Jigsaw Creative Care limited

Updated 24 August 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by an inspection manager, an inspector, an assistant inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Jigsaw Creative Care limited are a supported living and domiciliary care agency. They provide personal care to people living in their own homes as outreach and specialist supported living housing. They provide a service to older adults, younger adults and people with a diagnosis of learning disabilities and / or autistic spectrum disorder. The service provides care and support to people living in 19 supported living settings. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had two managers registered with the CQC at the time of the inspection. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. However, after the inspection one manager deregistered. A new manager had been taken on and they were intending to register with the CQC.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because people are often out, and we wanted to be sure there would be people at home to speak with us. We also needed to be sure that the registered managers would be in the office to support the inspection.

What we did before the inspection

Prior to the inspection we looked at all the information we had collected about the service including previous inspection reports and notifications the registered manager had sent us. A notification is information about important events which the service is required to tell us about by law.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with seven people who use the service and five relatives. In addition, we spoke with the registered managers, HR/Training manager, safeguarding lead and quality assurance consultant. We spoke with 15 members of staff and received feedback as a result of a short questionnaire we sent out from seven more staff. We visited people in their own homes and visited the Academy, the service’s day centre. We reviewed a range of records relating to the management of the service for example, audits and quality assurance reports; records of accidents, incidents; compliments and complaints. We looked at four staff recruitment files and staff support information. We looked at six people's support plans and associated records.We also contacted health and social care professionals for feedback and received five responses during and after the inspection.

After the inspection

We continued to seek clarification from the registered managers to validate the evidence found. We looked at training information, quality assurance audits and meeting minutes. We continued to review feedback given to us by staff and health and social are professionals.

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Updated 24 August 2019

About the service

Jigsaw Creative Care Limited provides both a domiciliary care agency and supported living services to people who either live in their own home, or people who share accommodation with others. The service is registered to provide care to children, younger adults, older adults and people with disabilities. At the time of the inspection the service was supporting 33 people.

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.

Not all care staff felt supported and listened to. However, we found the registered managers were working with care staff and their management team to continue to develop a supportive culture.

Not all health and social care professionals felt that they had a productive working relationship with the provider.

Relatives felt the registered manager was supportive and open with them and communicated what was happening at the service and their relatives.

The registered managers had strengthened their quality assurance systems to more effectively monitor the quality of the service being delivered and took actions promptly to address any issues.

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

We have made a recommendation about ensuring people’s Equality, Diversity and Human Rights (EDHR) have been explored and documented.

The outcomes for people using the service reflected the principles and values of Registering the Right Support.

People felt safe living at the service. Relatives felt their family members were kept safe in the service. The registered manager and care staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. Risks to people’s personal safety had been assessed and plans were in place to minimise those risks.

Staff recruitment and staffing levels supported people to stay safe. The management of medicines was safe, and people received their prescribed medicine on time.

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

People received effective care and support from care staff who knew them well. Care staff had received the appropriate training to support people effectively. People were encouraged to eat healthily. People had timely access to healthcare professionals such as their GP.

We observed kind interactions between care staff and people. Relatives confirmed care staff respected people’s privacy and dignity. People and their families were involved in the planning of their care.

The registered managers encouraged feedback from people and families, which they used to make improvements to the service. People were encouraged to live a fulfilled life with activities of their choosing and were supported to keep in contact with their families.

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

Rating at last inspection

At the last published inspection the service was rated good (report was published 3 January 2018).

Why we inspected

The inspection was prompted in part to follow up on concerns received about allegations of abuse raised with us in February 2019. This is subject to an ongoing criminal investigation.

Following the concerns raised in February 2019 a decision was made for us to undertake an inspection and examination of those risks. This resulted in urgent enforcement action being taken. The relevant safeguarding and commissioning bodies also commenced a provider concerns procedure to respond to and scrutinise the concerns raised. Due to unforeseen circumstances we were unable to complete all the necessary processes in order to publish the report. This inspection was part of the ongoing process to ensure people were receiving safe care. At this inspection we found no evidence that people were at risk of harm from this concern.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.