HF Trust - 330 Westward Road

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 in accordance with the provider’s Fusion Model which was based on the concept of Person-Centred Active Support (PCAS). This model followed 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. We found this creative staff approach had brought outstandingly individualised outcomes for people that reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

We found people were supported through this model to manage their own medicines, take ownership of the service’s garden and be actively involved as citizens through various projects.

People were given opportunities to live a fulfilled and meaningful life and were supported to reach their potential and live as independent as possible. People told us they were happy at the home which was supported by feedback from people’s relatives who were extremely positive about the care their family members received. They complimented the caring nature of staff and felt the service was well-led.

Staff told us they were confident in the leadership skills and vision of the provider and manager. A strong management team and an established staff team ensured the values and vision of the service were embedded in the care practices of staff.

The care people received was focused around their individual needs. The service was inclusive and empowered people to be involved in the local community. Staff were proactive in supporting people to maximise their potential and strengths and enable them to organise events in the home and community. People were supported to maintain relationships with people who were important to them.

Staff had a continuous approach and a healthy balance of supporting people to understand the potential risks linked with their activities. People’s needs had been assessed and their support requirements and preferences were recorded in detail to provide staff with the guidance they needed to support people. Effective systems were in place to manage people’s finances and medicines so that they received them safely and on time. People were supported to access health care services and to maintain a healthy lifestyle.

Sufficient numbers of suitably qualified staff had been safely recruited to support people. Staff told us they felt supported and trained and had access to the information they needed to support people. They understood their responsibility to report concerns and poor practices.

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 were skilled in de- escalation and distraction techniques when people showed signs of becoming upset or frustrated. People were given the space to be by themselves or use relaxation techniques if they felt they were becoming agitated.

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 13 January 2017).

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.

There was a 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.

People required various levels of support. Some people were independent in their personal care, managing their medicines and activities in the community, whilst others needed full support from staff. They had access to a variety of activities in the home and in the local community. Staff supported people to contribute towards daily activities and cleaning chores around the home.

People felt safe living at the home. They were cared for by staff who were kind and caring. Staff understood their responsibility to protect people from harm and support them to manage their risks.

Staff were aware of their responsibilities to report any accidents, incidents or safeguarding concerns. They showed concern for people’s wellbeing in a caring and meaningful way and responded to their needs quickly. People’s care records showed relevant health and social care professionals were involved with people’s care. People received their medicines as prescribed by staff who had been trained in the management of their medicines.

People were involved in the planning for their support. Their support plans were personalised and reflected their support needs and preferences. However, people’s daily activities and well-being were not consistently recorded. Where there had been some shortfalls in the recordings of people’s risks, daily activities and medicines this was addressed immediately.

Staff understood the importance in providing choices to people and acting in people’s best interests. They were encouraged to contribute towards the planning, shopping and preparation of their meals. There were adequate numbers of staff to support people in the home and attend activities in the community. Systems were in place to ensure new staff were appropriately recruited. Staff were suitably trained and supported to carry out their role.

The provider and staff valued people’s opinions and experiences of the support they received. People had the opportunity to attend house meetings or provider meetings (both locally and nationally) to express their views. People’s day to day concerns and issues were addressed immediately. Relatives felt confident in the management and the running of the home. The managers and provider monitored the quality of the service provided by carrying out regular checks.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from two records we reviewed.

Is the service safe?

We found the service to be safe because people were treated with respect and dignity by the staff. Staff knew what to do when safeguarding concerns were raised and they followed effective policies and procedures.

When people were at risk, staff followed effective risk management policies and procedures to protect them. Staff supported people to take informed risks with minimal necessary restrictions to as far as possible protect their welfare. People told us, 'Staff help me to do things for myself.'

Systems such as accident and complaint recording were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The service was in the process of re-assessing the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) for people who use the service and were having discussions with local authorities about this. This meant that people were protected from discrimination and their human rights were protected.

Staff demonstrated they knew their responsibilities in relation to infection control. The service kept the home clean and hygienic to protect people against acquiring healthcare associated infections.

Is the service effective?

We found the service to be effective because there was an advocacy service available if people needed it, this meant when required people could access additional support.

Care plans reflected people's current individual needs, choices and preferences. People's health was regularly monitored to identify any changes that may require additional support or intervention.

Staff supported people to take informed risks with minimal necessary restrictions. The environment enabled staff to meet people's diverse care, cultural and support needs.

Staff had effective support, induction, supervision and appraisal.

Is the service caring?

We found the service to be caring because people were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people. Staff responded in a caring way to people's needs when they needed it.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. Appropriate professionals were involved in planning, management and decision making.

Staff knew the people they were caring for and supporting. People were as independent as they wanted to be. Staff told us, 'Everyone is encouraged to do as much as they can for themselves'

Is the service responsive?

We found the service responsive because, where appropriate, a person's capacity was considered under the Mental Capacity Act 2005. When a person did not have capacity, decisions were always made in their best interests. Advocacy support was provided when needed.

People had their individual needs regularly assessed and met. There were arrangements in place to speak to people about what was important to them. People we spoke with said, 'I like staff' and 'They're good.' One relative commented on the annual questionnaire, 'We are happy and impressed with the way our relative is cared for.'

People completed a range of activities in and outside the service regularly. People had access to activities that were important and relevant to them and were protected from social isolation. People we spoke with told us they were able to choose what they did and said, 'I get to do lots' and 'I'm very happy, I've got plenty to do.'

Is the service well-led?

There was a registered manager in post on the day of our visit.

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving. Robust quality assurance and governance systems were in place and used to drive continuous improvement.

Concerns and complaints were used as an opportunity for learning or improvement.

People shared with us their experiences about living in the home and we spoke with three people. Everyone expressed positive comments and we were told 'I am happy here' and 'The best thing about living here is I can go out when I like' and 'I like living here everybody is happy and friendly'.

The registered manager and two support staff were available throughout the day and were very knowledgeable about the people in their care, the policies, procedures and systems in place to ensure the continued smooth running of the home.

We spent time in various parts of the home, including communal areas such as the lounge and dining area so that we could observe the direct care, attention and support that people who lived at the home received. There was a constant interaction between staff and people in the home. People were relaxed, happy and comfortable in each other's company.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained. People had detailed support plans in place which contained a comprehensive assessment of their current needs.

We looked at four care files of people who lived in the home. The care plans gave detailed information on all aspects of the person's daily life, such as, nutrition, communication, personal hygiene, mobility, sexuality and sexual health, spiritual and social values. The care plans evidenced that people's changing needs were being supported.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. We talked with six people about being safe. They said they felt safe in the home and would tell the staff if they had any problems with other residents or if they did not like something.

People were made aware of the complaints system. This was provided in a format that met their needs. We spoke with people who lived at the home. They told us that if they were unhappy about any aspect of the service they would have no hesitation in speaking with care staff or the registered manager.