Creative Support - High Street

Updated 19 June 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

One inspector carried out this inspection.

Service and service type

Creative Support High Street is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, Healthwatch and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service about their experience of the care provided. We spoke with five members of staff including the director, registered manager and care workers.

We reviewed a range of records. This included three people’s care records and two people’s medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two health and social care professionals who regularly visit the service and one relative about their experience of the care provided.

Updated 19 June 2020

About the service

Creative Support High Street is a residential care home providing personal care for up to six people. It is registered to support people, with a learning disabilities or autistic spectrum disorder, living with dementia, a physical disability, a sensory impairment, younger and older people. At the time of inspection there were six people using this service. Six people were living at the service at the time of the inspection.

The service is a single storey bungalow. There are six individual bedrooms, shared bathroom facilities, a shared kitchen, lounge and garden area. The office is located within the service.

The service has not been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. These are principles that ensure people who use the service can live as full a life as possible and achieve the best outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service did not receive planned and co-ordinated person-centred support that was appropriate and inclusive for them.

The service was no bigger than most domestic style properties. It was registered for the support of up to six people. The service was designed prior to building the right support guidance and the provider only took over the service in 2019. However, signs that deliberately identify the service as a care home had not been considered. These included things such as signs at the entrance gate asking for visitors to ring the bell and wait for staff. Industrial bins for various types of hazardous and non-hazardous waste were located at the front of the house and visible from the street. This did not promote people's dignity and respect of their environment.

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

People were supported with basic care needs and remained safe from physical harm. However, the service did not ensure sufficient staffing levels to promote interaction and to avoid social isolation. There was limited evidence that people were involved in the planning of their care or encouraged to voice their opinion about the service.

The ability for people to participate in activities of their choice and a time of their choosing was severely limited by the poor staffing levels. People were only able to go out for around four hours once a week when supported by an external company provided by the council.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. People’s rights were not consistently considered and consent for some areas of their life not always sought.

The service didn’t always (consistently) apply the principles and values of Registering the Right Support and other best practice guidance. The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons, there was inconsistent evidence that people had choice and control. People were not supported to live as independently as possible and there was a lack of social inclusion.

People told us they felt safe and were happy living at the service. People were able to access all areas of the service freely. Staff had a good understanding of how to keep people safe.

People were able to access various health and social care professionals as required. People were supported safely with their medicines.

Staff supported and treated people well and with kindness. Staff had a good knowledge of people’s needs, likes and dislikes and knew people well. People told us they would complain to the staff or the registered manager if they were upset or treated badly.

People had access to a variety of food and drink and told us they helped to prepare meals and clean up afterwards.

People who used different methods to communicate were supported to do so and staff all understood how to do this.

We have made a recommendation about ensuring people’s care records are current, correct and up to date. We have also made a recommendation about ensuring rubbish, furniture and other items are not stored in and around the service.

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 28 February 2018). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to sufficient staffing levels to enable people to make choices and participate in activities of their choosing. We also found breaches in relation to the need for consent. We found there was a breach in relation to ensuring effective systems and process to identify and promote required improvements and quality of care. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.