We undertook an announced inspection on 29 and 31 January 2018. HF Trust – North Oxfordshire Domiciliary Care Agency (DCA) is a service that provides care and support to people living in eight ‘supported living’ settings, so that they can live as independently as possible. At the time of the inspection the service was supporting 28 people. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. The service was managed by three registered managers. 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.

Rating at last inspection

At our last inspection in December 2015 we rated the service good. Since our last inspection, the local authority had been monitoring two of the location addresses as a result of concerns raised. Services are sometimes monitored under the local authority safeguarding measures called ‘Serious Concerns’. This requires the provider to work with the local authority to make improvements and provide regular reports to update on actions taken to improve the service. We spoke with the local authority safeguarding and contract teams and were informed that the service was no longer in the ‘serious concerns’ process due to the improvements made. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection 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.

Why the service is rated Good

People remained safe at the service. Staff knew how to recognise safeguarding concerns and what to do if they suspected any abuse. Risk assessments were carried out to promote people’s well-being and recognise people’s individual abilities. There were enough staff to keep people safe and the provider followed safe recruitment procedures. Medicines were administered in line with guidance.

People continued to receive support from effective staff. People’s needs had been fully assessed to ensure that staff had guidance to meet these needs. Staff were knowledgeable, skilled and had the relevant skills and experience. Records confirmed staff received regular supervision sessions and they told us they were well supported.

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 support this practice.

People were supported to access health professionals when needed and staff worked closely with various external professionals to ensure people’s health needs were met. People were given choice about what they ate alongside appropriate support to ensure a balanced diet.

The service continued to support people in a kind and caring way. People were treated with kindness and as individuals. People were involved in decisions about their care needs and the support they received. People’s dignity, privacy and confidentiality were respected, and they received person centred care that included access to information that met their needs.

The service remained responsive to people's needs and ensured people’s changing needs were recognised and appropriate changes to support were implemented promptly. People were supported to raise concerns if necessary. 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 disab

We inspected HF Trust North Oxfordshire on the 16 November 2015. The inspection was announced. HF Trust North Oxfordshire is a domicillary care service in Banbury that provides 24 hour support to adults with learning disabilities or autistic spectrum disorder to help people live independently in the community. At the time of this inspection the agency was supporting 33 people.

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

People who were supported by the service felt safe. The staff had a clear understanding on how to safeguard the people and protect their health and well being. There were systems in place to manage safe administration and storage of medicines. There were enough suitably qualified and experienced staff to meet people needs.

People received effective care from staff who understood their needs. Staff received adequate training and support to carry out their roles effectively. Staff understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework to assess people’s capacity to make certain decisions, at a certain time. The registered manager had a good understanding of the MCA and Deprivation of Liberty Safeguards (DoLS).

The service had a strong culture of person centred care.The people were supported in establishing and maintaining friendships thorough links within the community. Staff built good relationships with the people who used the service and had enough time to meet their needs

People received support that was based on their wishes and personal needs. The service responded positively to people’s requests, views and opinions. People’s interests were recorded and staff supported and encouraged them to pursue their areas on interests. Staff respected people’s privacy and maintained their dignity.

The service had good quality assurance systems in place. There were processes in place aimed at understanding the experiences of the people who were receiving support. The manager was committed to maintaining quality of support and keeping improving. Staff practices supported the service’s vision of person centred active support.

During our visit to HF Trust North Oxfordshire we met with the registered manager. We also met two service managers and the health and safety manager. We spoke with seven people who used the service and with six members of care staff. The provider was offering support to 33 people at the time of our visit.

People we spoke with told us they were treated with respect and given privacy. One person said "They [the staff] have to knock if they want to come in my room". People were encouraged to maintain their independence. A person we spoke with told us "I help to prepare the dinner and wash up afterwards".

People received support appropriate to their needs. A person told us "the support workers help me with my shopping. I love the staff. I really do".

People receiving support felt safe and care staff were well trained to spot and report abuse. One of the people we spoke with said "it's nice living here. Staff are nice and kind". Care staff we spoke with were knowledgeable about various forms of abuse and knew how to report abuse if they recognised it. A member of care staff we spoke with said “I know I can contact the local Learning Difficulties team”.

The provider operated appropriate recruitment procedures. We saw that checks were carried out before care staff were permitted to start work.

The provider had effective systems in place to monitor quality and safety. Monthly quality audits were carried out in each of the homes where people received support.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. People experienced care, treatment and support that met their needs and protected their rights. It was evident that the staff we spoke with knew people well. One person told us, “They support me well.” Another person's relative told us, "We’re 100 per cent happy with the care..."

We found that people were protected against the risks associated with medication. There were effective recruitment procedures in place to ensure that staff were of good character, had the relevant skills and experience and were physically and mentally fit to perform the role. People were also protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

People told us that they made choices for themselves. They told us that they were happy living in their homes and they had lots of things to do. People told us that staff treated them well and they felt very safe. They told us that staff listen to them and they can help to choose their staff.