This was an announced inspection which took place on 22 and 23 September 2016. The service was last inspected in July 2014 when it was found to be meeting all the regulations we reviewed.Creative Support - Bury Service is registered to provide personal care to people in their own homes. Support is provided both to individuals and to people living in small group settings. At the time of our inspection there were 36 people using the service.
The service had a registered manager in place. 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. People were complimentary about the registered manager and said they were a good manager. We found them to be enthusiastic and committed to providing good quality person centred care.
Everyone we spoke with was very positive about the service and the attitude of staff and managers and how they were supported. We found the registered manager and staff took pride in the providing a person centred service. We observed that interactions were respectful, relaxed and friendly.
People who used the service told us they felt safe using Creative Support - Bury Service. People told us they always received the support they needed from staff who were caring and knew them well. All the staff we spoke with were able to tell us about the people they supported and what their likes and dislikes were.
Robust recruitment procedures were in place which ensured staff had been safely recruited. Staff had received training in safeguarding adults. They were aware of the correct action to take if they witnessed or suspected any abuse. Staff were aware of the whistleblowing (reporting poor practice) policy in place in the service.
Staff received the induction, training and supervision they needed to carry out their roles effectively. Staff told us they felt supported and were very positive about the training the provider offered. Staff were complimentary about the registered manager and working for the service.
Care records were very detailed and person centred and contained information about people’s health and social care needs. We found they contained detailed risk assessments and care plans that were written using very respectful terms contained information about people’s preferences and routines and guided staff on how to promote people’s independence and how people communicated. The service also recognised and valued people's own communication methods including using signs, gestures and sounds. Care records included a ‘Communication Passport.’ This had sections such as; ‘when I do this, we think it means this.’ We saw these included descriptions of what certain gestures, facial expressions and body language meant. Care records provided staff with sufficient detail to guide them on how best to support people A system was in place to ensure care plans were regularly reviewed and updated. This helped to ensure they fully reflected people’s needs.
The service had detailed guidance for staff on how to support people when they showed behaviour that challenged the service. Records contained information about what may make someone upset or angry and guided staff in how to respond, what to say and what to do to help the person and diffuse situations. This included understanding how the person communicated whe they weer anxious or upset and guided staff on how to respond.
Important information about the service was available in easy read formats. These included pictures and photographs. This helped to ensure people had access to information they needed, such as tenancy agreements, complaints policy and safeguarding.
Managers and staff in the service spent time getting to know people and what their interests, hobbies and goals were. People were supported to access a wide range of activities, hobbies and places of interest. Some people were also supported to work or attend college.
The provider was working within the principles of the Mental Capacity Act 2005 (MCA). Staff were able to tell us how they supported people to make their own decision. The registered manager and staff were aware of the process to follow should a person lack the capacity to consent to their care. Care records included information on how people could be supported to make decisions.
Medicines were managed safely. There were policies and procedures in place, staff had received training in administering medicines and had their competency to administer medicines regularly assessed.
We saw systems were in place to monitor people’s nutritional needs. People had access to a range of health care professional to ensure their health needs were met.
Systems were in place to ensure the safety and cleanliness of all the premises where people who used the service lived.
The service had a range of ways of involving people and getting their ideas for how the service could be improved. People who used the service and their relatives had been involved in planning and reviewing the care provided. People who used the service were involved in recruitment, training and service quality auditing.
There was a robust system of weekly, monthly and annual quality monitoring and auditing in place to help improve the quality of the service provided. There was a complaints procedure for people to voice their concerns. People were confident that they would be listened to and action would be taken to resolve any problems they had.
The service had notified CQC of any accidents, serious incidents and safeguarding allegations as they are required to do.