HF Trust - Avon DCA

About the service

HF Trust – Avon DCA is a domiciliary care and supported living service. People are supported in 3 houses in Bristol and Bath. The properties provide self-contained flats with some shared spaces. There are two supported living houses in Bristol which can accommodate up to 9 and 17 people. The house in Bath provides support to up to 3 people.

At the time of our inspection, 28 people were receiving support from the service in these properties, but only 15 received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

Right Support:

Risks to people and the service were assessed, monitored and managed with people so they were protected, informed and their wishes respected. This meant people were supported to take appropriate risks and enjoy their lives safely.

Staff supported people to make decisions following best practice in decision-making. Staff encouraged people and promoted their independence. Staff communicated with people in ways that met their needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff supported people to access specialist services when this could better meet their needs or improve their quality of life. There was a desire for people to achieve the best outcomes possible.

Right Care:

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply their knowledge.

There were enough appropriately skilled staff to meet people’s needs and keep them safe. There was a core staff team who provided consistency.

People received kind and compassionate care from staff who knew them well. Staff ensured support was provided which met people’s individual needs.

Staff worked with people to assess and manage the risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Staff protected and respected people’s privacy and dignity. They understood and responded to their individual and cultural needs and actively promoted individual equality and diversity in their support of people.

Right Culture:

People, relatives, staff and professionals all felt the service was well led. The management team had good oversight of the services. The provider's monitoring processes were effective in helping to ensure people consistently received good quality care and support.

Staff understood their responsibilities and the part they played in achieving the best outcomes for people and focused on supporting them to live the best life possible. Staff had the knowledge, skills and attitude to provide responsive and compassionate care that was tailored to people’s needs and aspirations.

A core staff team provided consistent care with support from bank and agency staff. In some supported living houses, staff turnover was very low.

People and their relatives were asked for feedback, and this was valued. Staff encouraged people to be involved in developing the service and this enhanced their quality of life. People and relatives were confident in raising concerns and told us these would be noted and acted upon.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 12 August 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

HF Trust - Avon DCA is a supported living service which provides support to people at three houses. At the time of inspection, the service was providing personal care to 14 people. The service supported people had a learning disabilities and various other health conditions.

Not everyone at the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

People were supported by staff who knew how to keep them safe and protect them from avoidable harm. People were supported by regular staff who they knew well. People were encouraged to be as independent as possible with their medicines. Systems were in place for the safe management of medicines. Incidents and accidents were reported and investigated, and actions were taken to prevent recurrence. Staff followed infection control and prevention procedures.

The care provided by the service was effective. Staff were well trained and supported by wider health and social care professionals. The management was committed to upskill staff to enable them to support people to achieve their best outcomes.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

Staff had a good understanding of the Mental Capacity Act and knew how to support people to make informed choices about their care. Should people lack capacity this was quickly identified, and measures put in place to support those people.

People were supported by staff who were kind and caring and spent time getting to know them. People were supported to be involved in their care in a way that promoted independence and maintained privacy and dignity.

The service was responsive to people's individual needs. Support staff knew people well and could quickly identify any changing needs. The service had systems in place to meet people's different communication needs. People were supported to pursue hobbies and interests and to be part of their local community. People were empowered to achieve their goals.

The management team led by example and used all opportunities to drive continuous improvement at the service. Staff were motivated and spoke with pride about working at the service.

The management team were open, approachable and focussed on providing person centred care. Systems were in place to monitor the quality of care provided. The management team and staff communicated effectively and shared a passion for championing the rights for people they supported.

The service had established links in the local community and had worked in partnership with key organisations including local authorities and other agencies that provided social care services to improve people's opportunities and experiences.

Rating at last inspection

The last rating for this service was Good (report published in December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

HF trust-Avon DCA is registered to provide personal care and support for people with learning disabilities. At the time of our inspection, there were 29 people receiving personal care and support in three supported living properties. We visited the registered office. This was located in the premises where 18 people were receiving a 24 hour supported living service. A supported living service is one where the contractual arrangements for personal care and tenancy agreements are separate. We inspected the personal care people received.

There was no 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. Two senior managers from the provider’s quality and improvement team were providing full time support to the service. They are referred to in this report as the ‘managers.’

People and their relatives spoke positively about the care and support they received. They told us that staff were, “Very very good” and that, “Staff are wonderful.” People told us that staff were respectful and kind.

People who were supported by the service felt safe. Staff understood how to safeguard people and knew the actions to take if they suspected abuse.

Risk assessments were completed and plans were in place to reduce risks associated with people’s health and personal safety. Risks to people’s safety arising from their environment had not been fully considered and plans were not fully in place to keep people safe in their environment.

Care plans reflected that people’s individual needs, preferences and choices had been considered and then acted upon. Staff were knowledgeable about people’s individual needs.

There were recent improvements in the leadership and management of the service. The senior managers monitored the quality of the service and sought and acted on people’s feedback. Quality assurance systems were in place to monitor and mitigate the risks relating to the health, safety and welfare of people.

We saw that staff had a positive manner and approached people respectfully. They were supportive and worked in person centred ways. For example, knocking on doors before entering people's open doors, and respecting people's wishes.

People we spoke with told us that they were happy with their care and felt included in their support plans. One person told us they 'really love living here'. Another person showed us their support plans and said 'it's all mine'.

People told us they felt safe and that staff were kind to them. One person said 'I'd talk to any of the staff if I was worried'. Another person told us they would 'talk to the manager if I was sad'.

Complaints and concerns were listened to and acted upon immediately.

We saw everyone looked happy and relaxed. We saw that people were engaged in their own chosen activities during our visit. We saw that these activities were recorded in care records as things they enjoyed doing.

There were systems in place to monitor the quality of support people received. We viewed audits, quality reports and questionnaires.

We visited the office of HF Trust Avon where we met with the manager, the area manager and the administrator. The office was situated on the same site as the independent living accommodation where there were 18 bedsits. We were able to speak with five of the tenants and three of the staff that were supporting them.

People experienced care and support that was tailored to their individual needs. They were involved in making decisions about how they were supported. We observed staff supporting people in an appropriate manner ensuring their privacy and dignity was maintained.

People told us that they were confident that the service listened to them and any concerns that they had would be dealt with promptly. People told us they liked the staff that supported them. Staff were knowledgeable about the people they supported and they were provided with training appropriate to their roles.

People were encouraged to lead full and active lives including accessing the community either socially or through paid or unpaid work. Some records held by the staff in the office would benefit from a review to ensure that this was what the person wanted and reflected the service provision of supported living.