The inspection took place on 26 October 2016 and was announced. We told the provider 72 hours before our inspection that we would be visiting. This is in line with our current methodology for inspecting domiciliary care services. HF Trust-Avon DCA was last inspected on 22 October 2013 and met the legal requirements at that time.

HF trust-Avon DCA is registered to provide personal care and support for people with learning disabilities. At the time of our inspection, there were 29 people receiving personal care and support in three supported living properties. We visited the registered office. This was located in the premises where 18 people were receiving a 24 hour supported living service. A supported living service is one where the contractual arrangements for personal care and tenancy agreements are separate. We inspected the personal care people received.

There was no 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. Two senior managers from the provider’s quality and improvement team were providing full time support to the service. They are referred to in this report as the ‘managers.’

People and their relatives spoke positively about the care and support they received. They told us that staff were, “Very very good” and that, “Staff are wonderful.” People told us that staff were respectful and kind.

People who were supported by the service felt safe. Staff understood how to safeguard people and knew the actions to take if they suspected abuse.

Risk assessments were completed and plans were in place to reduce risks associated with people’s health and personal safety. Risks to people’s safety arising from their environment had not been fully considered and plans were not fully in place to keep people safe in their environment.

Care plans reflected that people’s individual needs, preferences and choices had been considered and then acted upon. Staff were knowledgeable about people’s individual needs.

There were recent improvements in the leadership and management of the service. The senior managers monitored the quality of the service and sought and acted on people’s feedback. Quality assurance systems were in place to monitor and mitigate the risks relating to the health, safety and welfare of people.

People who used this service received a good quality of support. People were encouraged to express their views and lived as they wished. We saw that people had full social lives and were provided with the appropriate level of support to do the things they wanted to do.

We saw that staff had a positive manner and approached people respectfully. They were supportive and worked in person centred ways. For example, knocking on doors before entering people’s open doors, and respecting people’s wishes.

People we spoke with told us that they were happy with their care and felt included in their support plans. One person told us they “really love living here”. Another person showed us their support plans and said “it’s all mine”.

People told us they felt safe and that staff were kind to them. One person said “I’d talk to any of the staff if I was worried”. Another person told us they would “talk to the manager if I was sad”.

Complaints and concerns were listened to and acted upon immediately.

We saw everyone looked happy and relaxed. We saw that people were engaged in their own chosen activities during our visit. We saw that these activities were recorded in care records as things they enjoyed doing.

There were systems in place to monitor the quality of support people received. We viewed audits, quality reports and questionnaires.

We spoke with five people who used the service, three members of staff and the manager during the visit. After the visit we completed telephone interviews with four relatives and two people who use the service in the Bath area.

We visited the office of HF Trust Avon where we met with the manager, the area manager and the administrator. The office was situated on the same site as the independent living accommodation where there were 18 bedsits. We were able to speak with five of the tenants and three of the staff that were supporting them.

People experienced care and support that was tailored to their individual needs. They were involved in making decisions about how they were supported. We observed staff supporting people in an appropriate manner ensuring their privacy and dignity was maintained.

People told us that they were confident that the service listened to them and any concerns that they had would be dealt with promptly. People told us they liked the staff that supported them. Staff were knowledgeable about the people they supported and they were provided with training appropriate to their roles.

People were encouraged to lead full and active lives including accessing the community either socially or through paid or unpaid work. Some records held by the staff in the office would benefit from a review to ensure that this was what the person wanted and reflected the service provision of supported living.

We spoke to individuals receiving a service from HF Trust Avon DCA it was evident that the outcome for individuals was positive. They liked the staff team supporting them and there was sufficient staff available.

Individuals were involved in many areas of the planning of their care. Evidence was provided that their views were sought on the care provision and making suggestions for improvements both at a local level and a national level within the organisation. Individuals spoken with knew how to complain and felt that they would be listened to and their concerns acted upon.

There were some areas where some individuals might benefit from more control namely the self administration of medication and looking after their finances within a risk assessment framework.

Individuals told us they could live the life their chose and the support given was flexibly to suit their needs.