Jigsaw Creative Care Limited

Jigsaw Creative Care Limited provides both a domiciliary care agency and supported living services to people who either live in their own home, or people who share accommodation with others. The service is registered to provide care to children, younger adults, older adults and people with disabilities. At the time of the inspection the service was supporting 33 people.

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.

Not all care staff felt supported and listened to. However, we found the registered managers were working with care staff and their management team to continue to develop a supportive culture.

Not all health and social care professionals felt that they had a productive working relationship with the provider.

Relatives felt the registered manager was supportive and open with them and communicated what was happening at the service and their relatives.

The registered managers had strengthened their quality assurance systems to more effectively monitor the quality of the service being delivered and took actions promptly to address any issues.

People’s experience of using this service and what we found

We have made a recommendation about ensuring people’s Equality, Diversity and Human Rights (EDHR) have been explored and documented.

The outcomes for people using the service reflected the principles and values of Registering the Right Support.

People felt safe living at the service. Relatives felt their family members were kept safe in the service. The registered manager and care staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. Risks to people’s personal safety had been assessed and plans were in place to minimise those risks.

Staff recruitment and staffing levels supported people to stay safe. The management of medicines was safe, and people received their prescribed medicine on time.

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

People received effective care and support from care staff who knew them well. Care staff had received the appropriate training to support people effectively. People were encouraged to eat healthily. People had timely access to healthcare professionals such as their GP.

We observed kind interactions between care staff and people. Relatives confirmed care staff respected people’s privacy and dignity. People and their families were involved in the planning of their care.

The registered managers encouraged feedback from people and families, which they used to make improvements to the service. People were encouraged to live a fulfilled life with activities of their choosing and were supported to keep in contact with their families.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

At the last published inspection the service was rated good (report was published 3 January 2018).

Why we inspected

The inspection was prompted in part to follow up on concerns received about allegations of abuse raised with us in February 2019. This is subject to an ongoing criminal investigation.

Following the concerns raised in February 2019 a decision was made for us to undertake an inspection and examination of those risks. This resulted in urgent enforcement action being taken. The relevant safeguarding and commissioning bodies also commenced a provider concerns procedure to respond to and scrutinise the concerns raised. Due to unforeseen circumstances we were unable to complete all the necessary processes in order to publish the report. This inspection was part of the ongoing process to ensure people were receiving safe care. At this inspection we found no evidence that people were at risk of harm from this concern.

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 was the first inspection of the service at its current location. It was carried out by one inspector and an ‘expert by experience’, who carried out the telephone survey calls and provided a report to the inspector on what they were told.

Jigsaw Creative Care provides care and support to 30 people living in 18 ‘supported living’ settings, so that they can live as independently as possible. People supported have a learning disability. Some of the people supported also have needs within the Autistic spectrum and some may at times need support to manage specific behaviours. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Not everyone using Jigsaw Creative Care Limited receives the 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.

The care service has been developed and designed in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

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.

People and relatives felt people were safe and well cared for. The service had effective systems for staff to report safeguarding concerns. Staff understood and had used these. Where concerns had been raised, appropriate action had been taken to investigate and the service had cooperated with external agencies. Risk assessments had been completed where potential risk had been identified and suitable steps taken to limit risk with the minimum restriction on people’s freedom. Staff recruitment was robust and the required checks of the suitability and conduct of potential staff were completed prior to employment. Incidents were monitored and analysed to enable ongoing review of people’s support needs. The service had an effective system to manage people’s medicines safely.

People’s rights and freedom were promoted by staff and the service. 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. People’s transitions between services were well managed. The process was communicated effectively to people through the use of pictorial and other techniques. The service complied with the Accessible Information Standard. This is a framework put in place from August 2016 making it a legal requirement for all providers to ensure people with a disability or sensory loss can access and understand information. Relevant documents were presented in a format so as to be as accessible as possible to individuals and staff worked with people to explain them.

People and, where appropriate, relatives were involved in planning and reviewing people’s care. Detailed preadmission assessments were completed to ensure the person’s needs could be met and were compatible with others they were to live with.

People were treated with respect and their dignity and privacy were promoted. Care and support were provided in a person-centred way, taking account of individual communication needs. Staff provided an inclusive and enabling culture. The views of people, relatives, external professionals and staff were sought and acted upon to develop the service.

Where people needed support to manage their behaviour, this was provided through a nationally recognised system and all staff received regular training to ensure their approach was appropriate and consistent. People’s nutritional and healthcare needs were well met.

Staff received a thorough induction and had their practice observed before providing support unaided, to ensure their competence. Effective ongoing training and support was provided to staff.

Management responded positively to concerns and complaints and sought to learn from these to continually develop the service. Monitoring and audit systems enabled the management team to exercise effective governance over the operation of the service.