Archived: Creative Support - South Lakes Service

At our last comprehensive inspection in of the service in October 2017 of the service we found a breach of Regulation 12 Safe care and treatment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.This was because people were at risk of not receiving their medicines safely because not all people had a care plan on how to manage their medications or the risk associated with them.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question safe, responsive and well-led to at least good. At this inspection we found that the provider had completed those actions and we found the service was meeting all of the fundamental standards of quality and safety.

This service provides care and support to people living in specialist ‘extra care’ housing in three locations. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is owned or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service. The purpose of the service is to enable people to live as independently as possible in the community. At the time of the inspection there were 31 people receiving the service.

Not everyone using Creative Support - South Lakes Service receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager in post. 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.

We saw significant improvements had been made to the care planning and management of risks associated with people’s medications. People received their medications as they had been prescribed and received the right level of support they needed to take their medicines safely. The staff identified if people were unwell and supported them to contact health professionals.

We saw that the service worked with a variety of external agencies and health professionals to provide appropriate care and support to meet people’s physical and emotional health needs.

There were sufficient numbers of suitably qualified staff available to meet people’s needs The frequency and duration of visits provided ranged depending on people's individual needs. and to allow flexibility in the service should people make a request to alter their visit times.

Where safeguarding concerns or incidents had occurred, these had been reported by the registered manager to the appropriate authorities. We could see records of the actions that had been taken by the home to protect people and the identified lessons that had been learned.

People’s rights were protected. The registered manager was knowledgeable about their responsibilities under the Mental Capacity Act 2005. People were asked for their consent before care was provided and the decisions they made were respected.

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

Auditing and quality monitoring systems were in place that allowed the service to demonstrate effectively the safety and quality of the home.

Further information is in the detailed findings below.

The service provides personal care and support to older adults in their own homes within three extra care sheltered housing schemes. The purpose of the service is to enable people to live as independently as possible in the community. At the time of the inspection there were 32 people receiving the service.

This was the first inspection of the service under this provider since they registered it with us in 2016. There was a registered manager in post on the day of our inspection visit. 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.

During this inspection we found a breach of Regulation 12 Safe care and treatment of the Health and Social Care Act (Regulated Activities) Regulations 2014 in relation to the management of people’s medications.

Although people told us that they felt safe receiving care and support from this service we found some care plans and records relating to the administration of medications were not always accurate or in place.

The quality of some care plans and risk assessments recorded were not consistent and information about some people’s care needs was not always current.

We have made a recommendation that records relating to care and treatment are consistent in providing accurate information to enable staff to follow the most appropriate plan of care.

We saw that recruitment procedures in place ensured only suitable people worked in the service. We saw that staffing levels according to the rotas were appropriate throughout the three housing schemes. However we received mixed comments from people we spoke with about whether there were sufficient staff. We were told that the provider was actively recruiting for more staff. Staff training was up to date and we saw that staff were supported by senior staff through supervisions and appraisals.

We found that the service worked well with a variety of external agencies such as social services and health care professionals to provide appropriate care and support to meet people’s physical and emotional needs.

People received support from a regular team of staff who they knew well and who understood the care and support they required. We saw that people were treated with kindness, dignity and respect and they made positive comments about the staff who supported them in their homes.

Support was provided in a manner to people to promote their independence for example supporting them to join in with activities in the community.

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

The service followed the requirements of the Mental Capacity Act 2005 Code of practice. This helped to protect the rights of people who were not able to make important decisions themselves. Best interest meetings were held to assist people who were not always able to make difficult decisions for themselves and where relevant independent advocacy was arranged if required.

We have made a recommendation that the service develops the quality and safety auditing systems of care records.