About the service: HF Trust 117 a&b Hitchin Road is a residential care home that was providing personal care for 11 adults with learning disabilities and other complex needs at the time of the inspection.

People’s experience of using this service:

People received very person-centred care and the service had a strong focus on promoting independence and equality.

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 told us they felt safe and thought that staff were kind and caring.

One person told us, “They [staff] treat me well and I feel safe. I can read my care plan and make choices. I can help myself to food and drinks, my favourite is fish and chips.”

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 was appropriate and inclusive for them.

Outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways, promotion of choice and control, independence, inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The registered manager had systems and processes in place ensuring risks were well managed and care was personalised and reviewed.

Staffing levels, skills and experience were suitable to meet the needs of people.

The provider implemented safe systems for the management of medicines which included staff training and assessments of staff competency. Staff encouraged people to self-medicate and be in control of their medicines where it was safe to do so.

Staff had a good understanding of preventing the spread of infection by using the protective equipment and good hand hygiene.

The registered manager shared lessons learnt with staff and managed complaints and concerns in an open and honest way.

Staff supported people with meals and drinks and to access specialised healthcare when needed.

People decorated their rooms in ways that they preferred and which met individual tastes.

The registered manager used systems such as training, policies and care plans to ensure that staff had the skills and knowledge to support people who might need end of life care in the future.

The registered manager and the staff team were clear about their roles and the impact of good care.

The registered manager showed ways that they are working with other agencies to improve the lives of people living at the home.

The service met the characteristics of good all areas. For more details, please see the full report which is on the CQC website at www.cqc.or.uk

Rating at last inspection: At the last inspection the service was rated Good. (Report published 05 May 2016.) Overall, since the last inspection, the service rating has remained the same.

Why we inspected: This was a planned inspection based on previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

This inspection took place on 05 April 2016 and was unannounced.

The service provides accommodation and support to up to 12 people with a learning disability in two older style houses, Oncemore and Applewood, which are linked on the first floor. Each house has its own kitchen, dining area and lounge. The provider’s resource centre is on the same site as the home. At the time of the inspection there were 11 people living at the home. The younger, more able people live in Oncemore whilst the people who require a bit more support live in Applewood.

The service has a registered manager. 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’s needs had been assessed, and support plans took account of their individual needs, preferences, and choices. There were risk assessments in place that gave guidance to staff on how risks to people could be minimised. There were systems in place to safeguard people from risk of possible harm.

Medicines were administered safely and people were supported to access other healthcare professionals to maintain their health and well-being. They were supported effectively and encouraged to be as independent as possible with individual goals set to improve their life skills. They were assisted to maintain their interests and hobbies and to make use of the provider’s resource centre. They were aware of the provider’s complaints system and information about this and other aspects of the service was available in an easy read format. Staff were always available if people wished to raise concerns informally. People were encouraged to contribute to the development of the service and to develop links with the local community.

The provider had effective recruitment processes in place and there was sufficient numbers of staff to support people safely. Staff had received regular supervision and had been effectively trained to meet people’s individual needs. They understood and complied with the requirements of the Mental Capacity Act 2005 (MCA). They were caring and promoted people’s privacy and dignity. Staff were encouraged to contribute to the development of the service, were aware of their roles and responsibilities and understood the provider’s visions and values.

The provider had effective quality monitoring processes in place and these had been used effectively to drive continuous improvements. People had no concerns about how care was provided or how the service was managed. There was good communication between the manager and staff, and this meant that they were able to deal quickly with any issues that arose.

During our inspection on 18 July 2013, we found the environment to be relaxed and supportive. As a staff meeting was in progress, most people were being supervised at the nearby Resource Centre. Whilst being shown around the home by the manager, we spoke briefly with four people who were either in the lounge or in their bedrooms.

We also spoke with three further people who told us that they were happy with the support they received from staff. All of the three people we spoke with were able to communicate with us verbally. We spent a longer period speaking with a person who told us about their plans for a community trip to a theatre. The person appeared relaxed and happy during our time with them.

We also observed respectful and compassionate interactions between staff and the people they supported, including during a time when a person was making arrangements for their trip to visit relatives over the weekend. Staff had good knowledge of the needs of the people they supported and we observed that they were responsive to people's needs or requests.

During our inspection to HF Trust - 117 a & b Hitchin Road on 25 July 2012 we spent time with five of the 11 people living at the home, four of whom were able to communicate with us verbally.

People told us they felt staff listened to them and gave them choices about their care and how they spent their time. For instance, they said they chose the time they got up and went to bed, what they wore and where they went on holiday.

People told us that they liked living at the home and liked the staff who supported them. They said that the staff knew them well, knew what they liked and discussed their care with them. They told us they felt able to tell the staff if there was something they disliked and that they felt they would be listened too.

People that we spoke with during our visit to 117A & B Hitchin Road on the 28 December 2011 told us that they were happy and felt safe living there, and that the staff that looked after them were all helpful and friendly and treated them with respect.

People looked clean and well groomed, and where people needed support or assistance with personal care this was done in the privacy of their bedroom to protect their dignity.

We observed that people were given choices and encouraged to make decisions about all aspects of their lives, including how they spent their time and what they had to eat.

Everyone at this home had the opportunity to attend day centres or college courses, however if people preferred not to do this their decision was respected, and alternative activities were available to them.