Archived: Creative Care and Support

The registered manager of the service was given 24 hours’ notice of the inspection, because the location provides a domiciliary care service; we needed to be sure that the registered manager and other staff would be present to talk with. We also wanted the service to make initial contact with some people, who we had identified we would like to visit, to ask them if we could visit them in their own homes.

Creative Care and Support is registered to provide personal care. Support is provided to younger adults and older people living in their own homes. Support can range from personal practical care or support from a short visit to a 24 hour package. The agency office has recently moved and is now in the Priory Campus Building in the area of Lundwood close to transport links.

Our last inspection at Creative Care and Support took place on 28 April 2014. The service was found to be meeting the requirements of the regulations we inspected at that time.

There was a manager at the service who was registered with CQC. 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 and associated Regulations about how the service is run.

We received lots of positive feedback about the service. The majority of people spoken with told us they were satisfied with the service they were provided with.

People who used the service and their relatives spoke highly about the staff, particularly the care staff.

The main issues for some people who used the service and their relatives were the timing of visits varying. There had been three recent missed visits. Records checked showed these were the first missed visits in the last six months. The business manager had met the family of the person who had experienced the missed visits, apologised and put in systems to prevent a reoccurrence.

Some people who used the service felt communication between the office staff and themselves needed improvement. We spoke with the registered manager and business manager present on inspection with regard to communication. They accepted that communication was a vital component of the service and they were striving to improve this part of the service.

People who used the service told us they felt safe and staff had received training in safeguarding people from abuse. They understood how to protect people from avoidable harm and how to report their concerns.

People's care plans contained up to date information about their care and support including risk assessments. These were regularly reviewed and updated when the person's needs changed.

People were supported to take their medicines as prescribed. There were systems in place to ensure care staff were competent in the administering of medicines.

Staff had received training in the Mental Capacity Act 2005, and we saw the registered provider and registered manager followed and worked within the principles of the Act.

Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

Individual staff supervision was less frequent and meetings were not always recorded. The registered manager and business manager were looking at the provider’s supervision policy so the type of support staff received was more varied and always recorded.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns. Where people had expressed concerns appropriate action had been taken.

The service used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys, spot checks and care reviews. We found the majority of people were satisfied with the service they received.

We gathered evidence against the outcomes we inspected to help answer our five key questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

We visited the services office and spoke to the two service managers and three support staff. We spoke via the telephone with one person and three relatives of people who used the service. Below is a summary of what we found.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People supported by the agency, or their representatives told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

The home had proper policies and procedures in relation to the Mental Capacity Act 2005 [MCA] and Deprivation of Liberty Safeguards [DoLS]. Staff received relevant training and were able to describe the Act and when a DoLS application would be necessary. This meant that people were safeguarded appropriately in line with current legislation.

People told us that they felt their rights and dignity were respected. They said, 'The staff are very polite and show mum lots of respect and courtesy.'

People and their relatives told us, 'Mum trusts the care staff, she's taken to them, she feels safe with them' and ' I feel very safe in staff's company.'

We found that risk assessments had been undertaken to identify any potential risk and the actions required to manage the risk. This meant that people were not put at unnecessary risk. We also found that people had access to choice and remained in control of decisions about their care and lives.

The manager organised the scheduling of visits to ensure people's preferences and identified needs were taken into account. Staff were also involved in these discussions during regular staff meetings that took place at the agency. This helped to ensure that people's needs were always met.

Recruitment practices were safe, thorough and effective. There were procedures in place to ensure staff were suitable for their role.

Is the service effective?

People's health and care needs were assessed with them and their representatives, and they were involved in writing the support plans. Relatives said that their family members support plans were up to date and reflected their current needs.

Staff were provided with training to ensure they had the skills to meet people's needs. Managers' were accessible to staff for advice and support.

Is the service caring?

We asked people using the service and their relatives or advocates for their opinions about the support provided. Feedback from people was very positive, for example; 'They [staff] have never missed a visit, they are excellent', 'I would certainly recommend this agency, staff are brilliant', 'staff don't just rush in and out, if they have finished providing care they sit and talk with her, she looks forward to staff coming', 'Overall I am really happy with the agency' and 'very good agency and very good staff, no worries at all.'

When speaking with staff it was clear that they genuinely cared for the people they supported and had a detailed knowledge of the person's interests, personality and support needs.

People's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People and relatives spoken with said they had never made a complaint but knew how to make a complaint if they were unhappy. We found that appropriate procedures were in place to respond to and record any complaints received. People could be assured that systems were in place to investigate complaints and take action as necessary.

People and relatives said they felt listened too and the agency would respond to their views. They told us that staff and the managers were flexible and accommodating with visit times. A relative told us that visit times had been changed in order to suit their 'loved ones' preferences and needs.

Is the service well-led?

The service had a quality assurance system. We found that the quality assurance procedures had not been fully implemented or developed. The manager explained that this was because the agency was still being established and the systems were being amended and tailored so that the methodology was suitable and sustainable for Creative Care and Support.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the agency and showed a commitment toward their work with Creative Care and Support. This helped to ensure that people received a good quality service at all times.