Archived: HF Trust - Kent North DCA

HF Trust Kent North DCA provides personal care to people living in their own homes and holding their own tenancy. It provides a supported living service to people who are living with a learning disability and/or autism. At the time of the inspection there were 26 people receiving personal care and support. These people lived at four addresses some of which were divided into flats and others were shared living arrangements within a large house. The shared homes had an office with a sleep-in room for staff.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

Three of the services were larger homes and one supported nine people. However, the size of the service having a negative impact on people was reduced by the building design fitting into the residential area. There were deliberately no identifying signs or anything else outside to indicate it was supported living accommodation. Staff didn’t wear anything that suggested they were support staff when coming and going with people. People chose who they lived with and had meaningful relationships with their house mates.

People’s experience of using this service and what we found

People were safe and happy in their homes and with the care and support they received. People received person centred care and support from support workers who were trained and competent. People enjoyed various activities and outings of their choosing and were enabled to have new experiences.

People were supported to stay well in line with their wishes. 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.

Staff were caring. People were respected, engaged in their support and involved in decisions around their care and support from choosing what they ate for dinner, what activities they did to having a voice in provider meetings.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent in all areas of their lives

The quality and safety of the service was ensured by the provider. There was a positive, high quality and caring culture in the service led by the registered manager and other managers which achieved positive outcomes for people. Support workers told us it was a good place to work and they were well supported. All feedback was positive from people, relatives, health and social care professionals, and staff for all aspects of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 30 August 2018) and there was one breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This was our first inspection since the service was registered on 20 October 2016.

The service was run by a company who was the registered provider. There was a registered manager who 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. In this report when we speak about both the company and the registered manager, we refer to them as being, ‘the registered persons’.

We found one breach of the regulations. This was because the registered provider had failed to suitably tell us about an occasion on which a person may have been placed at risk of experiencing abuse. You can find out what action we have told the registered provider to take at the end of the full version of this report.

Our other findings were as follows: Background checks had not always been completed in the right way before new care staff had been appointed. Although in practice there were enough care staff on duty, the registered persons did not operate robust systems to ensure that this remained the case. People were safeguarded from situations in which they may be at risk of experiencing abuse. People received safe care and treatment and they had been helped to avoid preventable accidents while their freedom was respected. Medicines were managed safely. Suitable arrangements were in place to prevent and control infection. Lessons had been learned when things had gone wrong.

Care was delivered in a way that promoted positive outcomes for people and care staff had the knowledge and skills they needed to provide support in line with legislation and guidance. This included respecting people’s citizenship rights under the Equality Act 2010. People were supported to eat and drink enough to have a balanced diet to promote their good health. Suitable steps had been taken to ensure that people received coordinated support when they used or moved between different services. People had been supported to access any healthcare services they needed. People had been helped to liaise with their landlords so that their homes were well maintained.

People were supported to have maximum choice and control of their lives. In addition, the registered persons had taken the necessary steps to ensure that people only received lawful care that was the least restrictive possible.

People were treated with kindness and they were given emotional support when needed. They had also been helped to express their views and be actively involved in making decisions about their care as far as possible. This included them having access to lay advocates if necessary. Confidential information was kept private.

People received person-centred care that promoted their independence. This included them having access to information that was presented to them in an accessible way. People were given opportunities to pursue their hobbies and interests. The registered manager and care staff recognised the importance of promoting equality and diversity. This included appropriately supporting people if they adopted gay, lesbian, bisexual, transgender and intersex life-course identities. Suitable arrangements were in place to resolve complaints in order to improve the quality of care. People were supported to make decisions about the care they wanted to receive at the end of their life in order to have a comfortable, dignified and pain-free death.

Suitable arrangements had not been made to enable the service to learn, improve and assure its sustainability by ensuring that all regulatory requirements were met. We have made a recommendation about the steps the registered persons should take to strengthen the way in which they monitor the running of the service.

People who received support, their relatives and members of staff were actively engaged in developing the service. The registered persons were actively working in partnership with other agencies to support the development of joined-up care.