Archived: Creative Support - Manchester Extra Care Services

Creative Support – Manchester Extra Care Services provides personal care to some people who live in their own flats within an extra care housing scheme. The service is provided from two premises, Hibiscus Court and Shore Green. Shore Green is specifically designed to provide care to people living with dementia or memory problems. At the time of this inspection 20 people received personal care.

People's experience of using this service:

People told us they felt safe and staff were able to recognise and knew how to report signs of possible abuse. Risk was safely managed with personalised assessments and detailed guidance for staff to follow.

Staffing levels were sufficient to ensure people’s needs were met promptly. Staff were caring and kind in their approach, and clearly knew people well.

People felt staff had the knowledge and skills to support them well. Staff were happy with the induction they received when they joined the service. They completed the provider's required training, which was updated regularly.

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. Privacy and dignity were promoted and respected at all times.

People were happy with how the service was being managed. We found evidence the service was providing people with person centred, high quality care. Staff liked working at the service and told us they felt well supported by the registered manager and team leader. The service sought regular feedback from people about the care provided. People expressed a high level of satisfaction with the support they received.

The service completed regular checks of many aspects of the service, including medicines, concerns, accidents and care documentation. The checks completed were effective in ensuring the service maintained appropriate levels of quality and safety.

The service met the characteristics of Good in all areas; more information is available in the full report below.

Rating at last inspection:

At the last inspection the service was rated as good (29 November 2016).

Why we inspected:

This was a planned inspection based on the previous rating. The service remains good.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

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

The inspection took place on 20 September 2016. The inspection was announced as Creative Support provides domiciliary care to people in their own homes and we notified the provider on 16 September 2016 that we would be commencing inspection on 20 September 2016.

Creative Support – Manchester Extra Care Services are a domiciliary care service that provides personal care and support to people who live in their own flat or bungalow. The service is provided from two premises, Hibiscus Court and Shore Green. Both premises provided accommodation for people from the local community. Shore Green is specifically designed to provide care to people living with dementia or memory problems

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.

The inspection took place with the registered manager and the locality manager. We spoke with members of the staff team including team leaders and care staff who told us that the registered manager was always available and approachable. We spoke with people who used the service and their relatives on the day of the inspection. We spoke to more people and relatives following the inspection.

We saw that peoples prescribed medicines were recorded when administered. We looked at how records were kept and spoke with the registered manager about how staff were trained to administer medicines and we found that the medicines administering, recording and auditing process was safe.

From looking at people’s support plans we saw they were person centred. ‘Person-centred’ is about ensuring the person is at the centre of everything and their individual wishes and needs and choices are taken into account. The support plans made good use of personal history and described individuals care, treatment, wellbeing and support needs. These were regularly reviewed and updated by the support workers and the registered manager.

People who use the service received person centred support and their individual needs and were respected and valued.

Individual support plans contained risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary for example: their GP and social worker.

Our conversations with people who use the service and their relatives during the inspection showed us that people who used the service were supported in their own homes by sufficient numbers of staff to meet their individual needs and wishes.

We looked at the recruitment process and found that relevant checks on staff took place and this process was safe. People who used the service chose their own staff and together with their families were a major part of the recruitment process.

People were encouraged to plan and participate in activities that were personalised and meaningful to them. People were supported regularly to play an active role in their local community, which supported and empowered their independence including; accessing local facilities and the wider community.

We saw compliments and complaints procedure was in place and this provided information on the action to take if someone wished to make a complaint and what they should expect to happen next. Staff knew how to access to advocacy services and safeguarding contact details if they needed it.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. Any applications must be made to the Court of Protection. At the time of this inspection one application had been made to the Court of Protection and several others had gone through the process. We found that staff were aware of the requirements of the Mental Capacity Act 2005 (MCA) but did not always have training to support this.

We found that staff were trained but quality assurance processes did failed to identify that training records were not kept up to date. Training was monitored through supervision and appraisal but we found it was not clear which staff were targeted for specific additional training in-line with the training policy.

At the last inspection on 8 September 2014 the service was compliant and there were no actions or requirements.

You can see what action we told the provider to take at the back of the full version of the report.

This is what we found:

Is the service safe?

Suitable policies and procedures were in place relating to the safeguarding of people who used the service. All staff had received safeguarding training. Risk assessments were in place for people and these were regularly updated. Systems were in place to make sure staff learned from incidents, complaints and other events.

Is the service effective?

A full assessment of people's needs was carried out prior to people starting to use the service. People were fully involved in this assessment. A care plan was put in place and this was updated at least every six months. Quality assurance checks were carried out to ensure the care and support provided was to a high standard.

People told us they were happy with the care they received. Satisfaction survey results provided evidence that people were satisfied with all aspects of the service.

Is the service caring?

Everyone who completed recent satisfaction surveys said they were treated with respect by staff. Relatives started they thought people were treated as individuals and staff were polite and courteous. The people we spoke with told us they liked their care workers and they were able to receive personal care from a care worker of their gender choice.

People’s preferences were clearly noted in their records. There was a record of what name people wanted to be called by, their food preferences, what time they preferred to get up and go to bed and how they liked to spend their time. People confirmed their preferences were respected.

Is the service responsive?

The service employed enough staff to be able to provide cover for staff absences. Staff received training to ensure they were competent in all aspects of people's care and support. We saw evidence that complaints were monitored and where someone made a verbal comment or complaint these were also recorded. Where improvements could be made these were recorded. We saw that incidents and complaints were routinely discussed in staff meetings so all staff were up to date and could make changes to their practice when required.

Staff knew people well and we saw evidence that changes to people's support were made immediately when required.

Is the service well-led?

Creative Support – Manchester Extra Care Services had a statement of purpose that included all aspects of the service. Staff were clear about their roles and responsibilities. They met regularly with the manager. Senior managers were also in regular contact with the service. There was an effective quality assurance system in place and any issues were addressed promptly.

People were happy with the care provided by Creative Support – Manchester Extra Care Services. One person told us: “I have no complaints. I'm very satisfied with the service I get." One other person said: "I've no complaints. The staff are very good.”

We found that people had their needs assessed before they received a service and staff were given plenty of information about people and their preferred way of having their care needs met.

We found that the registered manager worked well with commissioner and other partner agencies and this ensured that people who used the service had their needs met.

We found that staff were trained and supervised in their day to day work and because of this people who used the service received safe and appropriate care.