Creative Support - Simonside Court

At our last inspection we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. We saw evidence to show the service was meeting all of the fundamental standards.

There was a registered manager in post who had been registered with the Care Quality Commission (CQC) since October 2010. A registered manager is a person who has registered with the CQC 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.

The registered manager was aware of their responsibilities and had a clear strategy and vision for the service in partnership with the provider's organisational vision. The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service were supported to live as ordinary a life as any citizen.

There was a robust governance framework in place to continually monitor and improve the service. We saw evidence of involvement from the provider's senior management team and documented audits carried out during their visits to the service. The registered manager submitted notifications to the Commission appropriately.

During the inspection we observed people carrying out activities with staff and attending sessions in the local community. We saw records of activities undertaken by people and they were supported to carry out their own choices for activities.

There was training provided for staff in delivering end of life care. Staff treated people with dignity and respect. We saw kind, warm and caring attitudes between people in receipt of care from the service and staff. We observed people enjoying positive relationships with staff and it was apparent they knew each other well. Staff understood each person, how to support them and knew what they liked and disliked.

There were regular checks of the communal areas of the service, equipment and utilities which were documented to ensure the safety for people in receipt of care from the service, visitors and staff. People's care plans reflected their individual needs and personal risks were assessed. People’s care plans were reviewed regularly and people and their relatives were involved in care planning. We saw referrals to other healthcare professionals, for example dieticians and GPs, in people's care files if they needed such additional support. People were supported to eat and drink a healthy balanced diet.

People received personalised care and care records showed involvement from people and their representatives in their care planning. Staffing levels reflected the assessed needs of people and matched the dependency requirements for people.

We found there were policies and procedures in place to help keep people safe. Staff were safely recruited and they were provided with all the necessary induction training required for their role. We saw evidence of regular staff supervisions, yearly appraisals and team meetings.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There were infection control policies in place and staff adhered to these. Medicines were safely managed and there were medication policies and procedures in place. There was a business continuity plan in place for use in emergency situations.

The service had a comprehensive complaints and compliments policy in place. Any complaints received were logged, responded to within the stated time frames and analysed. Action plans were created and lessons learned were documented. The service promoted advocacy and there was accessible information available detailing what support people could access to help make choices about their individual lives. There was information available about safeguarding, complaints and advocacy displayed in communal areas and available in easy read formats for people.

Further information is in the detailed findings below.

Creative Support – Simonside Court is a supported living service that provides care and support for up to 18 people in their own homes including 24 hour care. This includes care and support for people with a learning disability or autistic spectrum disorder. At the time of the inspection 16 people were using the service.

There was a registered manager in post. 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 said they were happy with the support they received and felt safe. Staff showed a good understanding of safeguarding adults and were confident of how to keep people safe.

Risk assessments were in place for people when required with clear links to care and support plans. General risk assessments regarding the premises and environment were available.

The registered provider had systems in place to check the premises and equipment were safe for people to use. This included portable appliance testing (PAT) checks, a fire risk assessment, a legionella risk assessment and an up to date electrical safety certificate. The registered provider also had personal emergency evacuation plans (PEEP) in place for every person that detailed support they needed in case of a fire.

Medicines were managed safely, effectively and in a way which reflected people’s individual needs. All records were up to date and fully completed, with medicine audits being carried out regularly.

Staff were recruited in a safe and consistent manner with all appropriate checks carried out. Staffing levels were consistent with people’s needs.

Accidents and incidents were recorded with details of any action taken to deal with the issue.

Most staff training was up to date. A plan had been developed to ensure any overdue training was completed. Staff received regular supervisions, both standard and focussed. Staff also received annual appraisals.

The registered manager and project manager had a good understanding of the Mental Capacity Act 2005 (MCA) and best interest decisions were evident within care files.

The service provided personalised support to each individual. Staff demonstrated a good knowledge of each person and knew how to support them in a way that met their specific needs.

People had access to a range of health professionals when required, including GP’s, dentists, opticians, speech and language therapists and specialist nurses

The service supported people to access a variety of activities that aimed to improve their independent living skills and embrace their hobbies and interests.

People knew how to raise concerns if they were unhappy and were aware of different avenues they could use to express their thoughts about the service.

The registered provider had quality assurance arrangements in place to regularly assess the quality and safety of the service provided, and were effective in identifying issues and required improvements.

Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives and the staff supporting them, and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We saw checks had been completed by the manager around areas such as cleanliness, fire safety and hygiene. This meant that the provider ensured the building and practices were safe for the people who lived at the service. The provider had developed systems to ensure potential risks were assessed and managed. Where staff had identified a potential risk, either during the initial assessment or after admission, a risk assessment had been completed to ensure people remained safe.

Is the service effective?

Prior to commencing support the provider completed a holistic assessment that considered all aspects of each person's physical, social, emotional and mental health support needs. This allowed the provider to assure themselves they were able to meet the person's needs. Referral and assessment records showed the manager attended planning meetings with the person, their families, social care and clinical staff to ensure a smooth transition for the person moving into the service.

Is the service caring?

We found that people's independence was supported when planning and delivering their care. People's ability to be independent was recognised. People's plans of care also identified new skills and outcomes for people to aim for, supporting people to develop their independence. People were treated as individuals and supported to be involved in all aspects of their life as much as possible. We observed that staff treated people with respect, communicating in a way that maximised their involvement in their care. The home supported people to be involved in a range of social activities, both inside and outside the home. People regularly attended local cafes, shopping trips, attendance at local colleges and workplaces and visits to pubs for meals.

Is the service responsive?

One relative commented, 'Staff have let me know about any emeregencies in the past.'

Staff we spoke with were very knowledgeable about the people they supported and spoke about people using very positive language.

Care plans were evaluated each month to ensure they remained current. The record of the review included a summary about each person's current situation. Formal reviews of care and support took place, and the person was able to decide who they wished to invite to attend. For example, this included a relative, social worker and an advocate. Relatives we spoke with told us "I have come along to a review". and "I get invited to a review but they also let me know what is going on a regular basis".

Is the service well-led?

We were able to confirm that there were processes in place to monitor the quality of service provided.

This included regular service users' meetings with an advocate in place to chair the meeting and record the minutes. The manager and senior support worker told us they worked alongside support workers, observing and monitoring care practices. They carried out regular checks and audited records to make sure people were being supported safely.

We looked at the activities for people who use the service. These indicated that people attended community placements, had visits to and from relatives, went shopping, listened to music, watched television and played computer games.

The atmosphere at Simonside Court was calm and the staff focused on the people they were supporting.

We looked at how the service recruited staff by checking five staff files

We saw that the provider had implemented systems to monitor the quality and effectiveness of the service and these were used by staff.