Archived: HF Trust - Newcroft

HFT Newcroft can accommodate up to four people who have a learning disability or autism. At the time of our inspection there were three people living there.

People had their own bedrooms with access to a shared bathroom, lounge, kitchen and dining area. Grounds around the property were accessible.

The care service 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. This was particularly visible in the outstanding support people had received to develop their 'capable environments'. 'Capable environments' are characterised by; positive social interactions, support for meaningful activity, opportunities for choice, encouragement of greater independence and support to establish and maintain relationships.

This inspection took place on 9 January 2019. At the last comprehensive inspection in May 2016 the service was rated as Good in all key questions and overall. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good. The key question ‘Is the service Responsive?’ had improved to Outstanding.

A registered manager was in post who had been registered with the Care Quality Commission (CQC) in 2010. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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 received an exceptionally responsive service. People were empowered to develop their independence and involvement in the local community. Information was presented to people creatively in an accessible format to support them to make meaningful decisions. The registered manager had developed local opportunities for people to be involved in the provider’s feedback forums when they could not always travel to regional meetings.

The provider's vision and values were person-centred to make sure people were at the heart of the service. This vision was driven by the registered manager and management team. People had many opportunities to take part in as many interests as they chose. The service showed a real ‘can do’ attitude.

People’s care and support was individualised and reflected their needs and wishes. They had lived together for some time and had been supported by a core group of staff providing them with consistency and continuity of care. There were enough staff to meet their needs. This was kept under review as new people moved into the home. Staff recruitment and selection procedures were in place to ensure all necessary checks had been completed prior to employment.

People’s care and support was individualised and reflected their needs and wishes. They had lived together for some time and had been supported by a core group of staff providing them with consistency and continuity of care. People made choices about their day to day lives.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were involved in the planning and review of their care and support. They chose the activities they wished to take part in. They went into to the town centre shopping, to local day services, to the train station and were attending a pantomime the day following our inspection. They went on day trips, to social clubs and attended local places of worship when they wished to. People kept in touch with those important to them through supported telephone calls or weekly visits.

People’s preferred forms of communication were highlighted in their care records. Staff were observed spending time chatting and socialising with people. Good use was made of easy to read information which used photographs and pictures to illustrate the text. People had access to easy to read guides about advocacy and complaints. Documentation to support decision making and best interest decisions were in picture and large font formats to support people to make their own decisions wherever possible.

People’s health and wellbeing was promoted. A weekly menu encouraged people to have vegetables and fruit in their diet and people helped to prepare and cook their meals. People had access to a range of health care professionals. They had annual health checks.

People’s medicines were safely managed. Staff knew how to keep people safe and how to raise safeguarding concerns. Risks were well managed encouraging people’s independence

People, their relatives and staff were invited to give feedback through quality assurance surveys, meetings, complaints and compliments. People and their relatives had information about how to raise a complaint. The registered manager and provider completed a range of on-line quality assurance audits to monitor and assess people’s experience of the service. Any actions identified for improvement were monitored to ensure they had been carried out. The registered manager worked closely with local organisations and agencies and national organisations to keep up to date with current best practice and guidance. Comments about HFT Newcroft from people who use the service included, “It’s very nice here” and “I like all the staff."

This was an unannounced inspection, which meant the staff and provider did not know we would be visiting. The previous inspection was completed in October 2013 and there were no breaches of regulation at that time.

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 responsibilities for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was safe. Risk assessments were implemented and reflected the current level of risk to people. There were sufficient staffing levels to ensure safe care and treatment. The provider practised safer recruitment procedures. People felt safe and staff were trained to deliver medicines appropriately.

People were receiving effective care and support. Staff received appropriate training which was relevant to their role. The service was adhering to the principles of the Mental Capacity Act 2005 (MCA) and where required the Deprivation of Liberty Safeguards (DoLS).

The service was caring. People spoke positively about the staff at the home. Staff demonstrated a good understanding of respect and dignity and were observed providing care which promoted this.

The service was responsive. Care plans were person centred and provided sufficient detail to provide safe, high quality care to people. People felt listened to and they were able to attend meetings to voice their opinions.

The service was well-led. Quality assurance checks and audits were occurring regularly and identified actions required to improve the service. Staff and people spoke positively about the registered manager.

One person told us they were happy and another person told us 'I'm not worried about anything'. One relative told us 'I am very, very happy and have been for a long time. They seem to cope with [name] very well'. Another relative was equally positive and felt updates from staff were helpful.

We found that support plans were comprehensive, although some needed updating. Staff followed the content of the support plans. People seemed to have access to a range of activities.

People had a varied diet that met their personal preferences and dietary needs. One person told us 'I like the food'. People were encouraged to take part in food preparation and could make their own drinks.

Medicines were given safely to people with their consent. The recording and storage of medicines was appropriate. Staff had guidance from the national policy although local guidelines needed updating.

The building was clean, tidy and well maintained. People and staff undertook checks to ensure safety was maintained. People had personalised their rooms and had access to enough space in communal areas.

People's views were used to assess the quality of care provided. This included responding to complaints and gathering feedback informally or via a survey. Quality and risks were monitored and addressed as needed.

People told us that they understood the choices available to them and were involved in decisions about their care. We saw that people were supported to share their views about their care.

People were protected from the risk of abuse as there was a robust policy in place that was followed by staff. Staff had received appropriate training regarding abuse and were confident in raising concerns. People told us that they could speak with someone if they were unhappy about the service or felt scared in any way.

Staff were positive about the training available and the support that they received from their manager. A new system was in place to ensure that training was adequately monitored as this had been difficult to do in the past. Supervision meetings had historically been infrequent but this was also being addressed.

People's views on the services were sought through internal quality inspections and quality assurance processes. Actions raised were completed to ensure improvement to the service. The provider took account of complaints and comments to improve the service.