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Inspection carried out on 6 February 2019

During a routine inspection

About the service: HF Trust – Cornwall DCA provides care and support to people living in ‘supported living’ settings, so that they can live as independently as possible. The service’s office is based in Wadebridge and the supported living settings for people receiving personal care are in St Austell and Wadebridge. 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. On the day of the inspection 17 people who needed support with personal care were using the service.

People’s experience of using this service: People were supported to develop and maintain their independence and have choice and control over their daily lives. Staff supported people according to their individual preferences and needs. There was a drive to deliver person centred care which focused on getting the best outcomes possible for people.

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; independence, choice and control over day to day routines and inclusion and involvement in the local community. People's support focused on them having as many opportunities as possible for them to gain new skills and develop and maintain their independence.

People were supported in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff told us they were well supported through supervision and staff meetings. They commented on the availability of registered managers for support, advice and guidance at all times. Training covered a wide range of areas and was regularly refreshed. Staff were able to request additional training to meet people’s specific needs.

Where restrictions had been put in place to keep people safe this had been done in line with the requirements of the legislation as laid out in the Mental Capacity Act (2005) and associated Deprivation of Liberty Safeguards. Any restrictive practices were clearly recorded and regularly reviewed to check they were still necessary and proportionate.

People were involved in planning their care and decisions about how care was delivered. Easy read information was provided to help people make informed decisions. Where necessary other supporting information was provided such as visual and audio materials. We observed people were in charge of their routines and were able to request support when they needed it.

The service was exceptionally well-led. Staff told us they enjoyed working at the service and that HF Trust was an excellent organisation to work for. Staff were encouraged to develop their skills and contribute to the running of the service. The registered managers were enthusiastic and keen to share their experiences with us. They had high expectations for people and this was shared with the staff team.

At our previous inspection the service was rated Good. (Report published 27 September 2016)

Why we inspected: This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned based on the rating. If we receive any concerns we may bring our inspection forward.

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

Inspection carried out on 1 September 2016

During a routine inspection

HF Trust – Cornwall DCA is a domiciliary care agency that provides personal care and support to people with a learning disability in their own homes. It is part of a national provider, HF Trust who manage a range of services for people with learning disability throughout the country. At the time of our inspection the service was providing a service to 24 people, seven of those were receiving support with their personal care needs. The Care Quality Commission has responsibility for regulating personal care and this was the area of the service we looked at. These people were receiving a supported living service in one of four houses. A supported living service is one where people live in their own home and receive care and support to enable them to live independently. The contractual arrangements for tenancy agreements and personal care are separate so people can choose to change their care provider and remain living in the same house. The number of hours of support these people received varied from seven hours a day up to 24.

There was a registered manager in post who was responsible for the day to day running of the service. 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.

People told us they were happy with the support they received and felt safe. We observed people as they were being supported by staff. We saw they were relaxed and comfortable in their home and with the staff supporting them. Staff were warm and empathetic in their approach to people and there was laughter and gentle teasing between people and staff. Relatives told us they were confident their family members were safe and one commented; “We all work together, they know [person’s name] and me and my family.”

Staff knew the people they supported well and had a good understanding of their needs. Sometimes agency staff were used and there were systems in place to help ensure they had access to all important and relevant information to enable them to support people according to their plan of care. Recruitment practices were robust and people were involved in the process in a meaningful way. The induction process covered all relevant training and this was refreshed and updated regularly.

Staff were positive when talking about the people they supported and spoke of them with affection. This was reflected in the written documentation which emphasised people’s abilities and positive characteristics. People were supported to access the local community and take part in activities, work placements and attend college. Technology was used to help people develop and maintain their independence. For example, one person had automated alarms on their doors to enable them to be on their own without support when they wished while staying safe.

Some people had restrictions in place in order to keep them safe. The registered manager had a clear understanding of the Mental Capacity Act 2005 (MCA) and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected. Mental capacity assessments and best interest meetings had been carried out as required. Senior staff had identified where it might be necessary to apply to the Court of Protection to authorise a deprivation of liberty and highlighted this to the local authority.

Care plans were kept on HF Trusts electronic system. These contained a great deal of information which was often repetitive and might be difficult for staff to assimilate. Accompanying ‘Who Am I’ documents were more succinct and relevant to people’s everyday needs. Paper copies of these were kept at people’s homes as working files which staff could refer to at any time.

There was a management structure in plac

Inspection carried out on 27, 28 November 2013

During a routine inspection

HF Trust - Cornwall supported people with a diverse range of needs. Some people we met were able to make decisions about their lives, work and to a greater degree look after their homes, whereas others had very limited communication, needed full personal care and assistance with activities around the home. Subsequently the support people received ranged from a limited number of hours of outreach support to 24 hour support from up to two staff.

Everyone we met looked well cared for. Typical comments from people who used the service included, “the staff are very helpful, they are very nice people and they support me when I ask for their help.” We saw that people who used the service had given consent to their care.

Documentation regarding the service was to a good standard. For example care plans provided clear information regarding care and what support staff needed to assist people with. Medication practices were completed in line with policies and procedures.

Staffing levels were good, and there was evidence that staff had received training and support.

A satisfactory quality assurance system was in place.

Inspection carried out on 28 March 2013

During a routine inspection

One person we visited told us how proud they were of their home and showed us their garden and the room where they enjoyed art work.

We met one person who had spoken out about someone who had sent them abusive messages on a social networking site. They showed us a presentation they had given to a large meeting encouraging people not to agree to communicate with strangers on networking sites.

We saw people using a day care service. Some people were playing music, others were painting and there was a discotheque which people told us they were enjoying.

One person told us they had recently moved house. They had been unhappy and felt socially isolated. They felt able to voice their unhappiness at a 'speak out' event which was held weekly, facilitated by staff from the trust.