Creative Support - Willowtree House

Creative Support – Willowtree House is a residential care home providing personal care for up to six people in one adapted building. It specialises in supporting people who have learning disabilities and or autism. At the time of our inspection, there were five people living at the home.

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

The provider's quality assurance systems and processes were not always effective at identifying concerns and driving improvement in the service. Systems that were in place were not implemented effectively and audits had not identified concerns with the service.

Environmental risk management and infection control procedures were not sufficient. Staff had not consistently followed the provider’s systems and processes to assess and minimise environmental risks to people.

Not all staff had received mandatory training. Training had not always been refreshed at the timescales identified by the provider.

Safe recruitment procedures were followed. There were enough staff available to meet people’s support and activity needs.

People were supported to eat a balanced diet that met their needs and any associated risks were managed with appropriate specialist input. Staff worked effectively with community health and social care professionals to achieve positive outcomes for people and ensured their health needs were met.

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 interest. Policies and systems were in place; however, staff practice did not always follow policy in relation to the recording of mental capacity assessments and administration of Deprivation of Liberty safeguards (DoLS).

Staff knew the people they supported well and adopted a caring approach towards their work. People were treated with dignity and respect.

People's care plans were individual to them, covered key aspects of their care needs and promoted a person-centred approach. People had support to participate in a range of social and recreational activities.

People and their relatives understood how to raise any concerns or complaints with the provider.

The management team promoted effective engagement with people and their relatives. Staff felt well-supported and valued. People were encouraged to express their views about the care provided, and these were listened to.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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 8 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to environmental risk management and the governance of the service at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Delos – Willowtree House (Creative Support) provides accommodation and personal care to people with learning disabilities and autism.

At the time of our inspection the provider confirmed they were providing personal care to 5 people.

There was not a registered manager in post. The service had a manager that was going through the process of registering with the CQC to become the 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.

People told us they felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and how to report them.

People had risk assessments in place which recognised their rights and enabled them to be as independent as they could be.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs.

Effective recruitment processes were in place and followed by the service, to ensure that only suitable staff were employed to work with people.

Medicines were managed safely and the processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.

Staff received a comprehensive induction process and on-going training. They were very well supported by the manager and had regular one to one time for supervisions.

Staff had attended a variety of training to ensure they were able to provide care based on current practice when supporting people.

Staff always gained consent before supporting people. People told us that staff always checked with them before doing anything and respected their privacy.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were very knowledgeable of this guidance and correct processes were in place to protect people.

People were able to make choices about the food and drink they had, and staff gave support when required.

People were supported to access a variety of health professional as and when required.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People were comfortable around staff and confident in communicating with them.

People and relatives where appropriate, were involved in the planning of their care and support. People told us they felt in control of their own lives.

People’s privacy and dignity was maintained at all times. People were supported to follow their interests and maintain friendships and relationships.

A complaints procedure was in place and accessible to all. People knew how to complain and were confident that they would be listened to.

Effective quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.