This inspection was undertaken on 25 August 2018 and was announced. At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Creative Support (St Helens) is a supported living accommodation scheme which provides personal care to 10 vulnerable adults living within self-contained flats. The service is based within a residential area of Clock Face, St Helens.

This service provides care and support people living in a 'supported living' setting, so that they can live in their own home 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 people's personal care and support.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and of the best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service has a registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers they are 'registered persons'. Registered persons have a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated regulations about how the service is run.

Staff recruitment continue to be robust and this helped to ensure that only staff suitable to work with vulnerable people were employed. All staff had completed a comprehensive induction and had completed shadow shifts with experienced staff members before they loan worked. Staff at all completed mandatory training as well as additional training required for their role. Staff attended team meetings and had regular supervision. This meant that staff at the right knowledge and skills to support people.

Safeguarding policies and procedures were in place and staff had all received training. Staff demonstrated a good understanding of abuse and described clearly the processes to be followed in the event of a person being at risk of harm.

Medicines were ordered, stored, administered and disposed of in accordance with best practice guidelines. All staff had completed medicines training and had their competency regularly assessed. The registered provider had medicines policies and procedures in place. Staff consistently completed medicine administration records (MARs).

People were assessed prior to receiving support from the service. Information gained through assessment was used to create person centred risk assessments and care plans. These documents included clear guidance for staff about how a person was to be supported and how risk was to be mitigated. People and their relatives participated in regular reviews which ensured information remained up-to-date.

Staff had a good knowledge of people they supported and had developed positive relationships with them. People were offered choice and their independence was promoted. People were treated with kindness and patience by the staff team. We saw that people's privacy and dignity was respected by staff.

People were supported to participate in activities of their choice. People's food and drink needs were assessed and clear guidance was in place for staff to follow for these to be met. Records showed that people were offered choice and their specific dietary needs were met.

A complaint policy and procedure was readily available for people and their relatives. This was also available and easy read and pictorial formats. Relatives told us they felt confide

The inspection was announced and took place on 23 December 2015. We gave the community based adult social care service 48 hours’ notice to ensure we could access the information we needed.

Creative Support offers support to people to enable them to live independently in their own homes. The service provided personal care and support to10 adults with learning disabilities. The service was supporting 10 people at the time of the inspection.

The last inspection of Creative Support was carried out on 24 February 2014 and we found that the service was meeting the regulations we assessed.

There was 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.

Relatives told us they felt their family members were safe. Comments included “[Name] is quite happy, very safe and extremely well supported” and “The manager really listens to the family and the communication is good”.

Staff had received training in how to recognise and report abuse. All staff were clear about how to report concerns and were confident that any allegations made would be fully investigated to help ensure people were protected. There were sufficient numbers of suitably qualified staff to meet the needs of the people who used the service.

People were supported to take their medicines by staff that were appropriately trained. People received care and support from regular staff that knew them very well, and had the knowledge and skills to meet people’s individual needs. Relatives spoke very positively about staff; their comments included “The quality of the staff is good” and ”Staff are very caring”.

Before people started using the service the registered manager visited them to assess their needs and discuss how staff could meet their care needs. From these assessments individualised care plans were developed with the person and their relatives to agree how the care and support would be provided.

Care plans provided staff with clear direction and guidance about how to meet people’s individual needs. Relatives told us the manager was approachable and makes herself available.

People said they would not hesitate to speak to staff if they had any concerns about the service they received. People and their relatives knew how to make a formal complaint if they needed to. One relative said, “I have had cause to raise concerns and I felt my views were listened and responded to”.

There was a management structure within the service which provided clear lines of responsibility and accountability. There was a positive culture within the service, the management team provided strong leadership and led by example. Staff said “The registered manager is very approachable” and “It’s a very welcoming place to work”.

There were quality assurance systems in place to make sure that any areas for improvement were identified and addressed.

We encouraged the people using the service to communicate with us using their preferred methods of communication. During our visit we found that people who used the service and their relatives were positive about the support they had received. Their comments included:

“Whatever they are doing keep doing.”

“My relative is very happy here.”

Before people received care or support they were asked for their consent and the provider acted in accordance with their wishes. People’s needs were assessed and care and treatment was planned and delivered in line with their individual care record.

People told us they felt confident to report any concerns if they needed to.

We found the provider had effective staff recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

The provider had clear systems in place to monitor the quality of the service provided.