Creative Support - Teesside Services

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment, and support achieved positive outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment, the rating has changed to outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 92 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People received exceptionally effective, person-centred care because the management team and staff completed thorough, holistic assessments before support began. These were sensitively paced, involved people, families, and professionals, and ensured people were thoughtfully matched with staff, building strong relationships and tailored support from the outset.

Staff demonstrated an outstanding commitment to ensuring people experienced a positive and successful transition into supported living. For one person staff recognised the importance of moving at a pace that was right for them. Staff worked closely with both the person and their family to carefully assess their needs, preferences, routines and wishes before the move took place. A gradual introduction was planned, allowing regular visits and opportunities to become familiar with the environment and the staff team who would be supporting them. Their relative told us, "From the beginning they worked with me to take it really slow, we visited, decorated and made it all at the pace [person] needed." This thoughtful and personalised approach ensured the person felt comfortable, reassured, and fully involved in decisions about their new home.

Staff took the time to develop meaningful relationships with people before moving to their new home. This approached enabled staff to gain a thorough understanding of how best to support a person from day one leading to a seamless transition and a positive settling-in experience. Staff worked alongside people’s families to create a personalised living space that was reflective of each individual. One relative described the transition as "absolutely fantastic" and praised the quality of support, stating, "The care is wonderful, really good."

Care plans were in place from day one and were then reviewed regularly and updated promptly, ensuring care remained responsive and consistently achieved positive outcomes.

Staff actively engage in functional behavioural assessments, PBS planning, training, and multidisciplinary reviews, ensuring support was based on a clear understanding of each person's strengths, needs, preferences, and communication style. The teams were reflective, responsive, and willing to adapt approaches when people’s needs changed, helping people to remain safely in their homes and communities.

Strong leadership and effective partnership working with PBS professionals and the wider MDT have led to measurable outcomes, including significant reductions in distressed and aggressive behaviours, reduced use of restrictive practices, improved health outcomes, increased engagement in meaningful activities, stronger relationships, and improved wellbeing. The service's commitment to understanding the reasons behind anxiety and distress, rather than simply responding to incidents, ensures people received highly personalised support that promoted independence, dignity, stability, and an improved quality of life. This demonstrated an outstanding approach to assessing needs and delivering effective, evidence-based support.

The management team demonstrated an outstanding commitment to person-centred care, with leaders embedding a strong culture of partnership, innovation, and continuous improvement. Practice went beyond expected standards, demonstrating excellence in personalised care planning, consistency in delivery, and a proactive, evidence-informed approach that resulted in positive outcomes for people.

People consistently experienced exceptionally high standards of person-centred care. Staff demonstrated a thorough understanding and skilled application of evidence-based frameworks, including Right Support, Right Care, Right Culture, ensuring care was inclusive, empowering, and actively promoted people’s human rights. The culture of the service strongly emphasised freedom from unnecessary restriction, with leaders modelling and embedding values that placed people’s autonomy, dignity, and independence at the heart of practice. A professional told us, “Staff continue to work in a way that clearly reflects the values of Right Care, Right person ensuring [person] receives the right level of support at the right time, delivered by the right people. Their practice is thoughtful, responsive, and rooted in a genuine understanding of [persons] individual needs, preferences, and communication style.”

The staff team demonstrated outstanding practice by recognising the importance of regular medicines reviews and working proactively with GPs and healthcare professionals to ensure people's medication remained safe, effective, and tailored to people’s individual needs. Rather than simply administering medicines, staff closely monitored people's health, wellbeing, and responses to treatment, sharing observations with professionals and advocating for reviews when changes were needed.

This person-centred and evidence-based approach ensured medicines were regularly evaluated to achieve the best possible outcomes while reducing unnecessary risks. Through effective partnership working and professional curiosity, staff supported informed clinical decision-making and ensured people received the most appropriate treatment for their changing needs, leading to improved health, wellbeing, and quality of life. These reviews led to significant positive outcomes, including increased alertness, improved engagement, and greater participation in meaningful daily activities.

Staff were supported to excel through high-quality training, reflective supervision, and strong leadership oversight. This enabled them to deliver care that was not only safe and effective, butalso consistently compassionate, respectful, and responsive to individual needs and preferences.

The provider maintained a comprehensive person-specific training programme, which was regularly reviewed to reflect people’s individual changing needs and emerging best practice. Staff completed mandatory and specialist training, including learning disability and autism awareness training, Positive Behaviour Support (PBS), and bespoke physical intervention training. This ensured a highly skilled workforce capable of delivering consistent, trauma-informed, and tailored care that significantly enhanced people’s quality of life.

A professional told us, “The management team demonstrated outstanding leadership by responding proactively to complex situations and working effectively with multidisciplinary professionals to maintain stable placements for people. One professional told us, “Some people's placements may have been at risk if the management team had not been so responsive and supportive. Their strong advocacy and Positive Behaviour Support approach contributed to reductions in distressed behaviours and restrictive practices, while improving health outcomes, meaningful activity, relationships, and overall quality of life for people receiving support.”

A professional further reinforced the strength of leadership and values within the service, stating: “[Management and staff] demonstrate a passion to deliver the best care and support and share with their peers at meetings how they actively challenge stakeholder decisions that they feel will have a negative impact on the lives of the people they care for.” This reflected a strong, values-driven culture of advocacy and accountability, where staff confidently championed the rights and best interests of the people they supported.

The management team and staff demonstrated outstanding collaborative working, ensuring seamless, person-centred support across services. Assessments were effectively shared, so people only needed to tell their story once, promoting continuity and positive experiences.

Staff demonstrated remarkable drive in improving people’s quality of life. For example, staff worked collaboratively with healthcare professionals, social care partners and family members to achieve an outcome that had previously been considered unachievable. Through effective advocacy, detailed planning, and a person-centred approach, the service challenged assumptions about the person's ability to undergo surgery and worked closely with the multidisciplinary team to ensure reasonable adjustments were made under the Equality Act to enable the operation to go ahead. Staff maintained consistent support throughout the hospital admission, helping professionals understand the person's needs, reducing anxiety, and promoting a successful recovery. The impact was life-changing for person with significantly reduced pain, increased mobility, and greater independence, exceeding professional expectations. Reflecting on the experience, the person said, "My knee is better now and doesn't hurt as much anymore" and "I had staff with me, they helped me."

Staff developed strong and effective relationships with visiting professionals to ensure people received coordinated, high-quality care. Professionals consistently described managers as responsive, approachable, and proactive in sharing information, enabling joint decision-making and timely interventions. One professional commented, "My involvement with the service has been a positive one. The management are responsive, there is effective communication from management when needed, and they kept me updated with the client I was working with as required."

This open and transparent approach ensured professionals were fully informed and able to work alongside the service to achieve the best possible outcomes for people. The quality of communication and partnership working promoted continuity of care, strengthened multidisciplinary relationships, and supported person-centred decision-making. Feedback from professionals demonstrated that the service was highly valued as a trusted partner, with staff going above and beyond to work collaboratively in the interests of the people they supported.

The management team demonstrated an outstanding commitment to supporting people to maximise their health, wellbeing, independence, choice, and control. Practice was consistently proactive and grounded in evidence based approaches, with a strong emphasis on health promotion, prevention, and early intervention.

Staff recognised the importance of encouraging people to live a healthier lifestyle and the positive outcomes this could achieve. As a result, a ‘Year of Living Well’ calendar was introduced. People had access to and used this yearlong calendar which had ideas and examples of healthy habits, sleeping well, healthy heart, Mo-Mental health (awareness of mental health) and more.

The calendars were personalised for each person, taking into consideration their current health, any medical conditions as well as their interests and hobbies. People had been supported to plan their health goals, which were also recorded so people had a sense of achievement when they met specific targets. In addition, each person was supported to produce a personalised journal which contained tips and activities they could do to help reach their goals. This approach helped people increase their understanding, take ownership and be in control of their lives.

Staff were highly skilled at supporting people to develop in all aspects of their lives, recognising the positive impact this had on people’s well-being as well as their overall health. Developing practical skills was promoted with staff at every opportunity. Together, people and staff had created guidance tools such as cooking videos with subtitles and step by step instructions for others to follow to encourage people to cook healthy food independently. This easy to follow resource and hands on practice boosted confidence, independence, and motivation for people to live healthier lives. This in turn promoted improvement in people’s physical and mental health. Staff were skilled at truly understanding people as individuals.

Recognising that opportunities for exercise were limited following professional advice, staff worked proactively with external partners to develop alternative ways of supporting the persons health and wellbeing. This included reviewing their dietary intake across services, supporting healthier food choices, and introducing home-cooked meals tailored to their preferences. Staff also successfully linked healthy living with their interests, encouraging them to take an active role in meal preparation and batch cooking. The person was highly engaged in these activities, confidently leading tasks and making choices about food preparation. When asked about the changes to their meals, they responded with "two thumbs up" and a large smile. This creative and person-centred approach has supported healthier lifestyle choices, increased independence, and enabled them to enjoy meaningful activities that promote both her wellbeing and quality of life.

The management team listened to concerns raised by a relative, and worked in partnership with the social worker, and successfully advocated for a review of the person support arrangements to ensure they could access the community and pursue activities that were important to the person and would promote a healthier lifestyle. As a result, additional one-to-one support hours were agreed, enabling the person to make their own choices about how they spent her time. They now regularly access the local community, including shopping, bowling, and visiting cafés. When asked about the additional support, the person said, "I can do what I want......I like going shopping," and "I am happy."

Staff demonstrated outstanding person-centred practice by identifying and nurturing new interests that improved people’s health, wellbeing and independence. For example, one person was supported to grow their own vegetables and herbs, taking the lead in researching what to plant, creating shopping lists, caring for the crops and using the produce in meals. This meaningful activity significantly increased their confidence, sense of achievement and engagement in healthy eating. They proudly shared their progress with others and said, “I can’t wait to eat them!” The success of the project inspired another person to become involved,helping them develop a healthier relationship with food while learning new skills. The positive outcomes have led to plans for a raised vegetable garden, ensuring people can continue to pursue their interests and maintain healthy, active lifestyles.

The management team demonstrated commitment to monitoring outcomes and driving improvement. Systems were robust, proactive, and embedded in everyday practice.

The management team had oversight tools that tracked incidents and medicine errors, and feedback in real time. This enabled registered managers to identify trends quickly and take decisive action. Follow-up actions were logged on an improvement plan, ensuring accountability and transparency. Progress was monitored through graphs and audits, with managers signing off completed actions.

Care plans were regularly reviewed and updated to reflect changing needs, with multidisciplinary input and family involvement. This had led to measurable positive outcomes, such as preventing pressure sores, reducing falls, and maintaining emotional wellbeing. People told us they were safe and supported.

The management team demonstrated through our conversations and examples of their systems of process, that monitoring and improvement were not reactive but continuous and embedded. The provider used data intelligently, learned from mistakes, and celebrated success, ensuring people received care that was consistently safe, effective, and person-centred.

The management team and staff told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff had a good understanding of the Mental Capacity Act (MCA) and how to apply this in their roles. Staff had completed training in the Mental Capacity Act. A staff member told us, “Capacity to consent means a person is able to make and communicate an informed decision about something that affects them. Capacity is assessed for a specific decision at a specific time. Adults are usually presumed to have capacity unless there is evidence to suggest otherwise.”

People were supported to make decisions, with consent sought and recorded, and families involved in best interest decisions. Staff recognised and managed any restrictions appropriately.

As part of this assessment, we joined in the crafts session and attended an evening disco with people and staff. Staff continually asked peoples permission, gave choices and were patient in allowing people time to respond. A relative said, “They do get consent, there's no forcing [person], they often have to coax and say lots of “lovely bath bubbles etc” [person] can choose.” Another relative said, “They do ask their consent and almost [person] gets too much of their own way. With a few carers [Person] is quick and gets to know who is maybe firmer than who.”