About the service:

Creative Support Bury provides support to people who have learning disabilities and mental health needs. The agency helps people living in their own home or small group homes, offering support in meeting their social, emotional and personal care needs. The level of support provided varies on the individual assessed needs of people. Twelve people currently use the service.

People’s experience of using this service:

People told us the service was good and they benefitted from the care and support they received.

People were able to live their lives with full support from staff who respected their diverse needs.

Good systems and staff training helped keep people safe and known risks were managed effectively.

All documentation we saw was detailed and kept up to date. This helped keep staff informed of any changes to a person’s care and treatment.

The service liaised with other organisations to ensure support was based on best practice.

Staff had received sufficient training and ongoing support to help them carry out their roles.

People were encouraged to be independent. Staff supported them with daily living tasks and helped them to reach their goals.

People were encouraged to eat healthily. People could ‘win’ incentives for healthy living.

Activities were meaningful because they were what people wanted. People were encouraged, where possible, to attend work or educational activities.

There were systems to maintain and improve the quality of service through audits, surveys and meetings.

Rating at last inspection: At the last inspection (report published 28/10/2016) the service was rated as good overall.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up: We will continue to monitor information and intelligence we receive about the service to ensure care remains safe and of good quality. We will return to re-inspect in line with our inspection timescales for good services, however if any information of concern is received, we may inspect sooner.

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

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:

• 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-

Is the service safe?

We found that the service carefully assessed and managed risks to people's personal safety to make sure their support was delivered in a safe way. Suitable safeguarding policies and procedures were in place and staff had been trained in adult safeguarding. Staff who worked at the service had undergone DBS checks to ensure they were safe to work with vulnerable adults.

People told us they felt safe. Systems were in place to make sure managers and staff learned from events such as accidents and incidents, complaints and concerns.

Is the service effective?

People's support was well planned and kept under regular review to check it remained effective. The staff team received training that equipped them with the skills to understand and meet the needs of the people they supported. Staff told us they were well supported in their roles and their performance was regularly supervised and appraised. People were involved in developing their own plans of care.

Is the service caring?

We observed positive interactions between staff and people using the service and saw people being respected and involved in decisions and provided with choice.

A person-centred approach was taken in planning and providing care that was tailored to individuals' needs and wishes. People told us they received support from staff who were kind and caring and helped them to maintain their independence. We received positive feedback from people using the service about the care and support they received.

Is the service responsive?

The service actively involved people at all stages of their care. People contributed to assessments of their needs and met regularly with staff to plan and review their care and support. Records confirmed that people's support was provided in line with the outcomes they wished to achieve. People we spoke with knew how to make a complaint if they were unhappy with easy read complaint procedures accessible. The service worked well with other agencies and services to make sure people received care they needed.

Is the service well-led?

The manager and staff had a good understanding of the ethos of the service and their roles and responsibilities. Quality assurance processes were in place to check standards were maintained. People were routinely consulted about their level of satisfaction and feedback was used to improve the quality of the service.

During our inspection we asked to speak with people using the service. Only one person agreed to speak with us. We asked them for their opinion of the support they received. We were told, “The staff are brilliant” and “If I need anything I just go and ask, the staff are always there”. They felt confident that any issues raised with staff would be taken seriously and acted upon.

Systems were in place to protect the rights of people who may lack the capacity to make decisions about their own treatment, care and support.

Staff worked closely with other agencies so that people’s social, emotional and physical health care needs were effectively met.

We were told that there had been a number of changes in staff teams. Further recruitment had been undertaken to ensure that sufficient numbers of staff were available to meet the needs of people so that continuity could be provided.

Systems were in place to monitor and review the service provided. Suitable arrangements in the management and structure of the service were still to be made so that people continued to receive a safe and effective service. This was being explored by the provider.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.

We carried out our inspection of Creative Support Bury on the 18th and 20th July. On the 20th July we visited three people so that we could talk with them about the service and the support they received.

Due to their needs we looked at how support staff promoted and enabled them to be involved in making decisions about their care and support affording them choice and control over their lives.

Whilst people did not wish to answer direct questions they were happy to chat with us. People told us what they liked to do whilst at home and about their jobs. People appeared to have a good rapport with staff, who understood their needs.

One person told us; “I’m very happy here”. Another person referred to the people they lived with as their “friends" and said they liked living together. People also told us that staff had helped them to find a job and that they were kept “very busy”.

People were encouraged and supported to maintain relationships with their family and friends.