Creative Support - The Glade

Updated 25 January 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by one inspector

Service and service type

Creative Support- The Glade is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 2 hours’ notice of the inspection. This was because the service is small, and people may have been out, and we wanted to be sure there would be people at home to speak with us.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with three people who used the service and five relatives about their experience of the care provided. We spoke with eight members of staff including the service director, registered manager, team leader and support workers. We spent time observing the support that people received from the staff team.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies, procedures and audits were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 25 January 2022

About the service

Creative Support- The Glade is a residential care home providing personal care to eight people who were autistic, living with dementia or living with a learning disability, at the time of this inspection. The service can support up to eight people. People had their own personalised bedrooms and shared communal areas such as a kitchen, bathrooms, living rooms and a garden.

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

People were not always supported in line with their preferences, including social pastimes and interests. People were left for long periods of time without speaking to other people or staff increasing the risk of social isolation or boredom. Staff did not always describe people with dignity and respect and opportunities for people to be independent were being missed.

Risk assessments had been completed to guide staff how to support people safely, however these were not always followed in practice. There had been a large change in the staff team, and this had impacted on people’s lived experiences at the service.

Clinical waste bins were not stored appropriately which may lead to an infection control risk. Other infection control measures were effective in helping keep people safe.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. We have made a recommendation to the service around reviewing mental capacity assessments and best interest decisions to ensure they follow best practice guidance.

Audits were effective in picking up where improvements were needed in areas such as health and safety checks or medication. However, they had failed to pick up on areas for improvement we identified at this inspection. We were not assured that best practice guidance was being followed at the service in relation to Right Support, Right Care, Right Culture. Relatives gave us mixed feedback about how the registered manager and staff engaged with them.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, Right care, Right culture.

People were at risk of social isolation due to staff not being able to drive vehicles and the location the service being far away from areas of interest and local amenities. Some people living at the service, visibly were not happy living with other people using the service. Opportunities for people to leave the service and take part in preferred past times was limited. Staff did not support people to take part in their preferred past times whilst they were at home.

Despite our findings people and relatives were happy with their care and support. One relative said, ‘‘I think The Glade is the perfect place for [family member] and I have no concerns that they are well cared for.’’

Staff were trained in safeguarding and knew how to keep people safe. Staff were recruited safely and there were enough staff to support people with their support needs. People were supported safely with their medicines. Health professionals supported people if this was needed and staff worked well with them. Staff supported people to eat and drink according to their support needs and their preferences.

People told us that staff were kind and compassionate and we observed people were relaxed whilst being supported by staff. Staff offered people choices in some aspects of their lives and communicated with people in ways that made sense to them. There was a complaints procedure that people had access to if they needed to use it. Plans had been discussed with people about the support they would like at the end of their life.

The registered manager and service director were passionate about supporting people. They were keen to put improvements in place following this inspection. People were positive about the management of the service and the way they were supported. Staff worked with health professionals and other services to help ensure good outcomes for people.

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

Rating at last inspection

This service was registered with us on 29 April 2019 and this is the first inspection.

The last rating for the service under the previous provider was good (report published 15 August 2017). This service also had a focused infection prevention control (IPC) inspection completed and no issues were found (report published 13 March 2021).

Why we inspected

This was a planned inspection based on when the service registered with us.

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.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to person centred care and good governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.