Creative Support - Tameside Intense Support Service

Creative Support Tameside Intense Support Service specialise in supporting people who may be at risk of committing criminal offences and who have extreme behaviours. People they support have learning disabilities and may have a mental health diagnosis. The service supports people living in eleven flats across two buildings.

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

People were kept safe. The service had an open culture where people were encouraged to raise any concerns they had about people's safety and we saw concerns had been thoroughly investigated. The service had developed processes relating to recruitment and assessing risk to ensure people were kept as safe as possible.

People were supported by staff who were well trained and felt well supported. Staff spent time getting to know the people they supported well which helped them encourage the people using the service to try new things that might interest them.

We observed caring and supportive interactions between staff and people using the service. People we spoke with told us they liked the staff and were very happy in the service. People were encouraged to become more independent and express their views and make decisions about their support.

The service worked hard to ensure people built links with people and organisations in the local community. At the time of our inspection people were volunteering and working for numerous organisations. People were commonly out on activities rather than staying in their flats.

The management team had a focus on continually trying to improve the service. Staff told us they felt involved in developing the service for the benefit of people using it. Feedback from other organisations involved with the service was very positive.

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 supported this practice.

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 25 November 2015).

Why we inspected

This was a planned inspection based on the previous rating.

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.

This service provides intensive support to people who have a learning disability and may have a mental health diagnosis. Some people may have a forensic background, have behaviours that challenge or may be in crisis. The service is across two locations with seven and four single flats respectively. There were 11 people using the service when we visited.

The service had 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 2008 and associated Regulations about how the service is run.

This service provided tailor-made support that was designed to meet the very complex and challenging needs of people who may not have otherwise been able to successfully live in the community.

The service worked very closely with mental health and learning disability services to ensure a joint approach to the support and progress of people who used the service. It was very good practice that a clinical multi-disciplinary team meeting (MDT) was held every month to review individual people’s current well-being.

All the health and social care professionals we contacted were very positive about the unique service each person received and the positive impact it had on their lives. For example, one health professional commented, “I believe the Intensive Support Service provides excellent care and support to people who have some extremely difficult behaviours and issues who ordinarily would not be able to live within usual 24 hour community supported living environments.”

People said they felt safe and comfortable at the service. One person commented, “I feel really comfortable here. It feels safe in my own flat and I love it here.”

Staff knew how to recognise and report abuse. The provider made sure only suitable staff were employed. Medicines were managed in a safe way, and records were up to date with no gaps or inaccuracies.

There were enough staff to support people. Each person had a core staff team who were specifically recruited and matched to them so they were very familiar with their individual needs. Staff received very personalised and relevant training about each person’s needs so they knew how to support them in the right way. Staff also received regular supervisions and appraisals to support them in their roles.

People enjoyed good relationships with their key staff. One person told us, “My staff team are lovely – really nice and friendly. They made me feel very welcome when I moved here.”

People felt their independence and daily living skills were promoted. One person told us, I’ve been here a couple of years and since then I can do much more for myself, like make my own meals and go out.”

People had information about how to make a complaint and said they would talk with the registered manager if they were unhappy with any part of the service. There had been no complaints about the service for over a year.

People, staff and external professionals felt the service was well managed. People described the registered manager as “lovely” and said they could talk with her at any time.

People were asked for their views at individual key worker meetings and at tenants’ meetings. People felt their views were listened to.

Staff felt there was an “open” and “approachable” culture within the service. Staff said they felt valued and fulfilled in their roles.

The provider and management team monitored the quality and safety of the service.

The manager had taken appropriate steps to ensure only suitable people were employed to work in a social care setting with all necessary pre-employment checks being conducted before workers started to provide care in people's homes.

Staff had received appropriate training and we were confident that staff understood their roles and responsibilities.

We found that staff had received training in safeguarding adults and had access to safeguarding policies and procedures, including details of how to contact the local authority. In our discussions with staff around safeguarding people we were confident that they would report incidents to the management team who would then take appropriate action in line with local authority guidance.

The organisations recruitment practice was robust, safe and thorough.

Arrangements were in place to ensure people were administered their medicines safely.

Is the service caring?

People using the service gave us positive feedback about the staff and the service they received. Comments included, "The staff are good, I like my key worker [named] he helps me a lot", "I like to go out and we have a chat and talk about things" and "My key worker talks with me every week about my care plan".

Information in care records clearly focussed on people's preferred routines and what they liked to do on a day to day basis. For example, one person said, "They [staff] help me to do the things I can do for myself and they help with things I can't [do for myself]".

Staff had access to people's care plans and they were able to describe some of the methods used to support people's varying needs, especially where people had limited daily life skills and abilities.

Is the service responsive?

People were being supported by well trained staff and their care and support had been provided in accordance with their individual needs and wishes. For example, one person told us, "I like to go out and we have a chat and talk about things", "I like my key worker [named] he helps me a lot".

We saw that weekly reviews (summary meetings) had been carried out to ensure any changes in a person's needs was being picked up quickly and that care and support was adjusted appropriately to meet those changing needs.

Is the service effective?

We saw people's records that indicated other health care professionals such as doctors had been consulted in response to a change in the person's health condition. This meant that people using the service were receiving prompt, co-ordinated and effective care and support.

People using the service told us that they were involved in developing and writing their care plans. This was done on a monthly basis with their named key worker. For example, one person told us, "My key worker goes through my care plan with me every month. We sit and talk about things".

Is the service well-led?

The service had an appropriately qualified and experienced manager who was registered with the Care Quality Commission.

The manager ensured staff were able to deal with behaviours that could be challenging. Specific training had been provided to all staff. This training helped staff to understand and respond to behaviours that challenged in order to keep both themselves and people using the service safe.

The service worked in partnership with other agencies, such as the local authority, health authority and safeguarding teams. Such multi-agency working helped to ensure people's safety and well-being were being maintained at all times.

There were systems in place to regularly assess and monitor the quality of service being provided at Sycamore Court.

The manager was supported by regular visits from the Director of Services for the organisation.