This inspection took place on 13 and 14 September 2017 and was announced. The provider was given 48 hours’ notice of the inspection because the location provides a community based service and we needed to be sure someone would be in at the office.

Creative Support – Chorley Service supports people who have a learning disability in their own home and provides personal care in line with a ‘supported living’ model. Supported living is a way of supporting people in their own home with their personal care or support arranged separately with a specialist provider.

People who use the service have their own tenancies and receive their support from staff employed by Creative Support. The service also has an outreach programme providing support to people living with their family or carer. At the time of the inspection 28 people were receiving support from the service.

At the last inspection on 23 April 2015, we rated the service as overall “Good” but found there were shortfalls in the administration of medicines. During this inspection, we found the necessary improvements had been made in this area and the service was meeting all the current regulations.

Since the last inspection the registered manager had retired and a new manager had been appointed who was going through the process of registration. The manager had moved from another service run by the provider and was familiar with the Chorley Service. 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.

We found the provider had safeguarding adult’s procedures in place and staff had a clear understanding of these procedures. Staff had access to a whistle-blowing procedure and said they would use it if they needed to. Appropriate recruitment checks were carried out before staff started working at the service and there were enough staff to meet people's needs. Risks to people using the service were assessed, reviewed and managed appropriately. People received their medicines as prescribed by health care professionals.

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. People consented to the care and support they received. The service complied with the requirements of the Mental Capacity Act (MCA) 2005 and the associated Code of Practice. Staff had been trained and understood their responsibilities in relation to MCA.

People told us they liked the staff and that they were kind and caring. We observed that staff treated people with respect and promoted their dignity. People were supported to communicate their views about how they wanted to be cared for.

People’s nutritional needs were met. Staff helped people to purchase and prepare their food and people told us they enjoyed the choice of food that was available to them. People were supported and encouraged to participate in activities.

Staff were trained on various areas to ensure they had the relevant skills, knowledge and experience to provide good care to the people they looked after. Staff received regular support and supervision to carry out their duties effectively.

The service liaised with various healthcare professionals to meet the needs of people.

People had their individual needs assessed and their care planned in a way that met their needs. People received care that reflected their preferences and choices.

Reviews were held with people and their relatives to ensure people’s support reflected their current needs.

People and their relatives had opportunities to share their views and give feedback about the service and these were acted upon. The service was subjected to regular qualit

There were arrangements in place for the service to obtain,and act in accordance with the consent of people using the service. The staff we spoke with showed a good understanding of these issues and told us; “Choices are respected.” And “We have regular team meetings, where we could discuss capacity issues and agree strategies.”

People using the service provided positive feedback about the staff and the support provided. Comments included; “I get the same staff. If the rota is changed, they let me know.” “Yes, I have a regular worker. I give them nine out of ten.” And “I am happy with my support.”

Family forums, coffee mornings, house meetings and staff meetings all provided good opportunities for stakeholders to keep up to date with any changes and to share their views about the development of the service.

The complaints and suggestions policy was produced in an easy to read format, to aid the understanding of people using the service. Large text, pictures and symbols were used to explain the key messages within the policy. This helped people using the service to access, use and understand the policy and process regarding complaints.

The relatives we spoke with told us they were satisfied with the care provided. Comments included; “I am very happy with the service. If I wasn’t happy I could ring and I am sure it would be sorted.”

The provider gave people and their families information on the service and involved them in all aspects of planning support and helping each individual towards achieving a meaningful life. People's views and opinions were taken into account and they were able to make choices in relation to the support they received.

People experienced support that reflected their wishes and met their needs and the provider encouraged them to lead a healthy lifestyle.

There were suitable arrangements in place to ensure that vulnerable adults were safeguarded against abuse and staff were knowledgeable and confident about recognising abuse and what to do if they did.

Staff employed by the provider underwent a rigorous assessment process and appropriate checks were made by the provider before any new recruits were offered a position within the company.

The provider undertook regular review and constantly monitored the quality of the support being provided by the service to ensure that people's needs were met.

People told us:

"I always get good care...I'd be happy to raise any problems with the people that look after me."

"It's only been six weeks, but so far it's brilliant!"

"Staff seem to know what they're doing...It's fine. I'm really quite happy."

During our inspection we visited a number of people who use the service and talked to them about the support they received.

We received some very positive feedback from people and everyone we met expressed satisfaction with the service provided.

People spoke highly of support workers and told us they felt they were treated in a kind, respectful manner by staff.

Comments included;

‘’I feel very safe with the staff. They understand me and they understand the challenges I face.’’

‘’I like living in my house, I like my garden.’’

‘’We go for walks and we go shopping.’’

‘’I have moved on so much with Creative Support. I feel like I have made so much progress. I am becoming more independent and confident too.’’

People told us that they felt fully involved in their own care and were able to make decisions about the support they received. One person we spoke with explained that she preferred to have the main part of her support at the weekends and advised us that this had been no problem to arrange.

We observed people being supported and saw that service users and staff appeared to get along very well together. People looked relaxed, content and comfortable in their surroundings.

Creative Support – Chorley Service supports people who have a learning disability, in their own home, providing personal care in line with a supported living model. People who use the service have their own tenancies and receive their support from staff employed by Creative Support. There is also an outreach programme providing support to people living with their family or carer.

The last inspection of the service took place on 5 February 2014. During this inspection the service was found to be meeting all the regulations assessed. This inspection took place on 23 April 2015. The provider was given 24 hours’ notice of our intention to visit. This was because the location provides a domiciliary service and we needed to ensure there would be someone present at the office to provide us with the required information.

We were assisted throughout the inspection by the registered manager. 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 – Chorley Service had been in post for several years.

We spoke with a number of people throughout the inspection, including people who used the service, their relatives or main carers, staff and community professionals. Some very positive feedback was received with the majority of people expressing satisfaction with all aspects of the service. People were confident in the service to provide safe and effective care and spoke highly of staff and managers.

People felt that care workers understood their needs and were able to meet them. People were satisfied with the help they received to access community services, such as medical care, social work support and advocacy.

Staff worked positively with external professionals to ensure people received safe and effective care. Risks to people’s wellbeing and safety were identified and carefully managed.

There were clear procedures in place to manage people’s medicines safely. However, these had not always been followed, which had resulted in some errors being made when administering one person’s medicines on several occasions. Medicine records were not always updated in a timely manner, which meant care workers may not have had access to appropriate up-to-date information.

People felt involved in the development of their care plans and able to express their views and opinions. People felt that they were able to request any changes to their care plans and were listened to. There were processes in place to ensure the rights of people who were not able to consent to certain aspects of their care were protected.

People who used the service were supported to engage in fulfilling activities of their choosing. Many people we talked with spoke of staff encouraging and supporting them to try new activities.

Staff were carefully selected and a number of checks were carried out to ensure they were of suitable character before they were employed. There was a comprehensive training and support programme in place to help ensure staff were competent to carry out their roles effectively.

People were enabled to express their views, ideas and opinions about the service. The registered manager acted upon people’s feedback and developed the service accordingly.

There were arrangements in place to enable the provider and registered manager to monitor safety and quality across the service. Where any areas for improvement were identified, appropriate action was taken to ensure they were addressed.