HF Trust - Herts and Essex DCA

Updated 7 November 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 08 October 2018 and was announced. We gave the service 5 days’ notice of the inspection site visit because it is small and the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be available to support the inspection process. The inspection was undertaken by one adult social care inspector.

Before our inspection we reviewed information that we held about the service including statutory notifications that had been submitted. Statutory notifications include information about important events which the provider is required to send us. We had not requested a provider information return (PIR) to be submitted to us at this time. This is information that the provider is required to send to us, which gives us some key information about the service and tells us what the service does well and any improvements they plan to make.

Inspection activity started on 08 October 2018 and ended on 11 October 2018. We visited the office location on 08 October 2018 to meet the registered manager and office staff; and to review care records and policies and procedures. We also met five people who used the service when they visited the office during the day. On 10 October 2018 we visited three people in their homes together with the staff that supported them and on 11 October 2018 we spoke with relatives of four people who used the service to gather their views about the support provided. We spoke with a total of seven people who used the service, five staff members, and the registered manager.

We received feedback from representatives of the local authority health and community services.

We reviewed care records relating to four people who used the service and other documents central to people's health and well-being. These included staff training records, medication records and quality audits.

Updated 7 November 2018

The inspection took place 08 October 2018 and was announced. This is the first inspection of this service since the provider made changes to their registration in September 2017.

This service is a domiciliary care agency. It provides a service to younger adults and older adults who live with learning disabilities or autistic spectrum disorders to enable them to live in their own homes either on their own or sharing with others in supported living services. A supported living service is one where people receive care and support to enable them to live independently. People have a tenancy agreement with a housing provider and receive their care and support from HF Trust Herts and Essex DCA. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of our inspection a total of 22 people were receiving support with their personal care.

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 they were extremely happy with the staff that provided their care, relatives told us they felt staff went beyond the call of duty. People had a small team of staff who supported them which helped to ensure continuity and enabled people to form bonds with the staff. Examples shared with us included where a person had been very ill and staff had supported them to recover their independent living skills, a staff member had worked tirelessly in their own time to promote an anti-bullying campaign in the local community which had helped a person regain their confidence and further examples where staff used their in-depth knowledge and understanding of people to make their lives better in various ways.

People were offered choices and these were respected which contributed towards people feeling that they had control in their lives. Staff interacted with people in a warm, respectful and dignified way. It was clear that people trusted staff and that they worked in partnership to achieve as much independence as possible. Staff understood the importance of promoting people’s independence and support plans supported this to allow people to live as independently as possible.

People all said they felt safe using the service and their relatives confirmed this. People were comfortable in the presence of staff members and their relatives said they couldn’t praise them highly enough. Staff had been trained in how to safeguard people from avoidable harm and were knowledgeable about the potential risks and signs of abuse. People were supported to take risks to retain their independence and maintain their freedom. Risk assessments had been regularly reviewed and kept up to date.

People, their relatives and staff all told us that there were enough staff available to meet people’s needs. Safe and effective recruitment practices were followed to make sure that all staff were of good character and suitable for the roles they performed at the service. Staff completed a six-month probationary period where the provider checked if they were performing to a suitable standard. People were safely supported to take their medicines as they wished, some people were supported to self-administer their medicines, some people had automated pill dispensers and some people received support from staff members. Staff were knowledgeable about people’s individual needs and could tell us what support would be provided in the event of an emergency situation such as a fire. The management and staff team used incidents as a learning tool to help ensure people’s safety and wellbeing.

The care and support provided was appropriate to meet people's needs. Staff received training and supervision to support them to be able to meet people’s care and support needs. The service worked within the principles of The Mental Capacity Act 2005 (MCA) and staff understood their role in protecting people's rights in accordance with this legislation. People were happy with the support they had to eat and drink which varied depending on people’s individual circumstances and contractual arrangements. Relevant health and social care professionals were involved with people’s care when needed such as GPs, dentists and opticians.

Creative ways had been developed to help ensure people could understand important information by introducing various documents and guidance in an easy read format. People were encouraged to make individual goals to aspire to and staff supported people with goal action plans. Staff were knowledgeable about people's preferred routines, likes and dislikes, backgrounds and personal circumstances and used this to good effect in providing them with personalised care and support that met their individual needs. People were encouraged to be as independent as possible and were supported to have a voice about matters that affected their day to day lives.

People had good access to community facilities and the provider held various social events throughout the year to give people the opportunity to engage with family and friends. People were supported to embrace technology to help them achieve independence and manage their care needs. Concerns and complaints raised by people who used the service or their relatives were appropriately investigated and resolved.

People, relatives and staff told us they felt the service was well managed and that they were well supported by the registered manager and provider. People’s relatives told us they would be confident to recommend the service to anyone looking for care in the same situation. The registered manager demonstrated an in-depth knowledge of the staff they employed and people who used the service. There were regular management meetings held between the registered manager and the regional manager to discuss such issues as recruitment, the performance of the service and any matters arising. There were a range of management checks undertaken routinely to help ensure that the service continued to be safe. The organisational records, staff training database and health and safety files were organised and available. Feedback from people, external professionals and relatives was actively encouraged.