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HF Trust - Avon DCA

Overall: Good read more about inspection ratings

241 Redcatch Road, Knowle, Bristol, BS4 2HQ (0117) 924 3152

Provided and run by:
HF Trust Limited

Report from 16 May 2024 assessment

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Well-led

Good

Updated 17 July 2024

People, their relatives and staff gave us positive feedback about the culture and leadership of the home. The provider’s values focused on diversity, kindness and positivity and people’s needs and wishes were at the heart of the service. People’s individual and protected characteristics were respected. Staff received training and understood equality, diversity and human rights principles. People were supported to do the things they enjoyed and be part of their local community. They had contact with family and friends, and links with other professionals helped to ensure their needs were fully met. Staff spoke positively about working for the organisation, and about the people they supported. All the staff we spoke with felt they were treated fairly. Staff told us the management team were approachable, fair, and supportive. They felt the recent changes to management structures had improved the service. Managers were visible during our visits and appeared to know people well. Staff felt able to speak up and were confident that the management team would listen and address their concerns where possible. As appropriate, staff acted as advocates for people to ensure their needs were met. There were clear and effective governance, management and accountability arrangements and action was taken when shortfalls or concerns were identified. Progress against actions was monitored to ensure plans were achieved. Staff told us they tried to continually improve services for people. People were asked for their feedback, and creative solutions were encouraged to meet people’s needs and provide a high quality service.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Shared direction and culture

Score: 4

There was a very open, honest, friendly culture within the service, and staff and leaders had a positive approach. The vision of the service was shared with staff and promoted by the management team. Staff were relaxed and happy in the presence of the registered manager and regional manager. Staff told us the recent changes in management had improved the service. There were now managers in each service who were supported by deputies. Staff spoke positively about the leadership of the service. They said, “I can honestly say the manager is amazing” and “I have seen lots of changes to improve the service.” Staff told us they really enjoyed working for the service and were passionate about delivering individual person-centred care. Staff celebrated people’s successes with us and were inclusive and supportive of each other. We heard staff praising a colleague when they achieved something with a person who lived at the service. The registered manager spoke about the importance of recognising people’s individual and protected characteristics. Staff also respected this and told us about events people had attended and organisations they were involved with. Staff aimed to understand the unique needs and challenges faced by people in order to overcome barriers and meet their needs.

Regular team meetings, handovers, emails and supervision helped staff to feel involved in the service and kept them updated about any risks, challenges and best practice.

Capable, compassionate and inclusive leaders

Score: 3

People, their relatives and staff were confident about the managers in each setting and the registered manager. Recent changes to the management structure had improved staff’s experience. Further changes meant there would be an additional registered manager, which aimed to improve oversight and accountability. Staff told us the managers and registered manager were all visible and approachable. We saw the registered manager supporting people during the visit and taking an interest in the people they were talking to. They knew people well and were aware of their support needs and interests.

The management team had the skills, experience and credibility to lead effectively. They were available when we visited each of the services and were open and honest throughout the assessment. Managers told us they had regular supervision, meetings with peers and felt supported by the provider. The management team carried out regular checks on the service, including mock inspections and audits.

Freedom to speak up

Score: 3

Staff felt the culture enabled them to speak up and their voice would be heard. Staff felt confident that the management team would address the concerns they had. Two staff told us the management team had initially been slow to respond to concerns they had raised about the risks presented by a person who lived at the service. They added that, after the concerns had been shared with the safeguarding team, appropriate action was taken.

Staff had access to whistleblowing policies and systems were in place to support them when identifying concerns or raising issues. People were actively involved in the development of the service, and some attended regional groups where they could share ideas and raise concerns. On a more local level, people and relatives had opportunities to feedback including face to face meetings and in regular surveys. People received support from paid advocates and family and friends. Staff also advocated for people to help them get the service they needed.

Workforce equality, diversity and inclusion

Score: 3

Staff spoke positively about working for the organisation, and about the people they supported. Some staff had worked for the service for a long time. They were enthusiastic and passionate about supporting people in a person-centred way. Some agency staff had worked for the service for many years. They were recognised for their contribution and were treated as though they were employed by the provider. They were supported to attend training and participate in team meetings, and they received support via supervision. All the staff we spoke with felt they were treated fairly. The registered manager spoke about the importance of recognising staff’s individual characteristics and unique needs.

Staff had access to equality and diversity policies and guidance, and reasonable adjustments could be made to meet specific needs such as caring responsibilities or religious obligations.

Governance, management and sustainability

Score: 3

The service had clear and effective governance, management and accountability arrangements. Staff confirmed regular audits were completed and some staff had specific roles, such as lead for health and safety. Staff told us when areas for improvement were identified through audits, this was fed back to them during supervision and team meetings. Staff understood their role and responsibilities. They were motivated to follow guidance and manage risks to work with people to keep them safe and provide effective person-centred care. Managers could account for the actions, behaviours and performance of staff and acted where performance was not acceptable.

The provider had systems in place to monitor and improve standards and safety. Audits of topics such as medicines, health and safety and support plans were carried out regularly. There was oversight within the organisation which helped to hold staff to account, keep people safe, protect their rights and ensure good care was provided. There was evidence that actions had been taken to resolve shortfalls or concerns.

Partnerships and communities

Score: 3

People were encouraged to be part of their local community based on their wishes and aspirations. Some people did voluntary work, whilst others were in paid employment. One person told us they went to a local farm for work experience. This enabled them to be part of their community. People told us about other activities they enjoyed. This included shopping, attending a drama group for people with learning disabilities and an evening social club. People were supported to do the things they liked to do. Some relatives told us their family members had found it more difficult to go out following the restrictions of the Covid pandemic. They noted this was gradually improving now. During our visit, one person was being supported to attend a health care appointment. The person was upset as they wanted to go for a coffee and visit the local record shop. Staff were observed reassuring the person and explaining that they could still do this later. People were encouraged to maintain contact and relationships with those who were important to them. One person told us about their trip to visit family overseas and another person told us they caught the train to visit family in the north of England. One person said there was a barbeque at the weekend and were happy that they could ask family and friends to the event.

The management team made referrals to the local authority on behalf of people when their needs changed to ensure they had appropriate support at the times they needed it. Staff told us about fund raising that had taken place and enabled them to develop a sensory room and garden at one of the homes. A local business had assisted as part of their charity work. The registered manager said work was being done at another home to improve the garden. This was being funded by charity money that had been raised. The project was to support people who enjoyed gardening to grow flowers and vegetables. Staff planned to develop small allotments and were liaising with the housing association on behalf of people to ensure the home remained both a safe and comfortable place to live. One person had support from another agency during the week for social activities. The manager was able to show how they worked in partnership to ensure there was joined up care and a consistent approach.

Professionals told us the service worked in partnership with them to achieve good outcomes for people. One professional said, “Staff have been able to develop a positive professional relationship with the service users through the years that they have been supporting them. Staff are able to demonstrate that they have a person-centred approach, considering each service user’s personality, likes and dislikes, family, personal history and desires when supporting them."

Staff and leaders were open and transparent during this assessment process and engaged fully with the inspection team.

Learning, improvement and innovation

Score: 3

There was a culture of ongoing learning and improvement. Staff told us they were supported in their roles to develop additional skills and further their knowledge. For example, training relating to choking incidents, and changes made to improve medicines management. Staff said they were always seeking to improve services for people. One staff member told us they were exploring what people wanted to do. They explained that, just because a person did an activity for a long time, it did not necessary mean they were happy, so they were exploring with each person what they wanted to do and whether they wanted to do it differently. Staff were encouraged to be innovative and creative to improve people’s experience. For example, by using technology to give people more independence and remain safe when eating, or by the installation of a wet/dry toilet to enable a person to maintain their dignity and independence.

The provider had an overall development plan and specific action plans which provided evidence of ongoing learning, innovation and improvement. Impact and outcomes were measured with people, relatives, staff and other professionals.