when things went wrong, and incidents were investigated fully to learn and improve. People, public and staff were involved in the service. Management worked together with people’s families and healthcare organisations.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, 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 providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The care and home was adapted to supported people’s choice, control and independence. Care plans demonstrated person-centred care and people’s dignity, privacy and human rights were promoted in their support plans and day to day routines. The culture within the home filtered from leaders to care staff and they demonstrated values and behaviours which promoted inclusivity and empowered the lives of the people living there.

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 requires improvement (published 30 April 2019) and there was multiple breaches of regulation. We issued a warning notice against the provider of Doseley Road. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 27 February 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, need for consent and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

We looked at infection, prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

People’s experience of using this service:

People did not receive care and support that was delivered in line with the Mental Capacity Act. There was no evidence that people's capacity had been assessed and best interest meetings had been held.

Governance systems were not effective at identifying and acting upon necessary improvements.

Risk assessments were not always completed to the standard required and key information was found to be lacking.

The property had not been maintained to a standard that prevented impact on the people living there. Infection control risks were increased due to work not being undertaken.

People received their medicine on time by trained staff however, missed signatures on the medicine administration records had not been highlighted

There was not a registered manager in post at the time of inspection.

Accident and incidents forms were reviewed by the provider.

People were supported by a team that worked together although concerns were raised about the volume of agency staff that had been used.

People were supported by staff who had been safely recruited.

Staff members sought advice from other professionals when necessary.

People had access to activities although there had been a reduction in the range and frequency of activities due to staff issues.

People were supported to access healthcare.

People were treated with kindness and respect and involved in day to day decisions. Although this was impacted by agency usage if the agency worker did not know the people.

People were supported to have a balanced diet.

People were supported by a staff team that had received training relevant to their role.

People were safeguarded from the risk of abuse

People had access to a complaints process but relied on others to raise concerns on their behalf.

People’s end of life wishes had been considered.

The provider worked alongside people’s families and the local authority.

More information is in the full report

Rating at last inspection: This was the first inspection of this home under its current provider therefore there was no previous rating.

Why we inspected: This was a planned comprehensive inspection, however we had received some concerns regarding the staffing levels in the home.

Enforcement: Please see the action we have told the provider to at the end of the end of the report.

Follow up: We will continue to monitor the home and the required improvements.