Creative Support - Berkshire & Oxfordshire Services

At the time of the inspection a registered manager had been in post since July 2016. 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 knew how to keep people safe by reporting concerns promptly through the safeguarding procedure that was taught as part of the induction process. This was further followed through as a topic of discussion within team meetings and in individual supervision meetings. Systems and processes were in place to recruit staff who were suitable to work in the service and to protect people against the risk of abuse. There were sufficient numbers of suitably trained and experienced staff to ensure people’s needs were met. Staff were matched to meet people’s needs as per experience, knowledge, age and general personality, where possible. This was particularly noticeable within the service catering to support people with a primary diagnosis of a learning disability.

People using the service said they were very happy with the support and care provided. People and where appropriate their representatives confirmed they were fully involved in the planning and review of their care. Care plans focussed on the individual and recorded their personal preferences well. They reflected people’s needs, and detailed risks that were specific to the person, with guidance on how to manage them effectively. The care plans within the older adults services were going through a process of being updated to similarly provide information as that seen within the learning disabilities service. This included information on why people liked to have support in a particular way and how this made them feel.

People told us communication with the service was good and they felt listened to. Communication methods were employed by the service that ensured people were able to be kept up to date with their support plans and with general information on the service. Where necessary these methods of communication were used to inform decisions made by the service, including recruitment of staff.

People we spoke with said they were treated with respect and staff preserved their dignity at all times. We did receive a concern about one member of staff that was passed on to the registered manager. We were kept abreast of the action taken against the member of staff that included disciplinary action and informing the local safeguarding team.

People were supported with their medicines by suitably trained, qualified and experienced staff. Medicines were managed safely and securely. People who could not make specific decisions for themselves had their legal rights protected. People’s care plans showed that when decisions had been made about their care, where they lacked capacity, these had been made in the person’s best interests.

People received care and support from staff who had good skills and knowledge to care for them. All staff received comprehensive induction, training and support from experienced members of staff. Staff reported feeling supported by the registered manager and said they were listened to if they raised concerns. The quality of the service was monitored regularly by the registered manager, and the regional director. A thorough quality assurance audit was completed annually with an action plan being generated. Feedback was encouraged from people, visitors and stakeholders and used to improve and make changes to the service. We found evidence of compliments and complaints that illustrated transparency in management.

Comprehensive audit systems were employed by the registered manager to ensure that all regulations were met.

We saw people's care and support needs were documented and reviewed regularly to ensure people were supported safely. People told us they were involved in their care planning. Comments from people who use the service included 'Staff don't rush me, they look after me', 'I like my keyworker' and 'They look after you nice and listen to you.' Risks were assessed and managed to promote safety.

Staff understood the provider's safeguarding procedures and were confident with the reporting procedure. People who use the service told us they liked the staff and felt safe with them. We saw safeguarding concerns were dealt with appropriately.

The manager matched staff hours and skills to the support needs of people who use the service. Staff told us the training provided ensured they were suitably skilled to support people safely.

The provider, manager and senior staff conducted quality monitoring assessments to ensure the service supported people safely and in accordance with the provider's policies and procedures. An annual questionnaire was sent to people who use the service and their relatives to ask for feedback about care provision. One support worker told us 'The service is led by the clients, and involves them'.

People were protected from the risk of infection because the appropriate guidance had been followed. Staff undertook initial infection prevention and control training when they started employment, as well as regular updates on infection prevention and control.

We saw the provider had introduced a new policy which clearly defined procedures on how documents should be stored, retained and destroyed when it was appropriate to do so. The provider was in the process of archiving documents in line with the new policy.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Relatives we spoke with told us they were involved in people's care planning and that plans were regularly reviewed. One person told us they were 'very happy with the care and support' their relative received. Staff were knowledgeable about each individual's need, as well as how to meet those needs.

Relatives we spoke with told us people's homes were clean. Staff were knowledgeable about infection prevention and control. However, the provider did not have appropriate procedures in place to ensure staff had ongoing training in infection prevention and control.

Relatives we spoke with said staff were well trained. One relative told us 'they do a fantastic job'. Staff told us they felt well supported by managers and they had enough training to enable them to meet the needs of the people they support.

People's personal records, as well as staff and other records were accurate and fit for purpose. However, the provider did not have a policy or procedure in place which stated how records should be stored, retained and destroyed.