This inspection took place on 16 and 17 August 2018 and was announced. Creative Support – Apsley Court provides care and support to people living in specialist 'extra care' housing. Extra care housing is purpose built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant's own home. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people's personal care and support service.

Not everyone using Creative Support – Apsley Court receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. There were 17 people receiving support with ‘personal care’ at the time of our inspection.

The service 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.

This was the first inspection of the service. At this inspection we found breaches of regulations because people’s medicines were not safely managed, and because staff had not always completed training considered mandatory by the provider in order to keep up to date with current best practice.

We also found areas requiring improvement. Action had not consistently been taken to reduce the risk of incidents and accidents from recurring. Risks to people had been assessed, but staff had not always followed risk management guidelines to keep people safe. People told us there were sufficient staff on duty to meet their needs, but we found two examples of recent weekend shifts when staffing levels did not meet the service requirements based on the provider’s assessment of people’s needs. Staff received support through supervision, but night staff had not always been regularly supervised. The provider had systems in place to monitor the quality and safety of the service, but improvement was required to ensure medicines audits were effective in driving improvements.

People told us the service was well managed. Staff had mixed views about the management of the service and the changes that had been made since the provider took on the local authority contact to run the scheme. However, some of the changes they were concerned about had been implemented with a view to improving safety. Staff shared the provider’s vision in seeking to provider good quality care. The provider sought people’s views about the service and acted on their feedback.

People were protected from the risk of abuse because staff were aware of the types of abuse that could occur and the action to take if they suspected abuse. Staff followed safe practices in managing the risk of infection. The provider recruited staff safely.

People’s needs were assessed before they started receiving a service from the provider. People’s care was planned, in line with nationally recognised guidance. Staff sought consent from people when offering them support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff supported people to eat and drink where this was part of their assessed needs.

People had access to a range of healthcare services to maintain good health. Staff worked with other agencies to ensure people received good quality, joined up care across different services. Staff treated people with care and consideration. People were involved in making decisions about their care and support. Staff treated people