HF Trust-38 South Road is a residential care home for 10 adults with learning disabilities. This was a large house which had been extended and adapted over two floors. At the time of our inspection 10 people were using the service.

The care service had not originally 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 using the service can live as ordinary a life as any citizen. People were given choices and their independence and participation within the local community encouraged.

We inspected the service on 8 November 2018 and it was unannounced.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. 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.

People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and they felt confident in how to report these types of concerns. People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent.

There were sufficient staff with the correct skill mix on duty to support people with their required needs. Effective recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service. Effective infection control measures were in place to protect people.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people. People are 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 support this practice.

Staff received an induction process and on-going training. They had attended a variety of training to ensure that they were able to provide care based on current practice when supporting people. They were also supported with regular supervisions and observed practice.

People were able to make choices about the food and drink they had, and staff gave support if and when required to enable people to access a balanced diet.

People were supported to access a variety of health professionals when required, including opticians and doctors to make sure that people received additional healthcare to meet their needs.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times. Care plans were written in a person-centred way and were responsive to people’s needs. People were supported to follow their interests and join in activities.

People knew how to complain. There was a complaints procedure in place and accessible to all. Complaints had been responded to appropriately.

Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

Further information is in the detailed findings bel

The inspection took place on 03 May 2016 and was unannounced.

HF Trust 38 South Road is a care home that provides accommodation and personal care for up to 10 adults with learning disabilities. There were 10 people accommodated at the home at the time of this inspection. The service is also registered to provide personal care for people who live in supported living arrangements in the community. There were seven people receiving support with personal care at the time of this inspection.

The home had a registered manager. 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. The registered manager was based at 38 South Road and was also registered manager for the supported living service.

Our last inspection at HF Trust – 38 South Road took place on 23 April 2014. The service was found to be meeting the requirements of the regulations we inspected at that time.

People who used the service, their relatives and professionals involved with people’s care and support gave us positive and complimentary feedback about the service and said that they had no concerns about the care and support that people received.

People’s relatives and professionals involved with the care and support of people who used the service said that people were safe. People had health care and support plans in place to help staff know how people liked their needs to be met. Risks to people’s safety and welfare had been identified and support had been planned to enable people to live as safely as possible whilst enjoying a wide range of opportunities for engagement and stimulation. There were sufficient numbers of staff available to meet people’s care and support needs.

Staff members understood their roles and responsibilities and were supported by the registered manager to maintain and develop their skills and knowledge. People enjoyed a varied healthy diet and their physical and mental health needs were well catered for.

The atmosphere in the home was warm and welcoming and there was a warm interaction between the staff and people who used the service. The registered manager had made arrangements for people to access regular support from external advocacy services to help them make decisions about matters in their daily lives. People’s relatives were encouraged to be involved in developing people’s support plans and to visit at any time. People were actively supported to maintain family relationships. Staff promoted people’s dignity and treated them with respect.

The registered manager had made arrangements to support people and their families to raise concerns and meetings were held for people to discuss all aspects of the care and support provided at the home. The registered manager promoted a positive culture within the home that was transparent and inclusive. The provider had robust systems to continuously check the quality of the service provided. Staff were encouraged to develop their skills and knowledge and felt valued.

During our inspection of 38 South Road on 23 April 2014 we set out to answer five questions. These were whether the service is caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people who used the service, their relatives, and the staff that supported them. We also spent time looking at records. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People were cared for in an environment that was clean, safe and well maintained. Support staff had received the training necessary to support people safely.

We found that care was planned and delivered in a way that was intended to ensure people’s safety and welfare.

Records showed that people had regular health checks and medication reviews. Support staff told us that they worked closely with health and social care professionals to provide consistency and appropriate support.

Is the service effective?

People told us that they were happy with the care that they received and that their needs had been met.

It was clear from our observations and from speaking with support staff that they had a good understanding of people’s care and support needs and that they knew them well.

Family members of people who used the service told us, “I had always been a little wary about my relative going into a care establishment but 38 South Road has been a very positive experience.”

Is the service caring?

We noted that support staff were respectful when speaking with people. People who used the service were relaxed in their company and interactions were positive and friendly. Support staff spoke with great warmth and affection when telling us about the people they supported.

Relatives of people who used the service told us, “The support staff don’t just look after people; they are really involved with them. They teach them how to do things instead of just doing things for them.” Another person said, “The support staff are absolutely brilliant, we are very pleased.”

People’s preferences, interests, and diverse needs had been clearly recorded. This meant that the care and support could be provided in accordance with people’s wishes.

Is the service responsive?

We found that the service responded to issues identified through their own monitoring systems.

Records confirmed that people’s preferences, interests and diverse needs had been recorded and that care and support had been provided in accordance with people’s wishes.

People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives.

Is the service well led?

Support staff demonstrated a good understanding of the ethos of the home and we saw that quality assurance processes were in place.

People told us that they knew how to make a complaint and we noted that the management had responded appropriately to complaints made by people who used the service.

We asked family members if they would feel confident in raising any complaints or concerns with the management of the service. One person said, “Oh definitely, I would be very confident to raise any issue whatsoever with the management team if I thought my relative was struggling in any way.” Another person said, “On the contrary, they tend to raise issues with us before we have noticed them. It gives us great confidence that no-one tries to sweep anything under the carpet.”

Support staff told us they were clear about their roles and responsibilities and felt that they were well supported by the home’s management team.

People who used the service told us that freedom of choice was integral to their life at 38 South Road. They said they were consulted about their care and support and had the opportunity to ask questions of support workers and the manager at any time and were always provided with thorough explanations.

People who used the service told us there was an emphasis on ‘healthy eating’ at 38 South Road. We found that the menu and food records confirmed this statement.

Appropriate arrangements were in place in relation to the recording of medicine. We saw evidence that medicines were stored safely and were safely administered.

People who used the service were actively involved in the choices and decisions in the day to day running of the home and in assisting with quality audits.

We observed the interactions between people using the service and the staff working at the home and listened to everyday events and activities during the course of our visit. People using the service initiated interactions, approached staff with confidence and were responded to in a warm and respectful way.

Subsequent to the inspection visit we spoke with relatives of three people living in the home to gather their views about how people were supported and cared for. People told us that they felt their relatives were being cared for in a safe and appropriate manner. One person said they believed people were happy living in the home. They told us, “The basic impression I get is that everyone living there are all happy and well cared for. It is like a family.”

We looked at record keeping within the home. We found that personal and private information relating to the people living in the home was accurate and stored in such a manner that promoted confidentiality.