An unannounced inspection visit took place on 27 June 2018.

This was the first inspection of this service following its registration with us in July 2017.

Creative Support – Napton House is registered to provide personal care to adults with learning disabilities, autism or autistic spectrum disorders. Care and support was provided to people at prearranged times in a specialist ‘extra care’ housing service so each person had their own flat.

Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. Each person has their own individual tenancy agreement and is the occupant’s own home and Creative Support provides their care package. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection only looked at people’s personal care service.

Napton House has 15 individual flats. People living at Napton House share on site facilities such as a lift, lounge, kitchen, laundry, garden and an activities area.

At the time of this inspection visit, staff supported 15 people in 15 apartments, however the provider told us only six people received personal care. Therefore, for this inspection, we only looked at the care and support for those people receiving personal care.

The service did not have a 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.’ A manager had been appointed and was in the process of registering with us.

Overall, people were pleased and satisfied with the quality of care provided although for some people, inconsistency of staff and management had affected the quality of care they received. People were supported to remain as independent as possible so they could live their lives as they wanted. People made choices about what they wanted to do for themselves, such as what to do, where to go and what to wear. However, where people lacked understanding to make some decisions, there was limited information to demonstrate decisions were made in people’s best interests. People were encouraged to maintain important relationships with family and people built friendships with others living at Napton House.

Care plans contained information for staff to help them to provide the individual care people required. For people assessed as being at risk, care records included information so staff knew how to minimise risks. However, information to manage specific risks and behaviours that could become challenging, were not completed or followed which meant there was an inconsistent approach in how staff supported those individuals.

Staff knew how to keep people safe from the risk of abuse. Staff and management understood what actions they needed to take if they had any concerns for people's wellbeing or safety.

Staffing levels had recently improved and better shift management helped ensure people received their allocated care hours. Staff told us this had not always been the case. Care staff did not always receive sufficient training to effectively meet and support people’s health conditions. Senior staff and management told us their induction was limited and did not give them the background information about the service or the people in their care.

People’s care and support was provided by a caring staff team despite the organisational challenges from the provider. People told us they felt safe living at Napton House and they felt recent changes within the staff and management had begun to improve the service they received.

Staff worked within the principles of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity, staf