We inspected Creative Support - South Manchester Women’s Project (The Women’s Project) on 19 and 20 September 2017 and this inspection was announced. We gave the provider 24 hours’ notice because the location provided supported living services and we needed to be sure that someone would be in to assist us with our inspection.South Manchester Women’s Project provides care and support to women with enduring mental health needs. The service is provided across two properties in South Manchester, Amherst Road and Longley Lane. Both premises are close to local amenities and public transport. At the time of this inspection, the service was supporting 14 people in total. Only six people were receiving support in relation to the regulated activity of personal care.
This was the first inspection of this service since it was registered with the Care Quality Commission (CQC) in May 2016. There was a manager in post who had been registered with CQC since May 2016. A registered manager is a person who has registered with 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.
People told us they felt safe and comfortable in their homes. Recruitment processes in place helped to ensure staff of suitable character were employed. This meant people were protected from the risk of harm in this regard. We have made a recommendation that the service consider an alternative location for personal emergency evacuation plans to help ensure the relevant personnel are able to readily access them in the event of an emergency.
People’s support plans contained relevant and detailed risk assessments which guided staff to support them in a safe way.
Staff had a good knowledge of what safeguarding meant and could describe the types of abuse. They also knew what action to take if they suspected abuse was taking place. This meant staff knew how to respond to potential risks which could affect people’s safety and wellbeing.
There were suitable systems in place to record incidents and accidents. These were actioned in a timely manner and lessons learnt shared within the service. This meant people’s safety was considered and improvements made to help prevent future recurrence.
People told us there was sufficient staff to help them with care needs and leisure activities where needed. During our inspection we saw that staffing levels were adequate to the support needs of people. This meant that people were not put at risk due to inadequate staffing levels.
People were supported to take their medicines safely. Support plans contained detailed and person-centred information about people’s medicines and in some cases information about how the service supported people to administer their own medicines.
There were appropriate health and safety checks in place to ensure a safe environment for the people living there and the staff supporting them. These checks included gas, electrical systems and fire safety equipment.
People told us the staff at the Women’s Project supported them effectively. Staff were able to do this because they received an ample induction and mandatory training to ensure they were competent to carry out their roles. Training areas included food hygiene, safeguarding, manual handling, mental health and diabetes. We saw from training records that additional training in specialist areas such as hoarding disorder could be accessed depending on the need. Hoarding disorder is a pattern of behaviour that is characterized by excessive collection and an inability or unwillingness to discard large quantities of objects that cover the living areas of the home and cause significant distress or impairment. In addition to classroom and e-learning training, the registered manager cascaded any learning they received through training they attended. In addition to classroom and e-learning training, the registered manager cascaded any learning they received through training they attended.
Staff had regular supervision with their line manager which gave them the opportunity to discuss their performance and raise concerns they had about their roles.
We concluded staff received relevant knowledge and support to help ensure they carried out their roles effectively.
People told us staff always sought their consent before offering assistance. The registered manager and staff we spoke with had a good understanding and knowledge of the Mental Capacity Act (MCA) and we saw there was an up-to-date policy in place to guide practice. There was sufficient evidence in people’s care plans to show consent to care had been sought appropriately. We concluded that the service had suitable systems in place to help ensure consent was obtained appropriately and that the service was working within the principles of the MCA.
People were supported to plan and prepare their own meals. This demonstrated the service’s commitment to encouraging healthy nutrition and supporting people’s independence and choice. From care records, we saw that people were supported to access health care professionals such as GPs and to attend medical appointments. This meant the service had systems in place to ensure people’s healthcare needs were met as and when required.
People told us staff were kind and caring. We observed staff supporting people in a compassionate and respectful manner. We saw that staff and management knew the people they supported well and could describe to us people’s preferences, interests and aspirations.
People said and their care plans confirmed they had been involved in making decisions about the support they received. This meant that people and their relatives, where appropriate, were included in making decisions about the support provided.
Maintaining independence was encouraged at the Women’s Project and was one of the key aims of the service. Examples of this including supporting people to prepare their own meals and plan daily activities. This helped to ensure people maintained a good quality of life and wellbeing.
The Women’s Project provided a responsive and person centred approach to care. This helped to ensure support provided adequately met people’s specific needs. Transitional planning meetings and initial assessments were carried out to make sure the service met the person’s needs. People were involved in both of these processes. Each person had a member of staff who was their key worker and people had a monthly session with their key worker to help ensure they were getting the most out of the support provided.
Support plans were detailed and person-centred, containing personal histories, likes and dislikes and other notable information about the person. These records were reviewed regularly. This meant support staff had clear, current and specific guidance on how best to support that person.
There was a good system of recording and monitoring complaints. We saw that complaints were well managed and that people were encouraged to raise concerns and complaints formally or informally.
People were encouraged to engage in the activities that they enjoyed. These included meals out and trips to the theatre or for afternoon tea with each other. People we spoke with said they were able to maintain good links with their relatives and that the service supported them in doing so. This meant people’s wellbeing was supported as a result of engaging in meaningful activities and maintaining relationships.
We observed an open and friendly culture at the Women’s Project in which people had the opportunity to provide feedback about the service in an informal way. Everyone we spoke with said they could talk to the staff or registered manager if they needed to. Tenants meetings were held at Amherst Road and we saw people participated actively at these meetings.
People were happy with the service provided and got on well with other tenants. The registered manager was well liked and respected. Staff spoke highlight of the registered manager and told us they were a good manager and supportive.
People’s achievements in their personal and community life were celebrated across the organisation in a monthly awards scheme called Achieve Q. This meant the provider helped to improve people’s wellbeing by recognising and valuing their individual achievements.
There were good systems in place to continuously monitor the quality of service provided in areas such as medication, accidents and incidents and care records. Corporate audit processes in place helped to ensure the provider had oversight on any areas in which performance was failing. We saw examples such as with audits of medication errors and safeguarding incidents that the service had learnt lessons and made appropriate improvements. This meant people benefitted from an improved service.
The provider held the silver award in the Investors in People accreditation. This demonstrated their understanding in the benefits of investing in their workforce as this potentially had a positive impact on how people using their service were supported.
There were good staff support systems in place such as monthly team meetings and operational policies and procedures. This helped to ensure there were appropriate resources available for staff to do their job effectively and thus create better outcomes for people support.