This inspection took place on 19 and 20 September and was announced.

HF Trust-Lancashire DCA is a domiciliary care agency, it is owned by HF Trust Limited and is regulated by the Care Quality Commission (CQC). The service provides personal care and support for people who are living with learning disabilities or autistic spectrum disorders and who live in the Preston area. CQC only inspects community based services where people are receiving support with ‘personal care’ such as help with tasks relating to personal hygiene and eating.

The registered provider’s office is in Bamber Bridge on the outskirts of Preston. Some people receive support in ‘supported living’ accommodation and share facilities with other people. People also receive support in their own accommodation.

HF Trust-Lancashire DCA 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.

At the time of the inspection HF Trust-Lancashire DCA was supporting 44 people.

There were three ‘registered managers’ in post. A registered manager is a person who has registered with the 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 and how the service is run.

At the last inspection, in January 2016 the registered provider was rated ‘Good’ overall. However, we identified a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 for ‘safe care and treatment’ in relation to unsafe medication procedures. The registered provider was issued with ‘requirement action’ and requested to submit an action plan to identify how improvements would be made.

We checked to see if the registered provider was complying with regulations during this inspection.

We reviewed all medication processes during this inspection and found that there were safe practices in place. There was an up to date medication policy in place and all processes were adhered to by trained staff. A newly implemented medication system was in place; this reduced the number of errors and incidents which were occurring.

Care plans and risk assessments contained detailed and tailored information about each person who was receiving support. Risk assessments were comprehensive and tailored around the needs and risks of the person.

The registered provider had robust recruitment procedures in place. Rigorous pre-employment checks were conducted before candidates were confirmed in post. Employment histories were thoroughly checked, health questionnaires were in place and the necessary ‘Disclosure and Barring System’ (DBS) checks were conducted prior to employment commencing.

Accident and incidents were reported and recorded in accordance with the accident/incident reporting procedures. The registered managers ensured all such ‘events’ were analysed and trends were established to mitigate risk.

Staff were familiar with safeguarding and whistleblowing procedures. Staff had received the necessary safeguarding training and there was relevant safeguarding and whistleblowing policies and procedures in place.

Health and safety procedures were in place. People were living in safe, clean and well-maintained environments.

The registered provider operated within the principles of the Mental Capacity Act, 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People were involved in the day to day decisions in relation to the care and support provided.

HF Trust-Lancashire DCA had a designated learning and development department. Staff were supported with a variety of different training courses that enabled them to develop their skills

HF Trust - Lancashire DCA was first registered with the Care Quality Commission on 10 August 2015. It was previously registered at a different location and, until August 2013, with another provider. It is a domiciliary care service, which provides personal care and support for people who are living with learning disabilities or autistic spectrum disorder and who live in the Preston area. Some domestic assistance is also provided for those who need help in this area. The agency office is in Bamber Bridge on the outskirts of Preston. The agency supports approximately 44 people, who live in their own homes within the community. Some people are in supported living accommodation and share facilities with other people. The office base is easily accessible by public transport. HF Trust - Lancashire DCA is owned by HF Trust Limited and is regulated by the Care Quality Commission (CQC).

This was the first inspection conducted by the Care Quality Commission (CQC).

A visit to the agency office was conducted on 14 January 2016 by two Adult Social Care inspectors from the Care Quality Commission. The registered manager was given short notice of our planned inspection. This was so that someone would be available to provide the information we needed to see.

The registered manager of the agency was on duty when we visited HF Trust. 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 and associated regulations about how the service is run.

Records showed the staff team were well trained and those we spoke with provided us with some good examples of modules they had completed. Regular supervision records were retained on staff personnel files.

Staff were confident in reporting any concerns about a person’s safety and were aware of safeguarding procedures. However, there was some confusion around understanding authorisation routes and the use of terminology, in relation to those whose liberty was at times being restricted. Recruitment practices were robust, which helped to ensure only suitable people were appointed to work with this vulnerable client group.

The planning of people’s care was based on an assessment of their needs, with information being gathered from a variety of sources. Evidence was available to show people, who used the service, or their relatives when relevant had been involved in making decisions about the way care and support was being delivered.

Regular reviews of needs were conducted with any changes in circumstances being recorded well. Areas of risk had been identified within the care planning process and assessments had been conducted within a risk management framework, which outlined strategies implemented to help to protect people from harm.

People were supported to maintain their independence and their dignity was consistently respected. People said staff were kind and caring towards them and their privacy and dignity was always respected.

Staff spoken with told us they felt well supported by the manager of the agency and were confident to approach her with any concerns, should the need arise.

We found that medications were not always being well managed. The Medication Administration Records (MARs) were not always being completed accurately and the medication count was not consistently correct.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 for safe care and treatment.

You can see what action we told the provider to take at the back of the full version of this report.