Creative Support - Sonali Gardens Extra Care Service

Sonali Gardens is an extra care service which was providing personal care to 12 people at the time of our inspection, the majority of people using the service are from the Bengali Community. Also included in the location registration is Coopers Court, an extra care service which was providing personal care to 15 people at the time of our inspection.

Both services provide care and support to people who live in their own flats and provide 24 hour emergency cover. There are communal areas including a launderette, a lounge, dining room and shared garden. On each floor there is an accessible bathroom and sitting room.

The manager of Sonali Gardens is the registered manager 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.

At our last inspection we said the safety of the service required improvement, as there were not suitable checks carried out to ensure that medicines and money were managed safely. At this inspection we found that the provider had acted on our findings and had introduced thorough checks in this area. We haven’t changed the rating in this area, as at this inspection we found that although the provider had measures in place to assess and manage risk, in some cases risk management plans did not fully address the current risks to some people who used the service.

The provider managed medicines safely in most cases and ensured that staff had suitable training and checks of their competency to do this. We saw that managers carried out regular checks on medicines and addressed issues of concern promptly; but we found one case where a medicated patch was not managed safely, which the provider took action to address.

Staff were recruited in line with safer recruitment practice and staffing levels reflected the needs of people who used the service. Staff received suitable training and supervision to ensure they had the right skills, but some areas of supervision and appraisal records were quite generic and repetitive.

People had consented to their care plans appropriately and care was delivered in line with these. People received additional support when required, for example for health appointments, and people received the right support to eat and drink. People and staff were confident raising concerns with management and complaints were addressed appropriately. There had been two substantiated safeguarding incidents regarding the conduct of staff; there was evidence that the provider had taken appropriate action in response to these and had learnt from these incidents. People we spoke with told us they were treated with respect. Both services operated a varied activity programme which continued to develop and was a high organisational priority.

Managers had systems in place to check the delivery of care and the quality of records. These included carrying out spot checks and raising issues with staff through recorded conversations. Managers were visible in the service and people spoke highly of them. In practice the service operated as two separate services over the two sites, which was not in line with the provider’s registration, however the provider told us they intended to register Coopers Court as a separate service.

We have made a recommendation about how the provider ensures that all risk management plans contain clear guidance for staff.

The provider has recently taken over providing services to two other sites (Sue Starkey and Shipton Houses), and have informed us that they are temporarily managing these services from this location from 9 November 2015. As the Provider has applied to register these services in their own right, these were therefore excluded from this inspection.

The inspection took place at Sonali Gardens on 3 and 7 December 2015 at Sonali Gardens, and on 10 December at Coopers Court. The first day of our inspection at Sonali Gardens was unannounced.

Sonali Gardens is in a block of flats in Shadwell which consists of 30 one-person flats and 10 flats for couples. The building is owned and administered by Circle Housing. Creative Support are contracted by the London Borough of Tower Hamlets to provide extra care services to 21 people who live at Sonali Gardens, however at the time of our inspection 17 people were using the service. Sonali Gardens previously only accepted referrals from the Bengali community, and subsequently the majority of people who live there are Bengali speakers.

Coopers Court is a block of 34 flats in nearby Mile End, which is owned and administered by Sanctuary Housing. Creative Support provide extra care services to 33 people who live there. In extra care services, people occupy their own self-contained flats and receive care and support services which can include personal care and support with healthcare, finances and daily living skills. Coopers Court and Sonali Gardens contain additional shared facilities such as a laundry, accessible bathrooms and guest rooms. At Sonali Gardens there is a lounge on each floor and a prayer room on the first floor. Coopers Court has a large shared lounge and kitchen on the ground floor.

Coopers Court and Sonali Gardens have self-contained staff teams and each have a project manager. The area manager for Creative Support is the registered manager for both sites. 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.

Sonali Gardens is the registered location for both sites, which means that the Provider has told us that this is where the regulated activity is managed from. We found that this is not presently the case, although the registered manager had contacted us shortly before the inspection to ask whether this was a requirement and had put plans in place to address the matter.

The provider had a number of innovative means for delivering high quality support, particularly relating to staff training and supervision. This resulted in knowledgeable and skilled staff. People we spoke with were pleased with the care they received, and praised staff and managers. We found that the service delivered responsive and personalised care, with care plans regularly reviewed and support hours changed depending on people's needs.

Where there were risks to people using the service, the provider had comprehensive risk assessments in place in order to minimise these risks. People who used the service felt safe living there and safeguarding was taken seriously by managers, who were proactive at reporting concerns to the local authority.

The provider was not carrying out comprehensive audits of records relating to medicines, finances and daily records of support provided. This meant there was a possibility that mistakes could be made and not followed up appropriately. We have made a recommendation relating to how the provider carries out audits in relation to keeping people safe.

Care was person-centred and the service met people's cultural needs. People who used the service were treated with respect and people had the opportunity to tell their life stories. The service was proud of the work it did with people, and people benefitted from a varied and interesting programme of events and activities.