We carried out a review of the data available to us about HF Trust - Forest of Dean DCA on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about HF Trust - Forest of Dean DCA, you can give feedback on this service.
HF Trust - Forest of Dean DCA provides care and support to people in a supported living setting known as Ormiston. The service is registered to provide the regulated activity personal care. At the time of our inspection there were 4 people using the service.
Ormiston is one building which contains a staff office / communal kitchen, laundry, staff ‘sleep-in’ room and 4 individual flats with their own gardens.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support: People using the service lived independently from each other, with their own flats, gardens and transport. The service had done all possible to support one person to go out safely while their new vehicle was being built and to speed up its delivery, also to ensure adaptations were made to another person's home. Each person had a named staff member [keyworker] who supported them with planning and decision-making. Improvements had been made to staff recruitment, employment conditions and training to address staffing challenges and ensure staffs’ approach maximised people’s choice, control and independence.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Right Care: People’s medicines, incidents and behaviours were reviewed regularly with health and social care professionals to ensure any restrictions were in people’s best interests. Staff supported people to access medical care by ensuring reasonable adjustments were made. A professional said staff had, “Ensured that the right people were with him to explain to the resident the treatment but also advise [professionals] the adjustments required in relation to timing, the environment and his compelling likes dislikes.” One person was being supported to attend a slimming group, staff understood their weight loss programme and supported the person with cooking and food choices.
Right Culture: Managers were committed to ensuring improvements underway at the service were completed. Recruitment changes, staff training and support were having a positive impact on the service's culture. The staff we spoke with were compassionate and empathetic and understood people’s needs and risks. Effective working relationships had been established with most professionals, who told us about the positive impact improvements were having. However, areas for improved communication were identified which the registered manager said they would address. A staff member said, “It is 100% improving. Managers are working tirelessly, you can go to them with any worries or fears, there is always time.”
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 14 February 2019).
Why we inspected
We received concerns in relation to staffing, medicines, managing people’s health and behaviours and people’s access to activities. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe and Well-Led sections of this full report.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has not changed and the rating has remained good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for HF Trust - Forest of Dean DCA on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
HFT Forest of Dean is a service who provide care and support to people living in ‘supported living’ settings, so that they can live in their own home as independently as possible. At the time of our inspection there were five people receiving a service. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
Not everyone 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.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other 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
What life is like for people using this service:
People told us they felt safe. They were protected from potential abuse and discrimination. Risks to people were identified, assessed and action had been taken to reduce these or remove them. Medicines were managed safely and staff provided the support people needed to take their medicines as prescribed. Enough suitably recruited and skilled staff were deployed to meet people’s needs.
People’s health needs were assessed and people had access to a variety of healthcare professionals to support them. People were provided with the right amount and type of food to meet their health needs, and were supported to do their own food shopping and prepare their own meals. People’s religious preferences were being met.
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 were kind and caring towards people they supported. They maintained people’s dignity and privacy. People’s choices, preferences and wishes were known to the staff who had taken time to find these out. Care plans gave staff guidance on how to meet people’s needs. Further detail about people’s care needs was also communicated to staff by means of staff handover meetings and daily notes.
The service met the characteristics of Good in all areas; more information is available in the full report below.
Rating at last inspection:
The last inspection was on 24 May 2017 when the service was rated as ‘Requires Improvement’ overall. We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Care and treatment was not always provided in a safe way and not all risks to service users had been assessed and fit and proper persons had not always been employed. The provider sent us a detailed action plan at that time. At this inspection we found significant improvements and the breaches of regulation 12 and 9 had been met.
Why we inspected:
This was a planned inspection based on the rating at the last inspection.
Further information is in the detailed findings below.
The service was providing care and support to six people living in their own homes, Forest Close and Ormiston, so that they could live as independently as possible. People supported by the service lived with a learning disability and some with autism.
At the time of our inspection 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. The manager had been overseeing the service since November 2016 and had started the process of registering with the Care Quality Commission to ensure the provider would meet the conditions of their registration.
During this inspection we identified breaches against two of the Health and Social Care Act 2005 (Regulated Activities) Regulations 2014. Regulation 19 Fit and proper persons employed was not met. Pre-employment checks had been carried out in line with the provider’s recruitment processes. However, these fell short of regulatory requirements for staff working with vulnerable adults. Where staff had previously worked in health or social care, checks did not always include evidence of their conduct in these roles or verifying their reason for leaving, to ensure they were of good character.
Regulation 12 Safe Care and Treatment was not met. People were not always supported by staff who had the knowledge and experience to support them safely and effectively. When incidents occurred these were investigated but the action taken was not always robust or timely enough to reduce future risks.
You can see what action we told the provider to take at the back of the full version of the report. We also recommended the provider consider reviewing the mix of temporary and permanent staff on each shift and seek guidance about the frequency of supervision meetings for new staff.
The provider was recruiting more staff and making training and support available to ensure staff would develop the skills they needed. Key worker sessions were being introduced to ensure people had regular meetings with their key support worker to capture their feedback about their care and activities.
Staff and relatives gave us mixed feedback about the leadership in the service. Some were complimentary of the provider. Others told us improvements were needed to the communication in the service and to ensure concerns would always be responded to in a timely manner.
The provider had systems in place to monitor the quality of the service provided to people. They identified that improvements were needed during their audit of the service in May 2017. We saw the concerns they identified were similar to the ones we found at this inspection. However, the manager had not identified the extent to which one person’s community involvement and opportunity for social interaction had been compromised. The provider was working on a service improvement plan with commissioners. Time was needed before we could evaluate the effectiveness of the provider’s action plan in making and sustaining the required improvements.
Staff were caring and motivated to support people to enjoy meaningful activities and relationships. People’s likes and dislikes were respected and they were assisted to communicate their wishes. Where appropriate, people’s relatives were involved in decision-making and care reviews.
People were supported to maintain good health. A variety of health professionals were involved in assessing, planning and evaluating people's care and treatment.