13 October 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 9 and 16 August 2017 and was announced. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be able to give us access to files and documentation. This inspection was carried out over two site visits with two inspectors completing day one, and one inspector day two, which included visiting people and speaking with staff. In addition, a third day was used to complete telephone calls to professionals, relatives and any stake holders.
Prior to the inspection we referred to previous inspection reports, local authority reports and notifications. Notifications are sent to the Care Quality Commission by the provider to advise us of any significant events related to the service, which they are required to tell us about by law. As part of the inspection process we also look at the Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We had received the PIR for Creative Support - Reading, however this was out of date given the provider had acquired four additional services and registered these at the location. Two of the services were acquired at the end of March 2017 whilst the additional two were taken on by the company in July 2017. The provider advised us that these four services were in the process of completing registration with the CQC to become two independent locations. Each location would comprise of two services each. However, given this process was in its infancy, at the point of inspection, all areas were inspected equally. The service originally provided the regulated activity – personal care to people with a primary diagnosis of learning disabilities and/or autistic spectrum disorder. However, with the recent acquisitions personal care is also being provided to older adults, with dementia and/or associated health needs.
During the inspection we spoke with eight members of staff, including the registered manager, the regional director, one team manager, two team leaders and three care staff. We spoke with five people who use the service and three relatives of people who were authorised to speak with us on their behalf. In addition we spoke with three professionals from the local authority.
Records related to people’s support were seen for 12 people. In addition, we looked at a sample of records relating to the management of the service. For example staff records, complaints, quality assurance assessments and policies and procedures. Staff recruitment and supervision records for 12 of the staff team were reviewed.
13 October 2017
This inspection took place on 9 and 16 August 2017. This was an announced inspection as Creative Support Reading is a Domiciliary Care Agency (DCA) and supported living service and we needed to be sure someone would be at the office. A DCA is a provision that offers specific hours of care and support to a person in their own home. The service was broken into two main areas of support – learning disabilities and older adults. The latter was a recent acquisition whereby four locations were added to the original registration that catered solely for people with learning disabilities, who shared one home. These additional locations consisted of four complexes of privately rented flats, for older people. Across Cedar Court and Oak Tree, 54 people were supported by Creative Support Reading. Whereas Chimney Court and Corner Stones, had a total of 49 people supported by the service. These additional four complexes would eventually be registered independently to Creative Support Reading, however were at the time of the inspection under this registration.
At the time of the inspection a registered manager had been in post since July 2016. 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.
Staff knew how to keep people safe by reporting concerns promptly through the safeguarding procedure that was taught as part of the induction process. This was further followed through as a topic of discussion within team meetings and in individual supervision meetings. Systems and processes were in place to recruit staff who were suitable to work in the service and to protect people against the risk of abuse. There were sufficient numbers of suitably trained and experienced staff to ensure people’s needs were met. Staff were matched to meet people’s needs as per experience, knowledge, age and general personality, where possible. This was particularly noticeable within the service catering to support people with a primary diagnosis of a learning disability.
People using the service said they were very happy with the support and care provided. People and where appropriate their representatives confirmed they were fully involved in the planning and review of their care. Care plans focussed on the individual and recorded their personal preferences well. They reflected people’s needs, and detailed risks that were specific to the person, with guidance on how to manage them effectively. The care plans within the older adults services were going through a process of being updated to similarly provide information as that seen within the learning disabilities service. This included information on why people liked to have support in a particular way and how this made them feel.
People told us communication with the service was good and they felt listened to. Communication methods were employed by the service that ensured people were able to be kept up to date with their support plans and with general information on the service. Where necessary these methods of communication were used to inform decisions made by the service, including recruitment of staff.
People we spoke with said they were treated with respect and staff preserved their dignity at all times. We did receive a concern about one member of staff that was passed on to the registered manager. We were kept abreast of the action taken against the member of staff that included disciplinary action and informing the local safeguarding team.
People were supported with their medicines by suitably trained, qualified and experienced staff. Medicines were managed safely and securely. People who could not make specific decisions for themselves had their legal rights protected. People’s care plans showed that when decisions had been made about their care, where they lacked capacity, these had been made in the person’s best interests.
People received care and support from staff who had good skills and knowledge to care for them. All staff received comprehensive induction, training and support from experienced members of staff. Staff reported feeling supported by the registered manager and said they were listened to if they raised concerns. The quality of the service was monitored regularly by the registered manager, and the regional director. A thorough quality assurance audit was completed annually with an action plan being generated. Feedback was encouraged from people, visitors and stakeholders and used to improve and make changes to the service. We found evidence of compliments and complaints that illustrated transparency in management.
Comprehensive audit systems were employed by the registered manager to ensure that all regulations were met.