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Inspection carried out on 24 May 2018

During a routine inspection

This inspection took place on 24 and 30 May 2018 and was announced.

This was the first inspection carried out by the Care Quality Commission (CQC) for this provider at this location.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to people with Learning disabilities or autistic spectrum disorder, Older People and Younger Adults.

Not everyone using HF Trust receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service was divided into seven clusters and there was a manager for each cluster. Five of the seven managers were registered managers. 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.

At the time of this inspection 71 people were receiving a service from this provider.

Systems and processes were maintained to record, evaluate and action any outcomes where safeguarding concerns had been raised which helped to keep people safe from avoidable harm and abuse.

Risks for people and for staff from the environment were assessed and managed through individual risk assessments. These provided staff with information to help keep both people and themselves safe from avoidable harm with minimal restrictions in place.

The provider ensured there were sufficient skilled and qualified staff to meet people's individual needs and preferences.

Staff had received support with their role through a regular system of supervisions and appraisals. However, staff raised their concerns regarding frequent changes in management and an associated lack of consistent support.

People confirmed they received care and support from regular staff who they knew.

Staff had completed training on the Mental Capacity Act 2005 (MCA) and were able to discuss the importance of supporting people with their independence.

Records confirmed people received assessments of their capacity to make and agree to informed decisions about their care and support. The provider was following the MCA and where people were assessed as not having capacity best interest meetings were held. However, outcomes of best interest meetings did not always robustly record the individual attendees or include copies of their input following the provider’s guidance.

Procedures were in place to guide staff on the safe administration of medicines and staff had received medicines training. People confirmed, and the records we checked showed, that people had received their medicines as prescribed.

People received information in a format they could understand. Where people had communication difficulties, staff were trained to ensure their ability to communicate was enhanced.

People received at least annual reviews of their health and wellbeing.

The provider included people or their representatives in discussions regarding the use of medicines where their behaviour may at times, be challenging, and was pro-active in reducing any reliance on them favouring instead other interventions.

The provider had systems and processes in place to ensure staff were appropriately recruited into the service and had the necessary skills and personality to support individuals with their everyday needs and preferences.

Support plans included information to ensure staff were informed and respectful of people's cultural and spiritual needs.

People were supported to maintain a healthy and balanced diet. Care plans contained details

of people's preferences and any specific dietary needs, they had, for example, whether they were diabeti