Creative Support - Trafford Supported Living Service

Updated 20 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

3 inspectors visited the service’s office and 2 houses on the first day of the inspection. 1 inspector visited another house on the second day. An out of hours visit was also made to 1 house. An Expert by Experience telephoned people’s relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in 8 ‘supported living’ settings, so they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post. They were also the registered manager for a nearby supported living service with the same provider.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because some of the people using it could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this. We also needed to be sure the provider or registered manager would be in the office to support the inspection.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 3 people who used the service. Most people using the service were not able to verbally communicate with us. We observed interactions between people and the care staff in the 4 houses we visited. An Expert by Experience spoke with 9 relatives by telephone. We also spoke with 12 members of staff including the registered manager, service director, provider quality manager, project managers and care staff.

We reviewed a range of records, including 6 people’s care plans and multiple medication records. We looked at 2 staff files in relation to recruitment. A variety of records relating to the management of the service, including quality assurance, complaints and safeguarding were reviewed.

Updated 20 January 2023

About the service

Creative Support - Trafford Supported Living Service is a supported living service providing personal care for people with a learning disability and autistic people. Some people also had a physical disability. At the time of our inspection there were 26 people using the service, living in 8 supported living houses.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right support:

Risk assessments and associated guidance had not always been reviewed in a timely way. Medicines records and storage were not always robust in some properties. Environmental risks in one house had not been identified. The model of care met the right support, right care, right culture guidance. There were enough staff to meet people’s needs and support people to take part in activities of their choice. Staff were safely recruited. 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. However, records of best interest decision were not always kept.

Right Care:

Care plans were person-centred and promoted people’s privacy and dignity. Relatives were positive about the support and kindness of the support workers.

Right Culture:

The quality assurance systems did not give the registered manager and project managers full oversight of the service. In some properties, issues had not been identified, in others identified issues had not been escalated to the project or registered managers to ensure they were resolved in a timely way. Incidents were recorded and reviewed to identify any patterns and ensure actions had been taken to reduce any reoccurrence. The registered manager took action straight after our inspection visit to address the concerns we identified.

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 26 November 2018).

Why we inspected

We received concerns in relation to staff not meeting people’s needs, record keeping, and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. The provider took immediate action to begin addressing the issues we found.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Creative Support - Trafford Supported Living Service on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to managing medicines, risk assessments not always being reviewed, environmental safety and the quality assurance and oversight of the service at this inspection.

We have made a recommendation about introducing an escalation system to ensure all care plans are reviewed in a timely way and for following best practice in recording best interest decisions.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.