Archived: HF Trust - South Oxfordshire & Berks DCA

HF Trust - South Oxfordshire & Berks DCA provides personal care for people with learning disabilities. This service provides care and support to 31 people living in 13 ‘supported living’ houses which they either own or rent in the Oxfordshire and West Berkshire area 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 care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. On the days of our inspection 31 people were being supported by the service.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good overall.

Why the service is rated Good:

There were three registered managers responsible for the service. 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 last inspection, we rated the responsive area of the service as good. At this inspection, we had evidence that people were receiving exceptional support ensuring that people received highly individualised person-centred support. Support plans contained detailed and personalised information and we saw that people had been supported to have a full and meaningful life enjoying interests and gaining employment. People benefited from a large range of activities and interests of their choice. There were many excellent opportunities to optimise people's social and stimulation requirements.

There was clear guidance for staff on how to meet people’s individual needs and support them to achieve their goals. We saw that people were relaxed and staff demonstrated a caring attitude. The service had ensured people’s communication was maximised which assisted their engagement.

People remained safe living in their homes. There were sufficient staff to meet people's needs and staff had time to spend with people. Risk assessments were carried out and promoted positive risk taking, which enabled people to live their lives as they chose. People received their medicines safely and were protected from the risks of infection.

The service continued to provide support in a caring way. Staff supported people with kindness and compassion and provided individualised support as staff knew people well, respected them as individuals and treated them with dignity whilst providing a high level of emotional support. People and their relatives, were fully involved in decisions about their care needs and the support they required to meet those individual needs.

People’s nutritional needs were met and staff supported people to maintain a healthy diet. Where people had specific dietary needs, these were met.

People continued to receive effective care from staff who had the skills and knowledge to support them and meet their needs. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to access health professionals when needed and staff worked closely with people's GPs to ensure their health and well-being was monitored.

People had access to information about their care and staff supported people in their preferred method of communication.

The registered managers monitored the quality of the service and looked for continuous improvement. There was a clear vision to deliver high-quality care and support and promote a positive culture that was person-centred, open, inclusive and empowering which achieved good outcomes for people.

HF Trust – South Oxfordshire and Berkshire Domiciliary Care Agency (DCA) is registered to provide personal care. The agency office is based in Milton Heights in Oxfordshire. The service provides support to adults living in eight shared living accommodations in South Oxfordshire and Berkshire. Support can range from a few hours each week based around provision of activities, to twenty four hour support for all aspects of personal care and daily living. At the time of this inspection 25 people were supported by the agency.

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 felt safe and their relatives also felt their family member was safe in the service. Processes were in place to make sure people received their medicines safely. Staff recruitment procedures were thorough and ensured people of good character were employed. Staff were provided with relevant induction and training to make sure they had the right skills and knowledge for their role.

Risks associated with people's care and support had been assessed. Clear guidance was in place for staff to ensure people remained safe and were supported to be as independent as possible and participate in household tasks and access the community safely. The service had safeguarding procedures in place and staff had received training in these. Staff demonstrated an understanding of what abuse was and how to report any concerns in order to keep people safe.

Staff were knowledgeable about the people they supported and had access to development opportunities to improve their skills. Staff received support they needed to carry out their jobs safely and effectively. Staff were confident in the way the service was managed.

The service followed the requirements of the Mental Capacity Act 2005 (MCA) and the principles of the Deprivation of Liberty Safeguards (DoLS). This helped protect the rights of people who may not be able to make important decisions themselves.

The service was highly responsive to people’s changing needs. People's preferences were sought and respected throughout the whole planning process. We saw all people had a comprehensive person centred plan which they reviewed with staff support at regular intervals. People told us staff provided consistent personalised care and support. We noted care records were focused on empowering people to have control of their lives. People had been involved in developing their support to ensure it was person centred and flexible to suit their individual needs. People had opportunities to express what they wanted out of their lives and staff ensured that where possible, these aspirations were achieved. These included who they wanted to live with and to celebrate significant events in their lives, such as attending family events and going on holidays they had expressed a desire to do. People were encouraged to retain and gain skills to ensure they had as much independence as possible. There were opportunities for people to gain work skills and attain a qualification to use for securing work. People were promoted to live full and active lives and were supported to go out and use local transport and facilities. People were involved in groups to ensure their views were taken account of at a local and national level. People had also had the opportunity to discuss their care on a one to one basis.

People were involved in regular reviews of their care and support where they were able to discuss any changes they wanted in their care or support. We spoke with people and their relatives who said they could speak with staff if they had any worries or concerns and they would be listened to.

There were effective systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to. People using the service and their relatives had been asked their opinion via surveys, the results of these had been compiled in an action plan if improvements were identified.

We visited the registered offices and met with the registered manager, a representative of the provider, two senior members of staff and administration support staff. We met with three people who used the service and we observed a communal event that was taking place in the communal support centre. We observed interactions staff had with people who use the service. We read the care records for six people. We inspected the policies and procedures, the complaints files, the safeguarding logs and training and supervision records.

A single inspector carried out the inspection. The focus of the inspection was to answer the five questions: Is the service safe, effective, caring, responsive and well-led?

We found the service was safe.

We spoke with people who told us they felt safe. Safeguarding policies and procedures were in place and these included local authority guidance and contact details. We spoke with staff who understood their responsibilities with regard to safeguarding the people they supported.

We saw people were involved and supported to make decisions about their care and treatment, and this was documented.

We found records were maintained to a satisfactory standard. Care plans were in place and these were reviewed when there were changes or on an annual basis.

We found the service was effective.

People were supported in promoting their independence and community involvement. People told us how they were involved in the running of the service, and how they represented and spoke for others at weekly meetings. These were called, "parliament" meetings, where people debated and discussed local and service issues that were important to them.

People had individual support plans which set out and agreed their care needs. The support plans contained comprehensive information and were accessible to staff.

We saw that people had access to doctors, district nurses, occupational therapists, physiotherapists, opticians, dentists and chiropodists.

We found the service was caring.

People who used the service were able to participate in a range of activities which were tailored to their individual needs and abilities. We saw that some people were in paid employment, some people were in voluntary employment, and some people were supported to participate in their chosen recreational activities.

We spoke with people who told us they felt respected by the staff who provided care and support for them. They told us how they were involved in staff recruitment, in that they were part of the interview panel for new staff.

We found the service was responsive.

We found that people were supported to make their own decisions about their care, treatment and support.

We saw that complaints were recorded, investigated and resolved appropriately.

People we spoke with told us how staff had responded when their needs changed. For example, one person told us how they were supported when their personal circumstances changed.

We found the service was well-led.

We spoke with staff who spoke positively about the service and told us it was well managed and well led.

The provider had arrangements in place to encourage staff to express their views and identify improvements that could be made to the service they provided. We spoke with staff who told us they were proud to work for HF Trust.

We found that staff were appropriately trained to meet the needs of the people they were supporting.

We looked at audits that had been completed and found that recommended actions were documented. This meant that people could be confident that the service they received would be monitored, reviewed and improved where needed.

People were protected from the risk of infection because appropriate guidance had been followed. One person commented, 'Staff wear gloves to clean the toilet. They wash their hands before they make food.' People were cared for, or supported by, suitably qualified, skilled and experienced staff.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.