Creative Support - Bolton Service

This inspection took place on 25 July 2018. The provider was given 48 hours' notice of our intention to visit. This was because we needed to ensure there would be someone present at the office to facilitate the inspection.

We were assisted throughout the inspection by the registered manager and three project managers. 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 registered manager at Creative Support – Bolton Service had been registered since October 2011.

We spoke with a number of people during the inspection including relatives, staff and community professionals. People who used the service had limited means of communication and were unable to share their experiences. People who used the service relied on families or advocates to support them with decision making.

The service was last inspected on 18 May 2017 and was announced. The service was rated as Requires Improvement.

At the last inspection we found procedures were in place to manage people's medicines safely. However, these had not always been followed, which had resulted in some errors being made with medicines on several occasions. Arrangements for the safe recording and administration of people's medicines required improvement to ensure people were protected from the risk of unsafe medicines management.

This was a breach of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At this inspection we found that medicines management had improved and systems were now safe. The service had sought advice around medicines management from a healthcare professional external to the organisation and had incorporated a new system for auditing medicines.

Mandatory training had been completed by all staff.

There were systems and processes in place to protect people from harm. Staff had a good understanding about the signs of abuse and were aware of what to do if they suspected abuse was taking place.

The service had developed positive working relationships with health and social care professionals which led to joint working to expand people's communication skills.

A robust system for staff recruitment, induction and training was in place. This enabled the staff to support people effectively and safely.

People's needs were assessed before using the service and on an ongoing basis to reflect changes in their needs. Clear and well thought out arrangements were in place for people moving into the service which helped to significantly reduce possible anxiety about this change.

There were enough staff so people could take part in the activities they wished and be supported in meeting their individual needs. People had access to activities that were important and relevant to them, both inside and outside their home. People were protected from social isolation because of the support and range of opportunities offered by staff.

We observed positive relationships and observed the management team and staff interacting with people in a caring, good humoured and friendly manner. Management and staff demonstrated insight and understanding of people's personal preferences and needs.

The service had been developed and designed in line with the principles that underpin the Registering the Right Support and other best practice guidance; these values include choice, promotion of independence and inclusion. This policy asserts that people with learning disabilities and autism using a service should live as ordinary a life as any citizen. This policy can be found on the Care Quality Commission website.

The five questions we ask about services and what we found