Creative Support - Bury Service

Creative Support Bury provides care and support to people living in a number of 'supported living' settings, including houses and flats, so that they can live as independently as possible.

Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection, the service was supporting eight people with their personal care needs.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture. People were at the centre of their care and were supported to be as independent as possible. People lived in a small, domestic setting and received support from staff who understood their needs and preferences. Managers and staff empowered people to their own decisions about their care and support.

Staff told us they understood their responsibilities in relation to safeguarding, and people using the service told us they felt safe when receiving care.

Medicines were managed safely. People received their medicines when needed and appropriate records had been completed. We saw people had access to healthcare professionals.

Risks to individuals and the environment were well managed. There were enough staff to meet people's needs. The provider learned from accidents and incidents to mitigate future risks.

Staff development was supported by a thorough induction, support from the management team and training relevant to the needs of the people they cared for.

Infection control procedures were robust and staff had taken additional measures to protect people from infection control risks associated with COVID-19.

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 interests; the policies and systems in the service did support this practice.

The provider's quality assurance systems monitored the service provided to people. These included obtaining feedback from people about their satisfaction with the service they received. Improvements to the service were promptly made when needed.

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 30 May 2019).

Why we inspected

This was a planned inspection

The overall rating for the service has remained the same. This is based on the findings at this inspection.

Follow up

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

Creative Support Bury provides support to people who have learning disabilities and mental health needs. The agency helps people living in their own home or small group homes, offering support in meeting their social, emotional and personal care needs. The level of support provided varies on the individual assessed needs of people. Twelve people currently use the service.

People’s experience of using this service:

People told us the service was good and they benefitted from the care and support they received.

People were able to live their lives with full support from staff who respected their diverse needs.

Good systems and staff training helped keep people safe and known risks were managed effectively.

All documentation we saw was detailed and kept up to date. This helped keep staff informed of any changes to a person’s care and treatment.

The service liaised with other organisations to ensure support was based on best practice.

Staff had received sufficient training and ongoing support to help them carry out their roles.

People were encouraged to be independent. Staff supported them with daily living tasks and helped them to reach their goals.

People were encouraged to eat healthily. People could ‘win’ incentives for healthy living.

Activities were meaningful because they were what people wanted. People were encouraged, where possible, to attend work or educational activities.

There were systems to maintain and improve the quality of service through audits, surveys and meetings.

Rating at last inspection: At the last inspection (report published 28/10/2016) the service was rated as good overall.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up: We will continue to monitor information and intelligence we receive about the service to ensure care remains safe and of good quality. We will return to re-inspect in line with our inspection timescales for good services, however if any information of concern is received, we may inspect sooner.

Creative Support - Bury Service is registered to provide personal care to people in their own homes. Support is provided both to individuals and to people living in small group settings. At the time of our inspection there were 36 people using the service.

The service had a registered manager in place. 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 were complimentary about the registered manager and said they were a good manager. We found them to be enthusiastic and committed to providing good quality person centred care.

Everyone we spoke with was very positive about the service and the attitude of staff and managers and how they were supported. We found the registered manager and staff took pride in the providing a person centred service. We observed that interactions were respectful, relaxed and friendly.

People who used the service told us they felt safe using Creative Support - Bury Service. People told us they always received the support they needed from staff who were caring and knew them well. All the staff we spoke with were able to tell us about the people they supported and what their likes and dislikes were.

Robust recruitment procedures were in place which ensured staff had been safely recruited. Staff had received training in safeguarding adults. They were aware of the correct action to take if they witnessed or suspected any abuse. Staff were aware of the whistleblowing (reporting poor practice) policy in place in the service.

Staff received the induction, training and supervision they needed to carry out their roles effectively. Staff told us they felt supported and were very positive about the training the provider offered. Staff were complimentary about the registered manager and working for the service.

Care records were very detailed and person centred and contained information about people’s health and social care needs. We found they contained detailed risk assessments and care plans that were written using very respectful terms contained information about people’s preferences and routines and guided staff on how to promote people’s independence and how people communicated. The service also recognised and valued people's own communication methods including using signs, gestures and sounds. Care records included a ‘Communication Passport.’ This had sections such as; ‘when I do this, we think it means this.’ We saw these included descriptions of what certain gestures, facial expressions and body language meant. Care records provided staff with sufficient detail to guide them on how best to support people A system was in place to ensure care plans were regularly reviewed and updated. This helped to ensure they fully reflected people’s needs.

The service had detailed guidance for staff on how to support people when they showed behaviour that challenged the service. Records contained information about what may make someone upset or angry and guided staff in how to respond, what to say and what to do to help the person and diffuse situations. This included understanding how the person communicated whe they weer anxious or upset and guided staff on how to respond.

Important information about the service was available in easy read formats. These included pictures and photographs. This helped to ensure people had access to information they needed, such as tenancy agreements, complaints policy and safeguarding.

Managers and staff in the service spent time getting to know people and what their interests, hobbies and goals were. People were supported to access a wide range of activities, hobbies and places of interest. Some people were also supported to work or attend college.

The provider was working within the principles of the Mental Capacity Act 2005 (MCA). Staff were able to tell us how they supported people to make their own decision. The registered manager and staff were aware of the process to follow should a person lack the capacity to consent to their care. Care records included information on how people could be supported to make decisions.

Medicines were managed safely. There were policies and procedures in place, staff had received training in administering medicines and had their competency to administer medicines regularly assessed.

We saw systems were in place to monitor people’s nutritional needs. People had access to a range of health care professional to ensure their health needs were met.

Systems were in place to ensure the safety and cleanliness of all the premises where people who used the service lived.

The service had a range of ways of involving people and getting their ideas for how the service could be improved. People who used the service and their relatives had been involved in planning and reviewing the care provided. People who used the service were involved in recruitment, training and service quality auditing.

There was a robust system of weekly, monthly and annual quality monitoring and auditing in place to help improve the quality of the service provided. There was a complaints procedure for people to voice their concerns. People were confident that they would be listened to and action would be taken to resolve any problems they had.

The service had notified CQC of any accidents, serious incidents and safeguarding allegations as they are required to do.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found-

Is the service safe?

We found that the service carefully assessed and managed risks to people's personal safety to make sure their support was delivered in a safe way. Suitable safeguarding policies and procedures were in place and staff had been trained in adult safeguarding. Staff who worked at the service had undergone DBS checks to ensure they were safe to work with vulnerable adults.

People told us they felt safe. Systems were in place to make sure managers and staff learned from events such as accidents and incidents, complaints and concerns.

Is the service effective?

People's support was well planned and kept under regular review to check it remained effective. The staff team received training that equipped them with the skills to understand and meet the needs of the people they supported. Staff told us they were well supported in their roles and their performance was regularly supervised and appraised. People were involved in developing their own plans of care.

Is the service caring?

We observed positive interactions between staff and people using the service and saw people being respected and involved in decisions and provided with choice.

A person-centred approach was taken in planning and providing care that was tailored to individuals' needs and wishes. People told us they received support from staff who were kind and caring and helped them to maintain their independence. We received positive feedback from people using the service about the care and support they received.

Is the service responsive?

The service actively involved people at all stages of their care. People contributed to assessments of their needs and met regularly with staff to plan and review their care and support. Records confirmed that people's support was provided in line with the outcomes they wished to achieve. People we spoke with knew how to make a complaint if they were unhappy with easy read complaint procedures accessible. The service worked well with other agencies and services to make sure people received care they needed.

Is the service well-led?

The manager and staff had a good understanding of the ethos of the service and their roles and responsibilities. Quality assurance processes were in place to check standards were maintained. People were routinely consulted about their level of satisfaction and feedback was used to improve the quality of the service.

Systems were in place to protect the rights of people who may lack the capacity to make decisions about their own treatment, care and support.

Staff worked closely with other agencies so that people's social, emotional and physical health care needs were effectively met.

We were told that there had been a number of changes in staff teams. Further recruitment had been undertaken to ensure that sufficient numbers of staff were available to meet the needs of people so that continuity could be provided.

Systems were in place to monitor and review the service provided. Suitable arrangements in the management and structure of the service were still to be made so that people continued to receive a safe and effective service. This was being explored by the provider.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.