This inspection took place on 25 and 26 October 2017 and was announced.

Creative Care is registered to provide personal care and support for people with mental health needs and/or a learning disability or autistic spectrum disorder. At the time of our inspection there were eleven people using the service. People using the service resided within supported living accommodation.

Creative Care had 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.

The overall rating of good, which was awarded following the CQC's previous inspection of 20 October 2015, was displayed. Creative Care has retained its overall rating of good. We found the service following this inspection, to the key question is the service responsive? To be outstanding.

People’s safety and welfare was promoted, which was confirmed by the completed surveys sent out by CQC. Safety and welfare was promoted through comprehensive assessments and on-going review of potential risks to people. Where risks had been identified measures had been put into place to reduce the likelihood of risk and were recorded within people’s records and understood and implemented by staff.

Staff upon their recruitment had their application and references validated and were checked as to their suitability to work with people, which enabled the registered manager to make an informed decision as to their employment. Staff underwent a period of induction and training, which included them being introduced to people whose care and support they would provide.

Staff understood the importance of seeking people’s consent prior to providing care and support. Where restrictions had been placed on people as detailed in Court of Protection Orders, these were clearly understood by staff. Staff were aware of people’s rights to make decisions and were able to tell us how they encouraged people to express their opinions on their care and support. Staff were proactive in liaising with health care professionals and followed advice and guidance as detailed within people’s care plans. People received support with the planning, preparation and cooking of meals where needed to ensure people’s nutritional needs were met.

People's needs were comprehensively assessed and care plans gave clear guidance on how people were to be supported. Care was highly personalised so that each person's support reflected their preferences. We saw that people were at the centre of their care and found clear evidence that their care and support was planned with them and not for them.

Staff fully understood and were committed to providing the care and support reflective of people’s preferences. People were positive about the attitude and care of staff, stating they received support and care from a consistent group of staff. This was confirmed by the surveys completed by people using the service.

The care and support people received was very individualised and person centred, taking into account people’s specific needs. This enabled staff to provide a responsive service to support people reflective of their individual circumstances. Changes to people’s needs were planned for and fully documented and evidenced partnership working with external agencies. Information on how to raise a concern or complaint along with contact details for external agencies was made available to people when they commenced using the service.

The open and inclusive approach adopted by the registered manager, meant people using the service, staff and those employed by external services, such as health and social care were confident and liaised with the registered manager and staff about the service provided. This was reflected in people’s comment

This inspection took place on 20 October 2015 and was announced.

Creative Care is registered to provide personal care and support for people. At the time of our inspection there were five people using the service who resided within 2 individual properties referred to as ‘supported living’.

Creative Care had 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.

Staff were confident that if they had any concerns about people’s safety, health or welfare then they would know what action to take, which would include reporting their concerns to the provider, management team or to relevant external agencies.

Potential risks to people within their home and the wider community have been assessed and measures put into place to minimise risk to the person and the staff providing support. Risk assessments supported people’s safety, without compromising their independence and right to make choices and decisions about their daily lives. People’s choices and decisions were recorded within their care records.

There were sufficient numbers of staff employed who had undergone a robust recruitment process and had received training to enable them to meet people’s needs in a timely manner.

People were prompted to take their medication or had their medication administered by staff where their plan of care had identified that the person required support. We found people’s medicines were managed well.

Staff told us that they were regularly supervised and had their work appraised, which meant they had the opportunity to speak with the registered manager about the effectiveness of their work and discuss how improvements could be made for the benefit of those using the service, through training and their on-gong development. Staff told us that staff meetings were held and good communication with the staff team meant they were able to provide effective care to people.

People’s plans of care reflected the support they required and the areas of their lives where support was not required, this ensured people received effective care which recognised and promoted their independence.

Plans of care identified if the person required support in order that they maintained a balanced diet. People were supported with grocery shopping, meal preparation and cooking. Where full support was required this was provided by staff.

People’s health and welfare needs were met, which included providing support by liaising with health and social care professionals, where this was an identified need.

People were supported by a small group of staff which provided people with consistency and enabled them to develop positive relationships built on trust and familiarity. In some instances people had been involved in the recruitment of staff and had chosen who they wanted to provide their care.

Information had been made available on the range of services Creative Care provided and how to raise concerns in an ‘easy read format’, this helped to promote people’s understanding and promote their rights and choices.

People’s needs had been assessed by a representative of the local authority, which identified the support people required and the hours over which the support was to be provided. We found however that some assessments had been reviewed which had reduced the number of hours and level of support required. The revised assessments did not in all instances provide clear information as to the current level of support the person required. This meant that people were in some instances receiving support that the provider was not commissioned to provide, which meant they received support above and beyond their assessed need.

People’s plans of care were written from their perspective and provided staff with information as to the care and support they required, which included support with personal care, management of household chores and their daily lives, such as managing health and social care appointments. In addition people’s plans of care reflected accessing the wider community for activities and recreation.

People had the opportunity to comment on the service they received and to make decisions about their lives. Staff had confidence that they could speak with the registered manager and that any issues would be addressed.

A social care professional advised us that in their view the service was very good and that they found the registered manager and staff to be knowledgeable and that they provided person centred care to those using the service.

We spoke with one person who used the service and asked them for their views. The person told us they received a good service and that they were supported by two members of staff. The person told us staff supported them with daily living tasks which included, shopping, cooking and household chores. They also told us that staff supported them to access the community for leisure and recreational interests. The person spoke to us about how they had taken part in the interview of one of the members of staff to make sure that they liked them and would feel comfortable in receiving support from them.

People who used the service had been given a Service User Guide which had been written in plain English and was supported by symbols to aid people in understanding what services were provided. Records including care plans and staff recruitment and training records were accurate and update.