HF Trust Leeds and Bradford

Updated 11 July 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 24 and 30 May 2018 and was unannounced.

We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

The inspection process included contacting people and their relatives for feedback by telephone on the 23 and 24 May 2018. We visited the office location on 24 and 30 May 2018 to see the registered managers and office staff; and to review care records and policies and procedures. We visited people in their own homes to discuss the care and support they received and to review their records and to talk with the staff on duty on the 30 May 2018.

The inspection team included one adult social care inspector, one assistant 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. The expert-by-experience had previous experience with people with a learning disability and autism.

The registered provider had been asked to complete a provider information return (PIR) and this had been returned within required timescales. A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help plan this inspection.

We reviewed other information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to tell us about within required timescales.

We sought feedback from the local authority commissioning and safeguarding teams, and Healthwatch Leeds. Healthwatch is the consumer champion for health and social care.

During the inspection, we spoke with the senior regional manager, the operational manager, three registered managers, and eight staff.

We attempted to call 41 people and managed to speak with eight people in receipt of a service and eight relatives by telephone to seek their views. We visited three houses where eleven people received care and support from the provider. We spoke with six people in their own homes who provided feedback on the service they received. We spoke with four members of staff who were on duty in people’s homes during our visits.

We reviewed a range of records. This included six people's care records containing care planning documentation and daily records. We also viewed the records for ten staff relating to their recruitment, supervision, appraisal and training. We viewed records relating to the management of the service and a wide variety of policies and procedures.

Updated 11 July 2018

This inspection took place on 24 and 30 May 2018 and was announced.

This was the first inspection carried out by the Care Quality Commission (CQC) for this provider at this location.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to people with Learning disabilities or autistic spectrum disorder, Older People and Younger Adults.

Not everyone using HF Trust receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service was divided into seven clusters and there was a manager for each cluster. Five of the seven managers were registered managers. 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.

At the time of this inspection 71 people were receiving a service from this provider.

Systems and processes were maintained to record, evaluate and action any outcomes where safeguarding concerns had been raised which helped to keep people safe from avoidable harm and abuse.

Risks for people and for staff from the environment were assessed and managed through individual risk assessments. These provided staff with information to help keep both people and themselves safe from avoidable harm with minimal restrictions in place.

The provider ensured there were sufficient skilled and qualified staff to meet people's individual needs and preferences.

Staff had received support with their role through a regular system of supervisions and appraisals. However, staff raised their concerns regarding frequent changes in management and an associated lack of consistent support.

People confirmed they received care and support from regular staff who they knew.

Staff had completed training on the Mental Capacity Act 2005 (MCA) and were able to discuss the importance of supporting people with their independence.

Records confirmed people received assessments of their capacity to make and agree to informed decisions about their care and support. The provider was following the MCA and where people were assessed as not having capacity best interest meetings were held. However, outcomes of best interest meetings did not always robustly record the individual attendees or include copies of their input following the provider’s guidance.

Procedures were in place to guide staff on the safe administration of medicines and staff had received medicines training. People confirmed, and the records we checked showed, that people had received their medicines as prescribed.

People received information in a format they could understand. Where people had communication difficulties, staff were trained to ensure their ability to communicate was enhanced.

People received at least annual reviews of their health and wellbeing.

The provider included people or their representatives in discussions regarding the use of medicines where their behaviour may at times, be challenging, and was pro-active in reducing any reliance on them favouring instead other interventions.

The provider had systems and processes in place to ensure staff were appropriately recruited into the service and had the necessary skills and personality to support individuals with their everyday needs and preferences.

Support plans included information to ensure staff were informed and respectful of people's cultural and spiritual needs.

People were supported to maintain a healthy and balanced diet. Care plans contained details

of people's preferences and any specific dietary needs, they had, for example, whether they were diabetic, had any allergies or religious needs.

The provider ensured they had close working relationships with other health professionals to maintain and promote people's health.

Staff had a good understanding of people's needs and were kind and caring. They understood the importance of respecting people's dignity and upholding their right to privacy.

There was information available on how to express concerns and complaints. People were encouraged to raise their concerns and these were responded to.

There were systems of audit in place to check, monitor and improve the quality of the service. Associated outcomes and actions were recorded and these were reviewed for their effectiveness.

The provider worked effectively with external agencies and health and social care professionals to provide consistent care.