HF Trust - Forest of Dean DCA

Updated 17 December 2022

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 one inspector.

Service and service type

This service provides care and support to people living in a ‘supported living’ setting, so 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.

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

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. 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 spoke with 1 person who lived at Ormiston and observed 3 people interacting with staff. We spoke with 2 people's relatives. We received feedback from the local authority and 5 professionals about their experience of the care and support provided by the service. We saw recommendations made by Inclusion Gloucestershire following their visit to the service in July / August 2022.

We spoke with 9 staff including the registered manager, cluster manager (onsite manager), an agency administrator, 3 support workers, a regular agency support worker and 2 specialist behaviour support practitioners.

We reviewed a range of records. This included people's care records and records of incidents and accidents. A variety of records relating to the management of the service, including the service’s action plan and recent audits were reviewed.

Updated 17 December 2022

About the 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.