Archived: Creative Support - Elkin Court

Elkin Court is a block of flats built over three floors. There are 40 flats within the building. The communal areas consist of two lounges, a restaurant, a charity shop and a salon. Elkin Court is a domiciliary extra care scheme for older people. People living at Elkin Court are tenants of Housing 21, the housing provider. An Extra Care scheme is a type of supported housing for older people that helps them to live independently for as long as possible and to access services that are responsive to their needs. Creative Support are commissioned by Trafford Borough Council to provide personal care to 22 people living there as well as support to all tenants in the building after 5pm including pendant support. This is support to people who wear an alarm as a pendant round their neck for their own safety. In case of an emergency they can press the pendant and the alarm will sound, alerting staff who will deal with the situation.

The building itself is a community building; therefore during the day, the general public can access the restaurant, the salon and the charity shop as well as the communal lounges. The general public cannot access the service users’ flats or the communal lounges in the service user-only section of the building as there is a fob system in place to control access. The general public only have access during the day, the doors are locked in the evening and a fob is needed to gain access.

There was a registered manager in post. 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 spoke with three people who were supported by Creative Support. All told us they felt safe and were satisfied with the service being provided by Creative Support. People made positive comments about the staff and the care they received and they had regular care workers providing all or some of their care.

The service had appropriate arrangements in place to manage medicines safely to ensure people were protected from the risks associated with medicines.

The service had completed regular care plan reviews with people using the service. Individual risk assessments were completed for people so that identifiable risks were managed and these were regularly reviewed to ensure they were reflecting people’s changing needs.

Feedback received from other professionals with current or previous involvement with the provider was mixed. Although complimentary about the service, Healthcare professionals expressed concern about the needs of the tenants and the service “taking on [people] way beyond the ability/training of the carers provided to look after them properly.” However they went on to say some staff “Are extraordinary.”

Staff were able to describe how they respected people’s privacy and treated people with dignity and respect. Some staff told us however that they were aware that people could not always be supported in a timely manner because they did not always have the time. Some staff said more staff were needed especially at night.

Staff training records were in date and arrangements had been made to ensure all staff received regular supervisions which meant performance was formally monitored and areas for improvement may have been identified.

The provider had a current complaints process in place. The provider had an effective system in place for identifying, receiving, handling and responding appropriately to complaints and comments made by people or persons acting on their behalf.

The provider had ensured there were effective systems in place to monitor and improve the quality of the service provided. This meant they were meeting the requirements to protect people from the risk of unsafe care by effectively assessing and monitoring the service being provided.

During the inspection we checked to see how the service protected vulnerable people against abuse and if staff knew what to do if they suspected abuse. There was an up to date safeguarding vulnerable adult’s policy in place. Risks to people were assessed and risk management plans were in place. We found the staff we spoke with had a good understanding of the principles of safeguarding.

The service worked to the principles of the Mental Capacity Act 2005, which meant that care staff supported people to make their own choices about their care. Before any care and support was provided, they obtained consent from the person who used the service where appropriate. We were able to verify this by speaking with people who used the service, checking people’s files, our observations and speaking to staff.

The provider had recruitment processes in place which included the completion of pre-employment checks prior to a new member of staff working at the service. This helped to ensure that staff members employed to support people were deemed suitable and fit to do so.

We saw evidence of a comprehensive induction pack, with appropriate training provided for roles and responsibilities, along with competency testing. Staff also signed to confirm they had read policies and procedures and that they were aware of the provider's requirements in respect of data protection and confidentiality.

All care staff were given a manual which included policies and procedures. These were discussed with the staff member as part of the induction process. Staff received supervision and appraisal from the care management team. These processes gave staff an opportunity to discuss their performance and identify any further training they required.

People were supported with a range of services which enabled them to continue to live in their own homes safely. People who used the service and their relatives told us they had been involved in the assessment and planning of the care and support provided and that the service responded to changes in people’s needs.

The care records contained good information about the support people required and were written in a way that recognised people’s needs. This meant that the person was put at the centre of what was being described. The records we saw were complete and up to date.

All the care staff who dealt with people’s medicines had received medicine management training, been assessed as competent and were clear about their role in managing medicines safely.

We found from looking at people’s care records that the service liaised with health and social care professionals involved in people’s care if their health or support needs changed. The service worked alongside other professionals and agencies in order to meet people’s care requirements where required.

People who used the service told us that they were listened to by the service. People told us the service was well managed and they felt they could approach the registered manager and team leader with any concern and they would be listened to. Care staff told us they enjoyed working for the service, they received good training and they felt supported.

Robust systems were in place to monitor the quality of the service provided to help ensure people received safe and effective care and support. The registered manager and senior care staff had effective audit and quality assurance processes and procedures in place. Any actions required to improve the overall standard and quality of care were raised at the regular staff meetings and in formal supervisions. We also saw a number of audits in place such as spot checks, training, and supervisions with care staff to verify their competence in providing safe and good quality care.

There was an up to date accident/incident policy and procedure in place. Records of accidents and incidents were recorded appropriately within people’s care files. However we saw monitoring and analysis of incidents and accidents needed improving as we were unable to see the results of actions taken and the learning that had taken place following an accident or incident. We discussed with the registered manager and service development manager to ensure that all lessons learnt through analysis is identified and incorporated into daily practice. There was an up to date ‘business continuity plan’ in place which covered areas such as loss of access to the office, loss of utility supplies, loss of staff, office damage, loss of telephone/IT systems and adverse weather the action to be taken in each event.

There were detailed systems in place to record what care had been provided during each visit. Care plans contained a daily communication sheet which was completed by staff after each period of support. The registered manager showed us the daily booklet which recorded all care, incidents, accidents and other aspects of care in a twenty four hour period and was signed and dated by staff.

Staff told us they felt they were able to put their views across to the management, and felt they were listened to. The staff we spoke with told us they enjoyed working at the service and said they felt valued.

We saw the service had links with the local community through additional services provided in the building for example, the charity shop as well as external links including a local primary school which performed a Christmas service for the tenants.

The registered manager was aware of their responsibilities in notifying the Care Quality Commission of any significant events, and notifications had been received from the servi