This inspection took place at Creative Support Complex needs service on 31 October 2017 and was announced. It was carried out at the service offices in Salford by one adult social care inspector. The service was newly registered with the Commission in March 2016 and this was the first time it had been inspected.

Creative Support Complex needs service is a domiciliary care provider who provides flexible personalised care and support for people living with a learning disability/mental health support needs to enable them to live as independently as possible within the community.

At time of the inspection there was a manager at the service who had been registered with the Care Quality Commission since 18 October 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.

Positive feedback was received from people using the service and their families. Each person we spoke with and their family members told us they were well supported in a safe and informed way by staff. Staff training was in date and mandatory training was offered on an annual basis, with additional refresher training offered for those subjects of training which were more specialist to people’s needs.

Staff displayed a good understanding of the needs and requirements of the people they supported and gave suitable examples around how to keep people safe and promote positive risk taking. Safeguarding procedures were designed to ensure staff had the knowledge to identify and respond to any concerns and training was regularly provided to ensure staff were informed of any changes in Governmental policies.

Staff also understood the importance of ensuring person centred care was delivered in line with people’s wishes. Additional communication tools were used such as pictures to communicate with people who may be non-verbal this was to ensure every opportunity was offered to people to enable empowerment over their own lives.

Suitable environments were maintained for people, their visitors and staff. Environmental risk assessments were evident and further risk was identified in relation to areas such as water temperature, use of stairs, food hygiene, substances hazardous to health (COSHH), electrical and gas appliances, use of stairs and accessing the community. Lone working risk assessments were also evident to identify any possible areas of concern in relation to staff working alone.

Consistent staffing teams were evident in each of the tenancies and a suitable amount of staff were employed to meet the complex needs of the people they supported. Staff also felt they were allocated enough time to support people in line with their needs and enable people to access the community each day should they wish.

Recruitment procedures were robust and staff were recruited in line with current best practice guidance. New employee induction processes were in place which ensured staff had the correct amount of support and training prior to commencing the role unsupervised. Staff were not assessed as competent to work alone until they had undergone a series of observational practices by a manager and had undertaken a period of shadow shifts with a more experienced staff member.

Medicines were administered in line with best practice guidance from the National Institute for Health and Care Excellence. Staff received adequate training in the administration of medicines and were required to attend refresher training on an annual basis. All medicines were stored securely and safely in each tenancy.

Each person had their own individual care file containing support plans, risk assessments and other relevant documentation. These records gave clear information about people's needs, wishes, feelings and