We carried out a review of the data available to us about Creative Support - London Services on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Creative Support - London Services, you can give feedback on this service.
Creative Support is a domiciliary home care service, providing regulated activity personal care. The service provides support to people who require support to live as independently as possible either in shared houses or individually. At the time of our inspection there were 18 people using the service.
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:
Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. 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. Staff enabled people to access specialist health and social care support in the community.
Right Care:
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks. People’s care, treatment and support plans reflected their range of needs, and this promoted their well-being and enjoyment of life.
Right Culture:
People received good quality care, support, and treatment because trained staff and specialists could meet their needs and wishes. Staff placed people’s wishes, needs, and rights at the heart of everything they did. People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection
The rating for this service in our last inspection was good (published 26 May 2021) .
Why we inspected
This focused inspection was prompted by a review of the information we held about this service.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Why we inspected
We undertook this targeted inspection to look at the way in which the service assisted people with complex healthcare needs and how people have been supported during the COVID-19 pandemic. The overall rating for the service has not changed following this targeted inspection and remains Good.
CQC have introduced targeted inspections to follow up on a Warning Notice or other specific concerns or other matters. They do not look at an entire key question, only the part of the key question we are specifically wishing to investigate. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
We found the following examples of good practice
Most people had not had visitors during the COVID-19 pandemic as for much of the last year there had been restrictions about visiting and some people had been following the government advice around shielding. The service had adapted communal space in the shared houses we visited, where space allowed, to encourage social distancing. The registered manager and staff we spoke with told us about how they had continued to encourage and support people to maintain contact with their loved ones even if they were unable to see them in person.
During our visit, we spoke with one person briefly as they had plans to go out. Other people were unable to hold voice conversations with us, but we observed staff engaging positively with these people. We spoke with the registered manager, and three members of the shared accommodation staff teams.
This inspection was short notice, which meant the provider and staff did not know we were coming until shortly before we visited the service. At the last inspection on 12 and 26 May 2015 the provider met all of the requirements we looked at and was rated good..
At this inspection we found the service remained Good.
There was a registered manager in place at the time of the inspection. 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.
People were kept safe from harm and staff knew what to do in order to maintain their safety. Risks to people were assessed and action was taken to minimise potential risks. Medicines were safely managed. The provider operated thorough staff recruitment procedures to ensure they were safe to work with the people.
People were supported to have choice and control of their lives and support workers supported them in the least restrictive way possible. The policies and systems in the service also support this practice.
Support workers were trained and had completed an induction programme before starting their employment at the service. They were also supported through supervision and had their performance and development needs reviewed.
Support workers ensured that on-going healthcare support from local GPs and other healthcare professionals was made available and supported people to remain healthy.
People’s dignity and privacy was maintained and staff knew how people preferred to be supported. Support workers liaised with people’s families as necessary. People’s independence was promoted and support workers encouraged them to do as much for themselves as possible. People were given information on how to make a complaint and supported people to access advocacy services when needed.
The registered manager carried out regular audits of the service and used these as a means of maintaining high quality care. Any action that was required was taken and the service provider was open and transparent in the way that they communicated with people.
Further information is in the detailed findings below.
Creative Support (Camden & Barnet Learning Disability Services) provides supported living to approximately 50 people at eleven sites including floating support to a small number of people in their own homes.
This inspection was short notice which meant the provider and staff did not know we were coming until shortly before we visited the service. At the last inspection on 4 February 2014 the provider met all of the requirements we looked at.
At the time of our inspection the provider employed a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
From the discussions we had with people using the service, relatives and other stakeholders we found that people were usually highly satisfied with the way the service worked with people. There was confidence about contacting staff at the service to discuss anything they wished to and carers were thought to be knowledgeable and skilled. People felt that there was honesty in the way the service communicated with them.
People’s human rights were protected and the service was diligent with ensuring that the requirements of the Mental Capacity Act (2005) were complied with. Where Deprivation of Liberty Safeguards (DoLS) were applicable we found that this too was managed properly.
People who used the service had a variety of support needs, in some cases highly complex needs, and from the six care plans we looked at we found that the information and guidance provided to staff was clear. Any risks associated with people’s care needs were assessed, and the action needed to mitigate against risks was recorded. We found that risk assessments were updated regularly.
During our review of care plans we found that these were tailored to people’s unique and individual needs. Communication, methods of providing care and support with the appropriate guidance for each person’s needs were in place and regularly reviewed.
We looked at the training records of staff at three shared living projects. We saw that in all cases mandatory training had been undertaken and the type of specialised training they required was tailored to the needs of the people they were supporting. We found that staff appraisals were happening yearly and staff had development objectives were set arising from the appraisal system.
We found that staff respected people’s privacy and dignity and worked in ways that demonstrated this. From the conversations we had with people, our observations and records we looked at, we found that people’s preferences had been recorded and that staff worked well to ensure these preferences were respected.
Records which we viewed showed that people were able to complain and felt confident to do so if needed. People could therefore feel confident that any concerns they had would be listened to.
People who used the service, relatives and stakeholders had a range of opportunities to provide their views about the quality of the service. We found that the provider took this process seriously and worked hard to ensure that people were included and listened to.
People had the opportunity to participate in a wide variety of activities and to be involved in the development of the service. They generally spoke well of staff, saying 'they are good' or 'they are nice'. There were appropriate systems in place to ensure medication was safely administered; good relationships with other providers and stakeholders and staff reported that they were well supported to carry out their roles.
'I love it here'
'The staff are very good'
'I feel safe here'
'I can talk to staff'
'I get help with what I need'
We also spoke with family members of some people using the service. They told us:
'Staff know the person's support needs'
' I am kept up to date about the service provided'
'Staff have the right skills and experience'
In addition we spoke with the manager and some support staff. Overall, we found that people's views and experiences were taken into account in the way the service was provided and delivered. We also found that people experienced care and support that met their needs and protected their rights. We concluded that the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.
Appropriate checks were undertaken by the provider before care staff commenced their employment. Staff were supported to deliver care and treatment safely and to an appropriate standard, and undertook regular training. The provider had an effective system to regularly assess and monitor the quality of service that people receive. We found that the provider took appropriate steps to ensure the safety and wellbeing of people using the service when an accident of incident occurred. However, some important events had not been notified to the Care Quality Commission.