Creative Support - Bradford Personalised Services

Creative Support – Bradford Service is a domiciliary care agency providing personal care to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection the service was providing personal care to 44 people, some of them living with dementia or a mental health condition, and people with a learning disability.

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

The service continued to have an exceptional positive impact on people’s lives. People and relatives consistently shared very positive feedback about staff being extremely kind, “going the extra mile” and respecting people’s wishes. We also found several examples of people’s independence being extremely valued and promoted though the delivery of a flexible and person centred service.

People felt safe with the service provided. Accidents and incidents were recorded, investigated and analysed by the registered manager and changes implemented when required.

Risk assessments were in place to identify and manage risks to people and staff. There was after-hours support to assist staff when working on their own and out of office hours. Staff were knowledgeable about identifying and reporting safeguarding concerns.

Medication was administered safely.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People received support to maintain good nutrition and hydration and their healthcare needs were

understood and met. The provider kept in close contact with relevant healthcare professionals.

The provider completed person centred assessments and care plans were updated in response to changes.

People and family members knew how to make a complaint and they were confident that their complaint would be listened to and acted upon quickly.

The service was going through organisational changes and the provider had developed plans to manage these changes. There was a clear vision about the quality of care the provider wanted to provide and there was an open and person-centred culture in the organisation.

Staff told us the provider was a considerate employer and how they appreciated the career development opportunities offered to staff. The service communicated well and consulted with people, relatives and staff.

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

Rating at last inspection

The last rating for this service was Good (published in 19 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

At the last inspection the service was rated as ‘Good.’

At this inspection we found the service remained ‘Good’ and had improved in the ‘effective’ section from ‘Requires improvement’ to ‘Good.’ The service had improved in the ‘caring’ section from ‘Good’ to ‘Outstanding.’

Why the service is rated Good.

People and relatives provided very positive feedback about the service. They said it was safe; staff were well skilled and very caring.

Staff were recruited safely and there were enough deployed to ensure people received a reliable and consistent service. Staff training provision had improved since the last inspection and people received a greater continuity of care workers due to the way rotas were now organised.

Medicines were safely managed and action was promptly to address any shortfalls. Risks to people’s health and safety were assessed and clear and person centred plans put in place. The service worked well with external agencies such as the police to help keep people safe. Safeguarding procedures were in place and were well understood by staff.

People were supported appropriately to eat and drink. People’s healthcare needs were assessed and the service worked with external health professionals to ensure these needs were met.

The service was acting within the legal framework of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) which helped to ensure people’s rights were protected.

Staff demonstrated an outstanding commitment to providing person centred and dignified care for people. We saw numerous examples where staff had gone ‘the extra mile’ for people to ensure their comfort and wellbeing. Feedback about staff from people and relatives was extremely positive. The service worked exceptionally well at helping people maintain or gain independence and measured and evaluated its success in this area.

Care plans were very person centred and up to date. People’s likes, dislikes and preferences were recorded and care workers knew people well.

Incidents, accidents, complaints and safeguarding incidents were thoroughly investigated and used to drive further improvement of the service.

The service was well run and organised. People, staff and relatives all said communication was good and the management team acted on any concerns or queries they had. A range of audits and checks were undertaken to assess, monitor and improve the service. Electronic call monitoring had recently been introduced which alerted management if staff did not arrive at care visits, helping improve the safety of the service.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

This is a summary of what we found. The summary describes the records we looked at and what people who used the service and the staff told us.

Is the service safe?

At the time of our visit there were approximately 80 people who used the service. We spoke with four people who all told us they felt safe when staff visited them. We also spoke with three relatives who told us that overall they felt staff provided people with safe and effective support.

Each person's care file had risk assessments which covered areas of potential risk. When people were identified as being at risk, their plans showed the actions required to manage these risks.

The staff we spoke with understood the procedures they needed to follow to ensure that people were safe, such as what action to take in the event of a medical emergency.

There were enough skilled and experienced staff to ensure people received a consistent and safe level of support.

We found evidence that people were not always protected against the risks associated with medicines because there were not appropriate arrangements in place to ensure that medicines were managed safely. We have asked the provider to tell us how they will make improvements to meet the requirements of the law in relation to the management of medicines

Is the service effective?

People had an individual care plan which set out their care needs. We found people and/or their representatives were involved in the assessment and planning of their health and care needs. This meant people could be assured their individual care needs and wishes were identified and planned for.

We found the service had made improvements to ensure people received support from staff when they needed it and at consistent times each day. Whilst the manager recognised these improvements were ongoing, most of the people we spoke with recognised there had been an improvement. One person told us 'It's much better now because I know when staff are coming and can be ready for them'.

Is the service caring?

Overall people said they were pleased with the standard of care provided. One person said 'I would be lost without the help of these wonderful people'. Another person said 'Most of the staff are very good and I have seen a big improvement in my mum's wellbeing since staff have been helping her'.

Our discussions with people and the records we looked at told us that individual wishes for care and support were taken into account and respected.

Since our last inspection there had been a change to the management team at the service. During our discussions with them it was clear that they were committed to driving improvements in the standards of care people received.

Is the service responsive?

Care records were reviewed and any changes made either when people's needs changed or as part of the annual review process. We saw evidence of this within the care records we reviewed. The staff we spoke with told us they would immediately alert the manager if they noticed a change in people's needs.

We found people knew how to make a complaint if they were unhappy. We saw evidence that the service took complaints seriously and looked into them quickly.

Is the service well-led?

We saw there was a quality assurance monitoring system in place that was designed to continually monitor and identify shortfalls in the service and any non-compliance with the essential standards of quality and safety.

People who used the service told us if there were any problems they felt able to raise these with staff and were confident they would be listened to.

We found systems were in place to ensure valid consent was sought from people who used the service.

We found people's needs had been assessed. However, we found that visit times to people were inconsistent and in some cases not in line with their care plans. This meant care was not delivered to people's individual requirements. We found there was no management system in place to ensure people received consistent visit times.

We found suitable processes were in place to safeguard people from abuse.

Arrangements were in place to monitor the quality of the service and ensure people's views were regularly sought.

Documentation was in place in relation to people's care needs and in relation to the running of the service such as staff training files.