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Inspection Summary


Overall summary & rating

Good

Updated 30 June 2017

HF Trust – Devon DCA (Hft) is part of a larger national provider for people with learning disabilities (HF Trust) and is registered to provide personal care to people living in the community. At the time of this inspection the service was supporting 33 people with varying support needs in a total of 13 supported homes. Some people lived alone, requiring minimal support and others lived in shared accommodation with support during the day and overnight.

This inspection was announced and took place on 26 April and 2 May 2017.

The service had a registered manager in post. 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.

We previously undertook a comprehensive inspection of the service in April 2016 when we rated the service as ‘good’ overall with the question of ‘well-led’ rated as requires improvement. In December 2016 we undertook a focused inspection in response to concerns raised with us about people not receiving safe care and treatment and the staffing arrangements within the service. We rated the key question of ‘safe’ as requires improvement. We identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Following the inspection in December 2016 the service sent us a plan describing the actions they had taken to improve.

At this inspection, in April and May 2017, we found improvements had been made to staffing arrangements and how the service was managed. However, while people were receiving safe care and support, some improvements were required to ensure risk management plans accurately reflected the action staff were taking to keep people safe.

Risks to people’s health, safety and welfare had been assessed and the outcome recorded in their care files. Management plans had been developed to identify how to support each person in a way that minimised these risks. However, we found some management plans did not include all the actions staff were taking to keep people safe. For example, one person’s risk management plan did not identify that staff must supervise them at all times when they were in the communal areas. The registered manager gave assurances these plans would be amended immediately.

People received support from staff who had been safely recruited and well trained. Changes had been made to the number of people the service could support. This had resulted in improved staffing arrangements and the service was less reliant upon agency staff. Staff were aware of their responsibilities to protect people from abuse. The service provided people with guidance and information about protecting themselves when in the community.

Some of the people receiving support could become anxious and display behaviours that may put themselves or others at risk. Hft had a team of advisors who supported staff in assessing people’s needs and provided guidance to promote people’s positive behaviour. Staff told us they had completed training in supporting people who may display potentially aggressive behaviour and were familiar with appropriate distraction techniques.

People’s medicines were managed safely and they received their medicines as prescribed by their doctor. Medicines were stored securely and only staff trained and assessed as competent administered medicines. Senior staff undertook weekly audits of medicines in each supported home. This ensured medicines were ordered when needed, given as prescribed and records were properly completed. People were referred to health care services when necessary. These included GP or community nurses as well as more specialist services such as hospital consultants and physiotherapists. Staff monitored people’s health conditions and liaised with healt

Inspection areas

Safe

Requires improvement

Updated 30 June 2017

The service was not always safe.

Risks to people's safety and well-being were identified and action taken to mitigate these risks. However, some management plans required more information to reflect the actions staff were taking to keep people safe.

Staff were safely recruited and only staff assessed as suitable to work with people who may be vulnerable were employed.

People benefitted from staff who were trained and aware of their responsibilities to protect people from abuse.

Medicines were managed safely.

Effective

Good

Updated 30 June 2017

The service was effective.

People's rights to make choices about their care and support were respected. However some people’s liberty was being restricted due to staffing arrangements commissioned by the local authority.

Staff were well trained and knowledgeable about people's support needs.

People were supported to maintain good health and were referred to healthcare or other specialist services where required.

Caring

Good

Updated 30 June 2017

The service was caring.

Staff treated people with respect, kindness and patience.

Support plans were personalised and contained detailed information about how staff should support people.

People were supported to plan activities for enjoyment and for developing their independents living skills.

Responsive

Good

Updated 30 June 2017

The service was responsive.

The service was committed to providing person-centred support and promoting the rights of people with disabilities. People were supported to use assistive technology to help them become more independent.

People were listened to and complaints were investigated in line with the service's policy and procedures.

People were supported to use community facilities.

Well-led

Good

Updated 30 June 2017

The service was well-led.

People benefitted from having a registered manager who knew them well and was available to them.

Systems were in place to regularly review the quality and performance of the service.

Staff felt well supported and were encouraged to share their views about the running of the service.

People and their relatives were encouraged to share their views about the quality of the services provided. Actions were taken to improve the service in response to their feedback.