HF Trust - Oxfordshire DCA

Updated 21 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 2 inspectors and 2 Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in 24 ‘supported living’ settings, so that they can live 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 at people’s personal care and support. The service is also registered for domiciliary care providing personal care to people living in their own houses, flats or specialist housing.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to visit the office and had to be sure the registered manager would be in to support the inspection.

Inspection activity started on 19 April 2023 and ended on 2 May 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We visited the location’s office on 19 April 2023. We also visited 10 supported living settings on 25 April 2023 and spoke or observed 23 people who used the service. We also spoke with 10 relatives to seek their feedback about their family member’s experience of care provided. We spoke with 16 staff including the registered manager, area support manager, 7 cluster team managers (each responsible for management of certain premises) and care staff. We reviewed a range of records. This included 10 people’s care records and a range of medicines records. We looked at 3 staff files in relation to recruitment and supervision. We spoke with 1 professional who worked with the service. A variety of records relating to the management of the service, including audits and policies and procedures were reviewed.

Updated 21 June 2023

About the service

HF Trust Oxfordshire DCA is a supported living and domiciliary care service providing personal care to people with a learning disability and/or autistic people living in shared or individual accommodation. Personal care is help with tasks related to personal hygiene and eating and any wider social care provided. At the time of the inspection the provider supported 82 people in 24 supported living settings across Oxfordshire.

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:

Not all premises were of a quality to meet people’s assessed needs. In one setting, a person was at risk of harm due to their support needs increasing. The registered manager had identified this and was in the process of evaluating suitability of premises.

We have made a recommendation about consulting current and best practice guidance about expected standards of supported housing accommodation to reduce the risks of people living in potentially unsafe premises.

Most staff understood how to protect people from poor care and abuse. However, we found not all processes had been followed when people were potentially at risk of further harm. The registered manager had reflected on this and taken action to ensure reporting and investigation took place in line with the provider’s policy and procedures.

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 supported people to have as much choice, control and independence as they could.

Staff had received training and had competency assessments to ensure they had the skills to work with people.

Right Care:

People and their relatives told us they received care from staff who were kind and compassionate. Staff protected and respected people's privacy and dignity. They understood and responded to their individual needs. The service had enough suitably skilled staff to keep people safe. People who had individual ways of communicating could interact comfortably with staff because staff had the necessary skills to understand them and knew them well.

Right Culture:

There was an effective registered manager in place who had identified where improvements were needed. The registered manager ensured people were supported by staff that knew them well so they could be responsive in supporting people's needs. People received good quality care and support because trained staff could meet their needs and wishes. The staff we spoke with felt the registered manager was approachable and supportive and took action when needed.

People and their relatives had confidence and felt well supported by 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

The last rating for this service was good (published 15 March 2018).

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service sustained a serious injury. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk of falls. This inspection examined those risks.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for HF Trust - Oxfordshire 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.