HF Trust - East Lancashire

Updated 23 October 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.

The inspection took place on 19 and 20 September and was announced.

The registered provider was given 48 hours’ notice prior to the inspection visit. Prior notice is provided because the location provides a community care service and we needed to be sure that staff would be available on the day.

The inspection team consisted of one adult social care inspector and an ‘expert by experience’. An ‘expert by experience’ is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection visit we reviewed the information we held on HF Trust-Lancashire DCA. This included notifications we had received from the registered provider such as incidents which had occurred in relation to the people who were being supported. A notification is information about important events which the service is required to send to us by law. We had also received a number of safeguarding alerts which needed to be followed up on during the inspection.

A Provider Information Return (PIR) was received prior to the inspection. This is the form that asks the provider to give some key information in relation to the service, what the service does well and what improvements need to be made. We also contacted commissioners and the local authority prior to the inspection. We used all this information to formulate a plan for the inspection, this enabled us to identify key areas that needed to be focused on during the inspection.

During the inspection we spoke with the operations manager, three registered managers, six members of staff, six people who were receiving support and six relatives who agreed to be contacted over the phone. We also visited one of the supported living services two people were living at.

We also spent time looking at specific records and documents, including five care records of people who were being supported, four staff personnel files, staff training records, medication administration records and audits, compliments and complaints, accidents and incidents, policies and procedures, safeguarding records and other documentation relating to the management of the service.

Updated 23 October 2018

This inspection took place on 19 and 20 September and was announced.

HF Trust-Lancashire DCA is a domiciliary care agency, it is owned by HF Trust Limited and is regulated by the Care Quality Commission (CQC). The service provides personal care and support for people who are living with learning disabilities or autistic spectrum disorders and who live in the Preston area. CQC only inspects community based services where people are receiving support with ‘personal care’ such as help with tasks relating to personal hygiene and eating.

The registered provider’s office is in Bamber Bridge on the outskirts of Preston. Some people receive support in ‘supported living’ accommodation and share facilities with other people. People also receive support in their own accommodation.

HF Trust-Lancashire DCA has been developed and designed in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the time of the inspection HF Trust-Lancashire DCA was supporting 44 people.

There were three ‘registered managers’ in post. A registered manager is a person who has registered with the 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 and how the service is run.

At the last inspection, in January 2016 the registered provider was rated ‘Good’ overall. However, we identified a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 for ‘safe care and treatment’ in relation to unsafe medication procedures. The registered provider was issued with ‘requirement action’ and requested to submit an action plan to identify how improvements would be made.

We checked to see if the registered provider was complying with regulations during this inspection.

We reviewed all medication processes during this inspection and found that there were safe practices in place. There was an up to date medication policy in place and all processes were adhered to by trained staff. A newly implemented medication system was in place; this reduced the number of errors and incidents which were occurring.

Care plans and risk assessments contained detailed and tailored information about each person who was receiving support. Risk assessments were comprehensive and tailored around the needs and risks of the person.

The registered provider had robust recruitment procedures in place. Rigorous pre-employment checks were conducted before candidates were confirmed in post. Employment histories were thoroughly checked, health questionnaires were in place and the necessary ‘Disclosure and Barring System’ (DBS) checks were conducted prior to employment commencing.

Accident and incidents were reported and recorded in accordance with the accident/incident reporting procedures. The registered managers ensured all such ‘events’ were analysed and trends were established to mitigate risk.

Staff were familiar with safeguarding and whistleblowing procedures. Staff had received the necessary safeguarding training and there was relevant safeguarding and whistleblowing policies and procedures in place.

Health and safety procedures were in place. People were living in safe, clean and well-maintained environments.

The registered provider operated within the principles of the Mental Capacity Act, 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People were involved in the day to day decisions in relation to the care and support provided.

HF Trust-Lancashire DCA had a designated learning and development department. Staff were supported with a variety of different training courses that enabled them to develop their skills and knowledge around the area of health and social care. Specialist training was also provided when a training need was identified.

Staff received supervision and annual appraisals on a regular basis. There was also evidence of ‘group supervision’ and staff expressed that support was available on a ‘day to day’ basis.

People were effectively supported with nutrition and hydration support needs. People’s nutrition and hydration needs were appropriately assessed from the outset and the correct measures had been implemented to safely monitor and mitigate risks which had been identified.

People received a holistic level of care and support. Referrals took place to external healthcare professionals accordingly. Care records we reviewed contained information and the necessary guidance.

We received positive feedback about the quality and provision of care people received. People and their relatives told us that staff provided kind, caring, dignified and compassionate support.

Confidential and sensitive information was safely stored and protected in line with General Data Protection Regulations (GDPR). This meant that sensitive information was not unnecessarily shared with others.

Person-centred care was provided and care records we checked contained relevant information in relation to a person’s likes, dislikes, wishes, choices and preferences.

The registered provider had a complaints process in place. Complaints were responded to and managed in accordance to the complaints policy. People received information regarding the complaints procedure in a 'service user' guide.

People were supported to engage and participate in hobbies and interest they enjoyed. Records demonstrated the variety of different activities people took part in.

Quality assurance systems were effectively in place. We were provided with a variety of different audits and checks that helped to asses, monitor and identify any areas of developments and improvements that were needed.

A variety of different policies and procedures were in place. Policies were regularly reviewed and staff were familiar with a range of different policies that was discussed with them during the inspection.

The registered provider was aware of their regulatory responsibilities and understood that CQC needed to be notified of events and incidents that occurred in accordance with the CQC’s statutory notifications procedures.