Archived: Creative Support - Halton Service

During our inspection we spoke with a service director, an acting manager and three staff. We also contacted two relatives and two people who used the service via telephone. We also undertook a home visit so that we could speak to another person receiving personal care from the agency. This enabled the person using the service to participate in our visit using their preferred methods of communication.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

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

Is the service safe?

Policies and procedures had been developed by the registered provider (Creative Support Limited) to provide guidance for staff on how to safeguard the care and welfare of the people using the service.

Management spoken with demonstrated that they had a good understanding of the requirements of the Mental Capacity Act and how to access support for people who had difficulty in making their own complex decisions.

Likewise, staff spoken with confirmed they had received safeguarding training and had a good understanding of the different types of abuse, their duty of care to protect vulnerable adults and the action that should be taken in response to suspicion or evidence of abuse. Records highlighted there had been four safeguarding incidents since our last inspection and that appropriate action had been taken in response to incidents. We noted that the safeguarding log for the Halton Service was not as detailed as the log in use for other registered services operating from the same location and some key information was missing. We raised this with the management team who informed us they would take action to address these issues.

We looked at a sample of recruitment records for the three most recently recruited staff in the service. Examination of records and discussion with staff confirmed prospective employees had undergone a comprehensive recruitment process prior to commencing employment with the provider. This helped to safeguard the welfare of vulnerable people.

Is the service effective?

Files viewed contained assessment and care / support plans from care managers (social workers or health care professionals) which outlined the needs, support requirements and objectives for each person. Service reviews were also undertaken periodically to review the effectiveness of the service and to involve people using the service and their representatives in planning for the future.

The registered provider had developed a 'Complaints, Suggestions and Compliments' policy. Information on the complaints procedure had also been included in the agency's 'Statement of Purpose' and 'Service User Handbook'.

Records viewed confirmed that no complaints had been received from people receiving the service since the last inspection. We noted that the complaints log template for the Halton Service was not as detailed as those in place for other registered services operating from the same location. We discussed this with the management team who informed us they would take action to improve recording systems.

People using the service and / or their representatives spoken with confirmed that they were aware of how to complain and confident that should they raise a complaint with the provider that their views would be listened to and acted upon.

Is the service caring?

People using the service and / or their representatives spoken with during the inspection confirmed they had confidence in the service to provide good standards of care and that people were treated in a dignified and caring manner.

Comments received from people using the service included: 'I'm happy and have no complaints'; 'Everything is brilliant' and 'The carers are lovely people.'

Likewise, feedback received from the relatives of people using the service included: 'At first I was not happy with Creative Support but over the last couple of years I can't praise them enough' and 'I have no concerns regarding the standard of care provided and would describe the care provided as excellent. The staff do an exceptional job and appear competent and knowledgeable.'

Is the service responsive?

A range of records had also been produced and completed by the provider. For example: holistic assessments of need; person centred plans and support plans / guidelines had been completed for each person. This helped to ensure the needs and wishes of the people using the service were identified and planned for.

Likewise, a range of supporting documentation including: risk assessments; health action plans; health summary records; activity records; consent forms; service review records; summary of work notes and other miscellaneous documentation was also available for reference. Overall, records viewed had been kept under review and had been signed by people using the service or their representatives to confirm their agreement with the information recorded.

We spoke with support staff during our visit. Staff demonstrated a good understanding of the needs of the people they cared for and the value base of social care. Feedback received from people using the service and / or their representatives confirmed the service was responsive to individual needs.

Is the service well- led?

The service has a registered manager in place to provide direction and leadership to the staff team.

A range of internal and operational auditing systems had been established to enable the registered manager to maintain an overview of the service.

The provider had also established systems to involve and obtain feedback from people using the service and / or their representatives. Records highlighted that surveys had been circulated to families, carers and other stakeholders during August 2013. A summary report had been produced to ensure the on-going development of the service.

A basic 'project visit report' had also been completed for each property on a monthly basis. We noted that template in use for the Halton Service was not as detailed as those in place for other registered services operating from the same location. The management team told us that they would take action to ensure consistency in recording systems across services.

Periodic monitoring of the standard of care provided to people using the service was also routinely undertaken by Halton Borough Council's Quality Assurance Team. This was last completed between November 2013 and January 2014. This is an external monitoring process to ensure the service meets its contractual obligations. Six properties were visited, all of which received a rating of adequate to good as a number of action points were identified. An action plan had been completed by the provider following the assessment to address issues identified.

People using the service provided by Creative Support ' Halton Service confirmed that they were treated with respect and their dignity was maintained.

People also told us that they were generally satisfied with the standard of care provided and were of the opinion that staff understood their needs.

Comments received from people using the service included: 'I'm very happy living here'; 'The staff are nice to me' and 'I like my home. I get help from the staff when I need it'

Likewise, comments received from relatives included: 'They treat my son with respect'; 'The staff are great. They are always polite and helpful' and 'I've peace of mind knowing my relative is well supported.'

No complaints were received from the people using the service during our visit however some people spoken with expressed concern regarding the high turnover of staff, the cost of activities and communicating staff changes and other information with parents. These issues should be reviewed to ensure best practice.