Archived: Creative Support - The Chestnuts

Creative Support – The Chestnuts is a residential care home providing personal care for up to five people in one adapted building. It specialises in supporting people who have learning disabilities and or autism. At the time of our inspection, there were four people living at the home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes.

The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

The provider's quality assurance systems and processes were not always effective at identifying concerns and driving improvement in the service. Systems that were in place were not implemented effectively and audits had not identified concerns with the service.

Environmental risk management and infection control procedures were not sufficient. Staff had not consistently followed the provider’s systems and processes to assess and minimise environmental risks to people. Sufficient information was not always provided about people’s individual risks.

Not all staff had received mandatory training. Training had not always been refreshed at the timescales identified by the provider and training records were unclear.

Safe recruitment procedures were followed. There were enough staff available to meet people’s support and activity needs.

People were supported to eat a balanced diet that met their needs and any associated risks were managed with appropriate specialist input. Staff worked effectively with community health and social care professionals to achieve positive outcomes for people and ensured their health needs were met.

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 interest. The policies and systems in the service supported this practice.

Staff knew the people they supported well and adopted a caring approach towards their work. People were treated with dignity and respect.

People's care plans were individual to them, covered key aspects of their care needs and promoted a person-centred approach. People had support to participate in a range of social and recreational activities.

People and their relatives understood how to raise any concerns or complaints with the provider.

The management team promoted effective engagement with people. Staff felt well-supported and valued. People were encouraged to express their views about the care provided, and these were listened to.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 18 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to environmental risk management and the governance of the service at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service provides accommodation for up to five people living with learning disabilities. The service is located in a residential area of Wellingborough. Accommodation is on two floors and there is a communal lounge and kitchen dining area. The Chestnuts has a garden. At the time of our inspection three people were using the service.

The service was managed by a person who had applied to be a registered manager. 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 and associated Regulations about how the service is run.

Staff understood and put into practice the provider’s procedures for safeguarding people from abuse and avoidable harm. They advised people using the service about how to keep safe in the home and when they were out participating in activities. The provider had enough suitably skilled staff to be able to meet the needs of people using the service. Staff prompted people to take their own medicines. The provider had implemented new and improved arrangements for the safe management of medicines shortly before our inspection.

People using the service were supported by staff who had received relevant and appropriate training. This included training about people’s health. This meant staff understood the needs of people they supported. Staff were supported through effective supervision and training. Staff understood the relevance to their work of the Mental Capacity Act 2005. They sought people’s consent before they provided care and support.

Staff supported people with their nutritional needs by providing information about balanced diets and healthy eating. They supported people to prepare their own meals. People were supported to access the relevant health services when they needed to.

We saw several interactions between people and staff and it was evident that staff were considerate and caring. People were able to participate in a variety of meaningful activities that reflected their hobbies and interests at The Chestnuts and when they went out.

People were involved in the assessments of their needs and in reviews of their plan of care. People were provided with information about their care and support options and were involved in decisions about their care and support. Care worker’s respected people’s privacy and dignity.

People’s plans of care were centred on their specific needs. Those plans had agreed aims and objectives which care workers helped people to achieve. People knew how to raise concerns if they had any. The provider acted on concerns people had raised.

The provider had aims and objectives that were understood by staff and people using the service. They had effective procedures for monitoring and assessing the quality of service that promoted continuous improvement.

Further information is in the detailed findings below.