We carried out a review of the data available to us about Creative Support - Chorley & Wigan Services on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Creative Support - Chorley & Wigan Services, you can give feedback on this service.
Creative Support – Chorley Service supports people who have a learning disability in their own home and provides personal care in line with a 'supported living' model. Supported living is a way of supporting people in their own home with their personal care or support arranged separately with a specialist provider.
Everyone supported by Creative Support – Chorley supported living service had their own tenancy agreement. At the time of the inspection 21 people were receiving support from the service. The service also had an outreach programme providing support to people living with their family or carer. At the time of the inspection 2 people were receiving support from the service.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support:
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 interests. The policies and systems in the service supported this practice. When people lacked capacity to make specific decisions, we found the service was following the best interests principle. Relevant authorisations had been granted by the Court of Protection where people’s liberties were deprived.
People’s needs were assessed, and care plans were developed to promote positive risk taking. People’s homes and decor was personalised and reflected their personalities, showing their choices and decisions had been respected. Adjustments had been made in people’s homes to promote their independence and keep them safe. Staff had been employed following robust recruitment procedures and were trained in the safe storage and administration of medicines. Staff were knowledgeable on what actions to take should they witness any safeguarding concerns or hear any allegations of abuse.
Right Care:
The service had enough staff to meet people’s needs and keep them safe. Staff knew the people they were supporting well, including their health and wellbeing needs. Staff were trained and skilled to offer support and guidance to quickly lessen or minimise people’s distress. Staff and visitors had access to protective personal equipment to limit the risk of infection. Staff knew how to ensure people had the option of eating a healthy diet.
Right Culture:
People had the option of carrying out their daily living tasks and leisure activities in their local area. When people had chosen to opt out of certain tasks their decisions had been respected. Staff told us they could raise concerns with managers and feel safe and supported. People were comfortable and relaxed in the company of staff. People and staff had a friendly rapport and people had a positive relationship with the registered manager that included laughs and hugs. The provider carried out regular audits and could evidence lessons were learnt when things went wrong. The management team worked alongside staff and with outside agencies to keep people safe and achieve their goals.
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 08 November 2017).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Creative Support - Chorley on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Creative Support – Chorley Service supports people who have a learning disability in their own home and provides personal care in line with a ‘supported living’ model. Supported living is a way of supporting people in their own home with their personal care or support arranged separately with a specialist provider.
People who use the service have their own tenancies and receive their support from staff employed by Creative Support. The service also has an outreach programme providing support to people living with their family or carer. At the time of the inspection 28 people were receiving support from the service.
At the last inspection on 23 April 2015, we rated the service as overall “Good” but found there were shortfalls in the administration of medicines. During this inspection, we found the necessary improvements had been made in this area and the service was meeting all the current regulations.
Since the last inspection the registered manager had retired and a new manager had been appointed who was going through the process of registration. The manager had moved from another service run by the provider and was familiar with the Chorley 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.
We found the provider had safeguarding adult’s procedures in place and staff had a clear understanding of these procedures. Staff had access to a whistle-blowing procedure and said they would use it if they needed to. Appropriate recruitment checks were carried out before staff started working at the service and there were enough staff to meet people's needs. Risks to people using the service were assessed, reviewed and managed appropriately. People received their medicines as prescribed by health care professionals.
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 consented to the care and support they received. The service complied with the requirements of the Mental Capacity Act (MCA) 2005 and the associated Code of Practice. Staff had been trained and understood their responsibilities in relation to MCA.
People told us they liked the staff and that they were kind and caring. We observed that staff treated people with respect and promoted their dignity. People were supported to communicate their views about how they wanted to be cared for.
People’s nutritional needs were met. Staff helped people to purchase and prepare their food and people told us they enjoyed the choice of food that was available to them. People were supported and encouraged to participate in activities.
Staff were trained on various areas to ensure they had the relevant skills, knowledge and experience to provide good care to the people they looked after. Staff received regular support and supervision to carry out their duties effectively.
The service liaised with various healthcare professionals to meet the needs of people.
People had their individual needs assessed and their care planned in a way that met their needs. People received care that reflected their preferences and choices.
Reviews were held with people and their relatives to ensure people’s support reflected their current needs.
People and their relatives had opportunities to share their views and give feedback about the service and these were acted upon. The service was subjected to regular quality checks to ensure the service was of good quality and met people’s needs.
Creative Support – Chorley Service supports people who have a learning disability, in their own home, providing personal care in line with a supported living model. People who use the service have their own tenancies and receive their support from staff employed by Creative Support. There is also an outreach programme providing support to people living with their family or carer.
The last inspection of the service took place on 5 February 2014. During this inspection the service was found to be meeting all the regulations assessed. This inspection took place on 23 April 2015. The provider was given 24 hours’ notice of our intention to visit. This was because the location provides a domiciliary service and we needed to ensure there would be someone present at the office to provide us with the required information.
We were assisted throughout the inspection by 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. The registered manager at Creative Support – Chorley Service had been in post for several years.
We spoke with a number of people throughout the inspection, including people who used the service, their relatives or main carers, staff and community professionals. Some very positive feedback was received with the majority of people expressing satisfaction with all aspects of the service. People were confident in the service to provide safe and effective care and spoke highly of staff and managers.
People felt that care workers understood their needs and were able to meet them. People were satisfied with the help they received to access community services, such as medical care, social work support and advocacy.
Staff worked positively with external professionals to ensure people received safe and effective care. Risks to people’s wellbeing and safety were identified and carefully managed.
There were clear procedures in place to manage people’s medicines safely. However, these had not always been followed, which had resulted in some errors being made when administering one person’s medicines on several occasions. Medicine records were not always updated in a timely manner, which meant care workers may not have had access to appropriate up-to-date information.
People felt involved in the development of their care plans and able to express their views and opinions. People felt that they were able to request any changes to their care plans and were listened to. There were processes in place to ensure the rights of people who were not able to consent to certain aspects of their care were protected.
People who used the service were supported to engage in fulfilling activities of their choosing. Many people we talked with spoke of staff encouraging and supporting them to try new activities.
Staff were carefully selected and a number of checks were carried out to ensure they were of suitable character before they were employed. There was a comprehensive training and support programme in place to help ensure staff were competent to carry out their roles effectively.
People were enabled to express their views, ideas and opinions about the service. The registered manager acted upon people’s feedback and developed the service accordingly.
There were arrangements in place to enable the provider and registered manager to monitor safety and quality across the service. Where any areas for improvement were identified, appropriate action was taken to ensure they were addressed.
People using the service provided positive feedback about the staff and the support provided. Comments included; 'I get the same staff. If the rota is changed, they let me know.' 'Yes, I have a regular worker. I give them nine out of ten.' And 'I am happy with my support.'
Family forums, coffee mornings, house meetings and staff meetings all provided good opportunities for stakeholders to keep up to date with any changes and to share their views about the development of the service.
The complaints and suggestions policy was produced in an easy to read format, to aid the understanding of people using the service. Large text, pictures and symbols were used to explain the key messages within the policy. This helped people using the service to access, use and understand the policy and process regarding complaints.
The relatives we spoke with told us they were satisfied with the care provided. Comments included; 'I am very happy with the service. If I wasn't happy I could ring and I am sure it would be sorted.'
People experienced support that reflected their wishes and met their needs and the provider encouraged them to lead a healthy lifestyle.
There were suitable arrangements in place to ensure that vulnerable adults were safeguarded against abuse and staff were knowledgeable and confident about recognising abuse and what to do if they did.
Staff employed by the provider underwent a rigorous assessment process and appropriate checks were made by the provider before any new recruits were offered a position within the company.
The provider undertook regular review and constantly monitored the quality of the support being provided by the service to ensure that people's needs were met.
People told us:
"I always get good care...I'd be happy to raise any problems with the people that look after me."
"It's only been six weeks, but so far it's brilliant!"
"Staff seem to know what they're doing...It's fine. I'm really quite happy."
We received some very positive feedback from people and everyone we met expressed satisfaction with the service provided.
People spoke highly of support workers and told us they felt they were treated in a kind, respectful manner by staff.
Comments included;
'I feel very safe with the staff. They understand me and they understand the challenges I face.'
'I like living in my house, I like my garden.'
'We go for walks and we go shopping.'
'I have moved on so much with Creative Support. I feel like I have made so much progress. I am becoming more independent and confident too.'
People told us that they felt fully involved in their own care and were able to make decisions about the support they received. One person we spoke with explained that she preferred to have the main part of her support at the weekends and advised us that this had been no problem to arrange.
We observed people being supported and saw that service users and staff appeared to get along very well together. People looked relaxed, content and comfortable in their surroundings.