Creative Support - Teesside Services

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question as good. At this assessment, the rating has changed to outstanding. This meant people were protected by a strong and distinctive approach to safeguarding, including positive risk-taking to maximise their control over their lives. People were fully involved, and the provider was open and transparent when things went wrong.

This service scored 88 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The management team had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff confirmed they were actively involved in all aspects of safety learning. They described feeling valued, listened to and fully included in discussions about safety improvements. Learning was consistently shared across the team, and staff spoke confidently about how changes were implemented and monitored. This inclusive approach ensured that lessons were not only identified but embedded into daily practice, strengthening the delivery of safe, high-quality care.

A staff member said, “After incidents we usually discuss during handover or debrief what happened, what could have been done differently and how to reduce future risks. For example, after one person had repeated falls, staff reviewed the environment and encouraged more frequent checks. All debrief are also discussed during team meetings and speak about lesson learnt and how things could have been done differently.”

The provider’s electronic reporting system further enhanced safety. It enabled immediate communication, real-time oversight, and rapid managerial response. Concerns were reviewed promptly, and timely, effective actions were taken. This ensured risks were managed swiftly and consistently, contributing to excellent safety outcomes for people.

The management team worked with people and healthcare partners to establish and maintain safe systems of care. Risks were identified, managed, and monitored to help ensure people received safe support.

From the point of referral, the management team engaged with people and, where appropriate, their families to understand their needs and plan care effectively. Health and social care professionals were involved to support a coordinated, multidisciplinary approach. Planning processes ensured people’s needs were understood before care began, helping to provide consistent and safe support during transitions. Staff had access to relevant information and clear communication systems were in place, which supported continuity of care and reduced the risk of errors. Overall, the provider demonstrated good practice in maintaining safe and coordinated care.

The management team demonstrated strong safeguarding and partnership working, collaborating with people and professionals to manage risks. Concerns were shared promptly, with a focus on protecting people’s rights and dignity.

Staff were knowledgeable and vigilant, with a clear understanding of all forms of abuse and their responsibility to report concerns. They spoke confidently about safeguarding training and escalation processes to both internal and external agencies. A staff member told us, “I feel we have an amazing team who pull together and make all service users feel valued and safe.”

Robust systems supported safeguarding. Clear records identified actions and shared learning helped improve practice and reduce recurrence, with updates provided to people, relatives, and partners.

Professionals highlighted the provider’s proactive approach to safeguarding. One professional told us, “Creative Support work proactively with the Adult Social Care Transformation team. They continually engage in local authority initiatives.” They also recognised management’s focus on prevention and empowering people through safeguarding adults’ week sessions. National Safeguarding Adults Week sessions empower people with the knowledge and confidence to understand boundaries, recognise potential harm, and access the right support when needed.

People were supported to understand and contribute to their own safety. Some had attended safeguarding training organised by the provider, helping them recognise and report abuse, understand their rights and use reporting processes confidently. People were actively involved in preparing for emergency situations, helping them understand what to do and feel reassured about how they would be supported. This promoted people's safety, confidence, and involvement in decisions about their care.

Staff demonstrated an outstanding commitment to keeping people safe during both planned and unexpected events. When real incidents occurred, staff worked alongside people to ensure everyone was safe, informed, and supported. Staff were extremely knowledgeable of people who may require additional support to help them remain calm and reduce anxiety of distress. Clear and effective communication strategies were in place to support people and ensure relatives were kept fully informed. Their effective teamwork, leadership and person-centred approach ensured people remained safe and well supported throughout the most challenging situations.

People told us they felt safe, A person said, “I feel safe with [staff] close to me.” A relative said, “[Person] is safe in their environment, just had new bed at a different height as [person] is aging, [person] reticent with change but they introduce it slowly and, in the way most likely to be accepted.'

People can only be deprived of their liberty to receive care and treatment when this is lawful and appropriately authorised. In community settings, this is typically managed through applications to the Court of Protection (often referred to as community DoLS). The management team understood their responsibilities in recognising when care arrangements may amount to a deprivation of liberty and took appropriate action to ensure people’s rights were protected. Care arrangements were kept under review to ensure they remained necessary, proportionate, and the least restrictive option to keep people safe.

The management team always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive, and enabled people to do the things that mattered to them. Staff completed thorough risk assessments and used them to put proportionate plans and equipment in place.

Whilst day to day risks were extremely well managed and recorded, staff also demonstrated an outstanding commitment to enabling people to take positive, responsible risks and experience new opportunities that enhanced their quality of life. Through their exceptional understanding of the person's needs, interests and aspirations, staff created personalised adventures that built confidence, independence, and emotional wellbeing.

Staff consistently empowered people to safely broaden their experiences, achieve personal aspirations and lead fuller, more adventurous lives. This approach supported people to build and retain independence while risks of harm were reduced. Staff had fully supported one person's goal to travel and experience new places. A train trip to Newcastle had been carefully planned, ensuring risks were assessed and managed while enabling the person to enjoy a new experience. Due to extensive planning the person remained settled throughout the journey, engaged in activities they enjoyed and gained confidence in travelling further from home. The success of this experience encouraged the person to explore new opportunities and set even bigger goals, including planning their first holiday away.

A staff member told us, “People have the right to make choices if they have capacity, even if others disagree. Our role is to explain risks and support informed decisions. For example, somebody may choose unhealthy snacks despite being diabetic. We encourage healthier choices and explain risks but still respect their rights. I make sure all this conversation around risk is documented in their daily notes.”

The provider had arranged highly personalised, bespoke training for staff which focused on understanding people’s communication and how they expressed their emotions. Staff were given a safe and reflective space to understand people’s individual needs alongside complex care leads, developing a shared and consistent approach to responding to people through verbal interactions, body language, and actions. This proactive and person-centred approach has led to significant and sustained improved outcomes for people. One person, who was anxious and distressed had markedly improved, demonstrating how staff’s enhanced understanding of their communication had led to more effective, compassionate, and consistent staff approach.

The provider detected and controlled potential risks. They made sure equipment, facilities and technology supported the delivery of safe care.

Risks to people’s environments were assessed. People had detailed risk assessments within their care plans covering the environmental risks and potential hazards. There was a service continuity plan and a personal emergency evacuation plan to support the safe evacuation of a person from their home in the event of a fire. Records showed staff completed regular health and safety checks at people’s homes to maintain a safe living environment.

The management team demonstrated an exceptional approach to staffing, ensuring there were sufficient numbers of highly skilled, experienced, and well-supported staff who worked seamlessly together to deliver safe, person-centred care tailored to individual needs.

Recruitment processes were robust, values-based, and inclusive, ensuring only suitable staff were employed. The provider recognised the value in ensuring people who used the service were actively involved in decisions regarding recruitment of new staff. People were encouraged to be actively involved in the recruitment process, which meant people were in control of who would be providing support to them.

Staff received a high-quality, comprehensive training programme which focused on the importance of personalised, person-specific support to meet individual needs. People who used the service were often asked to participate in the induction training so new staff could get a real sense of peoples lived experiences and what was important to them. A relative told us, “[Staff] are all different and all really good. I can’t comment on the training, but performance is top notch.” A staff member told us, “The training we receive is outstanding. We are encouraged by Creative Support to continue learning and developing our skills.”

Staff demonstrated outstanding skills in understanding people's individual needs, preferences, and routines, enabling them to anticipate challenges and plan support proactively. The training completed, skills gained and staffs detailed knowledge of people meant they could prepare effectively for situations that may otherwise have caused anxiety or disruption. The management team were passionate about ensuring there were sufficient flexible staffing arrangements in place, enabling support to be adapted around people's changing needs, appointments, and preferences to achieve the best possible outcomes.

A relative highlighted this approach, saying, “How fortunate I feel to have [person] there; it’s a challenging job. I know [person] is delightful but not easy.” They described how staff carefully planned for an early morning medical appointment that was outside the person's usual routine. “Yesterday [person] had an early medical appointment, but normally [person] is not up till midday or early afternoon. I didn't know how it would go but when I arrived, [person] was up and dressed and ready to get in the car. The driver had come in a half hour early to help make sure it went off ok.” This demonstrated staff's exceptional preparation, flexibility, and person-centred approach.

The service also showed a highly innovative and responsive approach to developing skills and knowledge not just for staff, but for people too. When people who used the service expressed a desire to learn new skills, management worked in partnership with the provider’s training academy to deliver tailored sessions in areas such as first aid, food hygiene, infection control, online safety, and safeguarding. This empowered people and strengthened a culture of shared learning and safety, with skills gained proving invaluable in responding effectively to a real-life choking incident.

The provider truly valued their workforce and were committed financially to developing in-house staff. The provider had developed a ‘development pathway’ which allowed staff to develop from entry levels up to senior management positions.

The management team assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff had received training in infection prevention and control and understood how to protect people from the spread of infection. Staff told us they had access to personal protective equipment and that this was always available. When staff visited people at home, they assessed the cleanliness of individuals homes ensuring they were clean, clutter and dust free minimizing the risk of infectious diseases and promoting health and wellbeing.

The management team always made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff always involved people in planning, including when changes happened.

Staff demonstrated an outstanding commitment to the principles of ‘Stopping Over Medicating People with a Learning Disability (STOMP) by ensuring medicines were regularly reviewed and only used where they continued to meet the person's needs. Through effective advocacy and close monitoring of wellbeing, staff recognised when a person's antidepressant medicine was no longer achieving the desired outcomes and worked proactively with healthcare professionals to review treatment. The person was fully involved in decisions about their care and supported to explore alternative options, resulting in a change from a higher dose antidepressant to lower- dose medicines that better met their needs. This person-centred approach led to a significant improvement in the person's mood, wellbeing, and quality of life, with increased engagement in daily activities, community involvement, and family relationships. This demonstrated excellent partnership working, proactive monitoring and a clear commitment to ensuring medicines remained appropriate, effective, and focused on achieving the best outcomes for the person.

The provider has introduced a Medication Peer Support Group which demonstrated outstanding practice in medicines management by creating a strong culture of learning, accountability, and continuous improvement. All medication incidents were reviewed through a structured peer review process involving managers, senior staff, and Registered Managers, with incidents remaining open until all required actions have been completed and evidenced. The use of root cause analysis ensured that underlying causes were identified and addressed, while shared learning supported consistent and safe medication practices across services. People’s medicines were managed safely. Medication Administration Record (MAR) charts showed people received their medicines as prescribed.

People had guidance within their care and support plans about how they should be supported with their medicines. This included information about what medicines they take, how they take their medicines, and where their medicines were stored.