Archived: Creative Support - North Lincolnshire Service

This inspection of Creative Support - North Lincolnshire Service took place on 4 March 2016 was unannounced. We subsequently carried out a further inspection visit on 8 March 2016 which was announced. This was to enable us to meet the people living in supported living arrangements in their own homes and was in consideration of their needs and to ensure they would be available.

The service was last inspected on 27 and 30 June 2014, when it was found to be compliant with the regulations inspected.

At the time of our inspection the service was providing personal care to 21 people under supported living arrangements.

There was a registered manager in place for the service. 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.

Due the complex needs of people who used the service, many were unable to provide clear verbal comments about their experiences and views about the service. We therefore observed their interactions with staff.

Staff were safely recruited and received training about the protection of vulnerable adults to ensure they could recognise and report issues of potential abuse.

Assessments concerning the management of known risks for people were carried out and regularly reviewed to enable staff to keep people safe from harm. Staff training was provided to ensure they knew how to positively manage the behaviours of people who used the service. Incidents and accidents were recorded and analysed to enable them to be minimised.

Staff were provided with training to ensure they knew how to administer medicines to people safely and audits of Medication Administration Records (MARs) were carried out to ensure potential errors were identified and action taken to minimise them occurring again.

Staffing levels were monitored to ensure there were sufficient numbers available to keep people safe from harm. People who used the service appeared comfortable with staff, who we observed were very sensitive in ensuring their individual needs were met and communicated with them in kind and friendly way that could be understood.

People who used the service were supported by staff who had received training in how to meet their needs. People who needed support with making informed decisions and choices were protected by use of legislation to ensure their human rights were protected

People received support that was person-centred and based on their individual wishes, needs and preferences. People and their relatives were involved in the development and provision of their support where this was possible. People were supported to maintain a healthy and balanced diet to ensure their nutritional needs were met. Staff supported people’s medical needs and liaised with health professionals for advice and guidance when this was required.

We observed staff interacted positively with people who used the service and involved them in making decisions, to ensure they were happy with how their support was delivered. People told us that staff treated them with kindness, dignity and respect at all times.

People who used the service were encouraged to develop their aspirations and goals based on their personal strengths and interests. A comprehensive range of ‘creativities’ (opportunities for social interaction and personal development) took place at the office base of the service and in the community to ensure their independence was maximised and enable their social inclusion to be promoted.

People were asked for their views about the service. Satisfaction surveys were sent out to people and action was taken to help the service improve. There was an accessible complaints policy using pictures and words to help people raise a complaint if they were unhappy with support they received and have this resolved where this was possible.

The registered manager understood their responsibilities and reported accidents, incidents and other notifiable incidents as required. Arrangements were in place to ensure equipment was appropriately serviced and a business continuity plan was available for use in emergency situations.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Due to the complex needs of the people using the service we were unable to gain some people's views. We therefore used a number of different methods to help us understand their experiences. This included observing how staff supported people, speaking with staff and their relatives and checking records. If you want to see the evidence supporting our summary please read the full report.

Below is a summary of what we found.

Is the service safe?

We observed that care and support was delivered to people who used the service in a safe way by staff who had received appropriate training.

We found that systems were in place to make sure managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helps the service to continually improve.

We saw evidence that robust background checks were carried out on new staff before they were employed, to make sure they were suitable to work with vulnerable people. We saw that checks with the Disclosure and Barring service (DBS) were renewed for staff every three years.

The service had policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards to ensure people's human rights were protected. Relevant staff had received training on this to enable them to understand when an application about this should be made and how to submit one. This meant that people's rights would be safeguarded as required.

Is the service effective?

We found people were encouraged to express their views and be involved in making decisions about their care and support. Staff we spoke with gave us examples of how people were involved in making decisions about their care and support.

We saw that people's health and support needs were assessed on a regular basis. We found that people who used the service and their relatives had been involved in the development of their plans of support and these were reviewed and updated.

Staff received appropriate professional development. We saw that staff had access to a variety of appropriate training to help them meet the needs of the people they supported.

Is the service caring?

We observed staff interacted with people who used the service in an open and friendly way. We saw that people were provided with support that was appropriate for their needs and that encouragement to help them be as independent as possible was provided.

We observed care staff were considerate of people's needs and responded to them in a compassionate and sensitive manner.

Care files contained information about people's needs. This included people important to them, together with people's personal aims and goals. We saw that care and support was provided to people in accordance with their individual preferences.

Satisfaction surveys and review meetings were used by the provider to enable people and their representatives to share their views on the quality of the service provided. This helped the provider to assess the quality of support people received.

Is the service responsive?

Care records demonstrated that when there had been changes in people's needs, outside agencies had been involved, to make sure people received the correct care and support.

Records showed people had access to a variety of social activities. During our visit we observed people being supported to go out into the community and participating in stimulation activities.

The service had a complaints procedure which was available to people who used and visited the service. There was evidence the provider listened to people's views and followed up their concerns appropriately to put things right.

Is the service well-led?

There was a quality assurance system in place to assess if the service was operating correctly. This included surveys and audits of service provision. We saw action plans in place to address shortfalls that had been noted and there was evidence of ongoing progress to address identified issues.

Staff were clear about their roles and responsibilities. We saw that staff had access to policies and procedure to inform and guide them in their work. There was evidence staff training and development needs were assessed by the provider to ensure staff were able to meet people's needs and help the provider to arrange future training when this was required.

The service worked well with other agencies and external services to ensure people who used the service received care in a joined up way.

What people who used the service, and those that matter to them, said about the care and support they received:-

We observed staff interacted with people in a kind and friendly manner and had a good understanding of people's individual needs. We observed people who used the service appeared comfortable and at ease with the staff. One relative told us they would, 'Trust staff with (their son's) life' whilst another told us the provider was 'Honest' and 'Don't hide things.'

A relative we spoke with said they were, 'Very happy' with the service and that support in the project was provided, 'Like a family.'

Another relative told us the service was 'Brilliant' and their member of family had 'Come on in leaps and bounds' since they had first joined the service. They told us 'The difference is unbelievable'he always looks clean and well looked after."

One relative told us they visited regularly to ensure the needs of their member of family were appropriately met. They told us overall they were happy with the service and that staff were 'Absolutely fantastic.' However, they did tell us about a meeting that had been arranged to discuss their concerns following recent staff changes that had impacted on people who used the service on occasions.