HF Trust - Thetford Road

About the service

HF Trust - Thetford Road is a residential care home providing personal care to up to 8 people. The service supported people with learning disabilities and autism. At the time of our inspection there were 8 people using the service.

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

Right Support: Model of Care and setting that maximises people's choice, control and independence. There were safe staff recruitment procedures in place and staff had the necessary training on how to safely support people using the service. People's medicines were managed in line with current best practice.

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. However, mental capacity assessments completed by the provider had not always included all the necessary information. Actions taken by the provider to address this gap will be reviewed at our next planned inspection.

Right Care: Care is person-centred and promotes people's dignity, privacy, and human rights. People were encouraged to access community independently and be active participants in the society. People’s care and support needs were assessed, and staff did their best to meet them. People's care records were person- centred and up to date. However, risk assessments required reviewing making sure staff were provided with information in relation to the impact the identified risks had on people.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive, and empowered lives. There was a good leadership at the service. Staff knew people well and empowered people to make decisions about their care. However, communication with the healthcare professionals and the family members required improving to ensure good information sharing.

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 15 April 2019). You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for HF Trust - Thetford Road on our website at www.cqc.org.uk.

Why we inspected

This was a planned inspection based on when the service was previously inspected.

This was a focused inspection and the report only covers our findings in relation to the Key Questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

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

People’s experience of using this service:

¿ People were safe in the home. Staff could explain to us how to keep people safe from abuse and neglect. People had suitable risk assessments in place. Recruitment practices were safe. Staff were trained in medicine administration and the checks we made confirmed that people were supported to receive their medicines in a way that they had agreed.

¿ People were supported by staff who received appropriate training and support. Staff had the skills, experience and a good understanding of how to meet people's needs.

¿ We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met.

¿ People were supported to prepare meals to meet their nutritional needs. Staff worked with people's GP and other healthcare professional to ensure they stayed well.

¿ People told us staff respected their privacy and treated them with dignity. People's needs were assessed before they started to use the service and care was planned and delivered in response to their needs. The provider had arrangements in place to respond appropriately to people's concerns and complaints.

¿ Systems were in place to monitor and improve the quality of the service. The provider had effective quality assurance systems to monitor the scheme's processes. These systems helped ensure people received the care they needed as detailed in their support plans.

Rating at last inspection:

At our last inspection, the service was rated Good. Our last report was published on 14 September 2016.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

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

HF Trust - Thetford Road provides accommodation for up to eight people who require care and support on a daily basis. The home specialises in looking after adults with a learning disability. At the time of our visit, there were eight people using the service.

The home had a registered manager at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (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 about how the service is run.

People were safe at the home. The provider took appropriate steps to protect people from abuse, neglect or harm. Training records showed staff had received training in safeguarding adults at risk of harm. Staff understood what constituted abuse and the action they would take to protect people if they had a concern.

Risks were managed so that people were protected and supported in a non-restrictive way. We saw that risk assessments and support plans were appropriate to meet people’s needs. Where risks were identified, risk management plans were in place. We saw that regular checks of maintenance and service records were conducted. This helped to keep people and the environment safe.

We observed there were sufficient numbers of qualified staff to support people and to meet their individual needs. We saw that the provider’s recruitment process helped to ensure that staff were suitable to work with people using the service.

People were supported by staff to take their medicines when they needed them and records were kept of medicines taken. Medicines were stored securely and staff received annual medicines training to ensure that medicines administration was managed safely.

Staff had the skills, experiences and a good understanding of how to meet people’s needs. Staff spoke about the training they had received and how it had helped them to understand the needs of people they cared for.

The service had taken appropriate action to ensure the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) were followed. DoLS were in place to protect people where they did not have capacity to make decisions and where it is deemed necessary to restrict their freedom in some way, to protect themselves or others.

Detailed records of the support people received were kept. People had access to healthcare professionals when they needed them. People were supported to eat and drink sufficient amounts to meet their needs.

People were supported by caring staff and we observed people were relaxed with staff who knew and supported them. We saw that people had the privacy they needed and they were treated with dignity and respect at all times.

The provider had arrangements in place to respond appropriately to people’s concerns and complaints.

People’s needs were assessed and information from these assessments had been used to plan the support they received.

People had the opportunity to engage in activities according to their preferences. Records showed activities were risk assessed to ensure the person and others were safe. This helped to ensure the person enjoyed a good experience of the activity of their choosing.

From our discussions with the registered manager it was clear they had an understanding of their management role and responsibilities and the provider’s legal obligations with regard to CQC.

The provider had policies and procedures in place and these were readily available for staff to refer to when necessary. There were systems in place to assess and monitor the quality of the service. Weekly, monthly and annual health and safety and quality assurance audits were conducted by the home. The provider's quality assurance systems were effective in identifying areas where improvements were required so they could take the necessary action to address any concerns.

Following the inspection the provider sent us an action plan on 5 September 2014 setting out the steps they would take to make the necessary improvements.

A single inspector carried out this inspection. The focus of the inspection was to answer one of our five key questions: is the service safe, effective, caring, responsive and well-led? The summary is based on the evidence we saw in five staff records and with talking with three members of staff and the registered manager.

Below is a summary of what we found.

Is the service effective?

From the records we looked at we evidenced that staff received regular one to one supervision and that yearly appraisals were being planned. Staff files were kept securely and were accessible.

On the day of our inspection eight people lived at HF Trust Thetford Road (HFT. All people had a learning disability and/or behaviours that challenged. We looked at the care records of four people, spoke with seven people and three members of staff.

Below is a summary of what we found.

Is the service safe?

Care plans had details of people's needs and how these were to be met. Risk assessments relating to the care and support being provided were regularly reviewed to ensure people's individual needs were being met safely.

We reviewed maintenance contracts for the building and various pieces of equipment and found that these were all valid and within date. A Fire Safety inspection conducted in July 2013 was non-compliant and a follow up inspection was due in August 2014.

Staff had undertaken training on the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) and understood how this could impact on the people they cared for.

Is the service effective?

From the records we looked at we could not evidence that staff received regular one to one supervision or yearly appraisals. Staff had received a range of training appropriate to their roles.

We saw that people were happy, well cared for and treated with respect. People we spoke with said they liked living at Thetford Road and they liked the staff. Care plans were regularly reviewed with the person using the service.

Is the service caring?

The service was caring. This was confirmed by our observations of staff and people using the service. Staff respected people's privacy, dignity and their right to be involved in decisions and making choices about their care.

We observed that people using the service made decisions about how they spent their time. People went to work or college, others to the day centre. Each person took a share in household tasks, such as menu planning, shopping, cooking and cleaning.

Is the service responsive?

People's needs were reassessed on a regular basis and we saw the service responded to any changing needs

We saw that each person had a daily plan of activities. On the day of our visit which was unannounced, we saw that people were cleaning their own rooms, doing their laundry or making something to eat. Other people were going out and other people chose to stay in their room.

Is the service well-led?

The home employed a manager who knew their staff and people well. The manager told us about the audits that they conducted and showed us the evidence to support these. Regular audit of medicines by the provider and the supplying pharmacy helped to reduce the associated risks with the storage and handling of medicines.

Audits of the environment, laundry and the kitchen were also conducted. We saw that the fire alarm and fire door closures were checked weekly. People were kept safe because information about them was regularly checked.

"It's nice here", "I'm happy here", "the staff are good", "I choose what I do and what I eat", "I have all I need in my room", "I go out", "I see my friends and family" and "we go on holiday" were just a few of the comments from people living at the home. People said that staff treated them with respect and maintained their privacy. People said that they felt safe living at Thetford Road and if they had any worries or concerns they would speak with staff or their relatives.

Staff were happy to be working at the home and said they had the training they needed to help them do their job. Staff said they provided individualised support to people who use the service. They said that Thetford Road provided a homely atmosphere and was a good place for people to live and for them to work.

We saw some good interactions between staff and people who use the service. Staff responded to people in a supportive and caring way. Staff had time to be with individuals, giving them the support they needed. We saw people were relaxed and had developed positive relationships with staff.

Comments about the food included "I like the food", "I choose what I eat" and "staff support me to cook my meals". People said that staff were available and gave them the help and support they needed, saying "staff are kind", "staff help" and "staff are good". We saw good interactions between staff and people who use the service with staff showing detailed knowledge of individual's needs and how to provide appropriate support.

Staff were positive about working at the home, saying they received the training and support they needed to do their job.