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Inspection carried out on 17 November 2017

During a routine inspection

This inspection took place on 17th and 20th November 2017 and was unannounced. HF Trust - Cromwell Crescent provides accommodation for up to three people with learning disabilities, physical disabilities or sensory impairments. At the time of our inspection there were three people using the service. The home is based in a residential area of Market Harborough and is set over one level.

HF Trust - Cromwell Crescent is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

We inspected HF Trust - Cromwell Crescent in November 2016 and rated the service as Requires Improvement. That was because action had not always been taken in response to accidents and incidents and records of the care people had received were not always sufficiently detailed. During this inspection we found that the provider had implemented improvements in these areas and we rated the service as Good.

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 could be assured that they would be supported by sufficient numbers of staff that knew them well. Risks to people had been assessed and plans of care developed to support staff in minimising the known risks to people in order to maintain their safety. People could be assured they would receive their prescribed medicines safely. Accidents and incidents were recorded and analysed by senior staff and action was taken to reduce the likelihood of them reoccurring again in the future. Staff had been subject to appropriate pre-employment checks to ensure that were of good character and suitable to work with vulnerable adults.

Staff received the support, training and supervision that they required to work effectively in the home. Staff worked closely with people’s allocated healthcare professionals to ensure that people’s health and wellbeing was actively promoted. People could be assured that they would receive the support that they needed to eat and drink enough to help maintain their health and well-being.

People’s needs were assessed prior to moving into the home and detailed plans of care were developed to guide staff in providing consistently person centred care and support. The home provided a safe and accessible environment for people and had been well maintained by the provider.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People were supported by a stable staffing team that knew them well and consistently treated people with dignity and respect. People were actively encouraged to make decisions about their care and support and to direct their care as much as they were able to.

The provider had developed systems to manage feedback and complaints from people appropriately. People had been supported to develop detailed communication aids to support staff in communicating with them and information was provided to people in a format that they understood.

The service had a positive ethos and an open culture. The registered manager and provider were committed to develop the service and actively looked at ways to improve the service. There were effective quality assurance systems and audits in place; action was taken to address any shortfalls.

Inspection carried out on 9 November 2016

During a routine inspection

We inspected the service on 9 November 2016. It was an unannounced inspection.

HF Trust - Cromwell Crescent provides accommodation for people with learning difficulties and sensory impairments. There were three people using the service on the day of our inspection.

The service had 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.

People and their relatives told us that they felt safe. Staff were aware of their responsibility to keep people safe. However, action was not always taken when a potential concern had been identified by staff.

Risks were assessed and managed to protect people from harm and staff understood what to do in emergency situations. Accidents or incidents were not always investigated and actions taken if required.

There were enough staff to meet people’s needs. Safe recruitment practices were being followed. Staff had received training and supervision to meet the needs of the people who used the service. Staff told us that they felt supported.

People received their medicines as required. Medicines were administered safely by staff who were appropriately trained and competent to do so. The way that people’s medicines were stored was not regularly checked.

The provider was meeting the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards. The registered manager was clear of their role in ensuring decisions were made in people’s best interest.

People’s eating and drinking needs were assessed and met. People’s health needs were met and when necessary, outside health professionals were contacted for support. People’s health records were being maintained.

People were supported by staff who understood that they should be treated with dignity and respect. We saw that people were encouraged to be involved in making choices about the things that were important to them. People’s independence was promoted and encouraged. People’s bedrooms were well maintained and decorated in a manner of their choosing, with their own belongings.

Records were not always detailed and did not always reflect the support that people had received. Where staff were required to monitor aspects of people’s health and wellbeing, they had not consistently done so. The provider told us they were looking at making improvements to their recording.

People’s care plans included information that guided staff on the activities and level of support people required for each task in their daily routine. Where people required support to manage their anxieties this was provided.

People were supported to engage in activities that they enjoyed and to maintain links with people who were important to them. People were not asked for feedback about the service that they received. However, the provider was making plans to improve this.

People’s relatives felt that the service was well-led. They knew how to complain should they have needed to. Staff felt supported. They were clear on their role and the expectations of them. There were systems in place to challenge poor staff practice and take action where concerns had been raised.

Systems were in place to monitor the quality of the service being provided however, these were not always effective. There was a culture which was open and inclusive putting people at the centre of their support.