Archived: HF Trust - St Austell

Updated 21 June 2016

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.

The inspection visit took place on 24 May and was announced. This meant we gave notice of our intended visit to ensure someone would be available in the office to meet us. The inspection team consisted of one adult social care inspector.

Before the inspection we reviewed information held about the service. This included the Provider Information Return (PIR) which is a form that asks the provider to give key information about the service, what the service does well and improvements they plan to make. We also reviewed previous inspection reports and notifications. Notifications are specific events registered people have to tell us about by law. We sent questionnaires to people, relatives and staff asking them for their views of the service. We received responses from three people who used the service, one relative and 14 members of staff.

During the inspection visit we spoke with the registered manager, training co-ordinator and two members of staff. We visited five people who were receiving care and support from the service and observed their interactions with staff. We reviewed three people’s care files, looked at two staff records and reviewed a range of other records relating to the running of the service. Following the inspection visit we spoke with another three members of staff.

Updated 21 June 2016

The inspection took place on 24 May and was announced. We gave the provider 24 hours’ notice of the inspection in accordance with our current methodology for inspecting domiciliary care services.

HF Trust – St Austell is a domiciliary care agency that provides personal care and support to people with a learning disability in their own homes. At the time of our inspection the service was providing a service to 22 people, 18 of those were receiving support with their personal care needs. The Care Quality Commission has responsibility for regulating personal care and this was the area of the service we looked at. These people were receiving a 24 hour supported living service. A supported living service is one where people live in their own home and receive care and support to enable them to live independently. The contractual arrangements for tenancy agreements and personal care are separate so people can choose to change their care provider and remain living in the same house.

People receiving a service were living in one of four supported living services. One of these was used by people who did not need support with their personal care and so we did not look at that particular service. One of the services was a complex of individual self-contained flats. Each person had their own front door and exclusive possession of the flat. A communal area was used by staff for meetings and supervisions and to carry out paperwork. In the other two services people rented a bedroom and only had exclusive possession of that area. Other parts of the house were shared areas such as kitchens, living areas and bathrooms. Staff sleep-in rooms were also used as office spaces where staff could complete paperwork or have supervisions.

There was a registered manager in post who was responsible for the day to day running of 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.

People told us they felt safe. We observed people as they were being supported by staff. We saw people were relaxed and comfortable in their home and with the staff supporting them.

Staff had received training in how to recognise and report abuse or poor practice. Staff were confident any allegations or concerns would be taken seriously and investigated to help ensure people were safe and protected.

Risk assessments were in place to inform and guide staff so they were able to minimise any identified risk. People told us staff helped keep them safe while supporting them to maintain and develop their independence. We found one person’s behaviour sometimes put other people or staff at risk. This had not been recorded in their care plan and there was no appropriate risk assessment in place. This meant staff would not be aware of the actions to take in this situation.

There were sufficient numbers of suitably qualified staff to meet people’s needs. The recruitment and induction process for new staff was thorough and helped ensure staff were safe and suitably prepared to work with vulnerable people.

People received the support they needed to take their medicines as prescribed. Any medicine errors were investigated and recorded. Following an error staff were required to undertake refresher training or be re-assessed as competent to administer medicines by a senior member of staff.

People received support from staff who had the knowledge and skills to meet their needs. People told us staff knew them well.

Some people had restrictions in place in order to keep them safe. We looked at these people's files and saw there were no mental capacity assessments in place or any evidence of best interest discussions taking place. This meant people’s liberty could have been unlawfully restricted as the provider was not working in accordance with the processes set out in the Mental Capacity Act (2005).

Staff talked about the people they supported affectionately. They demonstrated a pride in people’s achievements and told us they enjoyed supporting people. Positive relationships had been formed between staff and people. We observed people chatting with staff and sharing any concerns they had with them. Staff were supportive and encouraging in their responses. They shared common values and a shared approach to support which centred on independence and community inclusion.

Care plans were well laid out and contained clear guidance for staff. Staff told us they referred to them regularly and found them to be informative and accurate.

There was a management structure in the service which provided clear lines of responsibility and accountability. People and staff knew who to speak to if they had any concerns and felt any issues would be addressed.

The manager and staff monitored the quality of the service by undertaking a range of quality audits and speaking to people to help ensure they were happy with the service they received. In addition regular audits were carried out by HF Trust’s head office.