HF Trust - Lympne Place (High Trees and The Beeches)

Updated 16 January 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 was planned to check 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.

This inspection took place on 30 November 2017 and was unannounced. Two inspectors carried out the inspection.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We looked at the previous inspection reports and any notifications received by the Care Quality Commission. A notification is information about important events, which the provider is required to tell us about by law.

We spoke with the registered manager, and six members of staff. We looked at five people’s care plans and the associated risk assessments and guidance. We looked at a range of other records including two staff recruitment files, the staff induction records, training and supervision schedules, staff rotas and quality assurance surveys and audits.

We last inspected HF Trust – Lympne Place (High Trees and The Beeches) in August 2016 when two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were identified.

Updated 16 January 2018

This inspection took place on 30 November 2017 and was unannounced.

High Trees and The Beeches are two residential care homes. The services are registered as one location to provide accommodation and personal care for up to 12 people who have a learning disability and other complex needs. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. 12 people were living at the service at the time of the inspection and each had their own personalised bedroom. In both High Trees and The Beeches, people had access to a lounge, dining room, a kitchen, bathrooms and gardens.

The service had a registered manager in post. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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 last inspected HF Trust – Lympne Place (High Trees and The Beeches) in August 2016 when two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were identified. We issued requirement notices relating to safe care and treatment, good governance and a lack of notifications.

At our inspection in August 2016, the service was rated 'Requires Improvement'. We asked the provider to take action and the provider sent us an action plan. The provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook this inspection to check that they had followed their plan and to confirm that they now met legal requirements. Improvements had been made. We made two recommendations to improve people’s care and support, however, all of the breaches had now been met.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. However, best interest decisions regarding people’s finances had not been recorded. We made a recommendation about this. There was some confusion amongst staff regarding the provider’s policy on supporting people to eat out. Staff had an understanding of The Mental Capacity Act (2005) and any restrictions on people’s liberty had been legally authorised.

There was an open culture and people were encouraged to be as independent as possible. Staff and the registered manager had a good understanding regarding supporting people with learning disabilities. However, the principles regarding person-centred planning (a way of helping a person to plan their life) had not always been followed. Staff had not always recorded goals for people to work towards and did not consistently record what people did or their achievements. We made a recommendation regarding this.

Medicines were now managed safely and stored in people’s individual rooms. Senior staff undertook regular checks and audits of medicines to reduce the risk of errors occurring.

Any risks relating to people’s care and support had been assessed and any action needed to reduce these risks were clearly recorded. When incidents had occurred the registered manager had analysed them and taken action to ensure they would not happen again. Staff knew how to keep people safe and any potential safeguarding incidents had been reported to the local authority safeguarding team. Lessons were learnt when things had gone wrong.

People’s preferences regarding their care and support had been recorded. Staff knew how to support people in the way they preferred. Some people had health conditions such as diabetes and epilepsy and these were stable and managed well.

Staff had an understanding of people’s equality and diversity needs and told us they would challenge discrimination in any form. Staff knew people well and supported them to make their needs known. Some people required assistance to communicate and staff knew how to interpret people’s non-verbal communication. All complaints had been documented and responded to in line with the provider’s policy.

Staff treated people with dignity and respect. People told us that staff were kind and caring. When people’s loved ones had died staff had supported people compassionately.

People had been involved in making decisions about the design and décor of the service. People were able to access their kitchens, whenever they wanted and were supported to prepare meals and drinks of their choosing. People were supported to eat a healthy and balanced diet. Some people required a specialist diet, and this was provided at each meal time. People were supported to keep the service clean and wiped down the surfaces of the kitchen during the inspection.

There was enough staff to keep people safe. Some people received one to one support and this was always provided. People were able to go out and do the things they wanted throughout the inspection. They took part in a range of activities both inside and outside of the service. Staff had received essential training and told us they felt well supported by the management team. Staff had received training in topics related to working with people with learning disabilities. Staff had been recruited safely.

The registered manager was experienced in working with people with learning disabilities and providing person centred care. Staff and the registered manager consulted with other professionals regarding people’s care and received support from the provider to provide consistent care. The service worked in partnership with a range of other agencies such as the local authority safeguarding and commissioning team.

The registered manager had a good knowledge of the regulatory requirements and had informed CQC of any important events that occurred at the service, in line with current legislation. The provider had displayed their rating clearly and legibly on their website and at the service.

The registered manager regularly carried out audits to identify any shortfalls and ensure consistent, high quality, personalised care. Regular health and safety checks were undertaken to ensure the environment was safe and equipment worked as required. Regular fire drills were completed.

People’s relatives, staff and other stakeholders were regularly surveyed to gain their thoughts on the service. These were collated and analysed and the results were displayed within the service so everyone could read them. When areas of improvement were identified, these were acted on and people’s views were listened to.