We inspected HF Trust – Trelowen on 20 September 2017, the inspection was announced. This was because it is a small service and we wanted to be sure people and staff would be available to speak with us.

HF Trust – Trelowen provides care and accommodation for up to seven people who have a learning disability. At the time of the inspection six people were living at the service. The service was last inspected in August 2015 when it was rated as Good. At this inspection we found the service remained Good.

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.

We saw people and staff interacting and engaging with each other in a friendly and relaxed manner. Staff had completed training in how to recognise the signs of abuse. People received their medicines safely and as prescribed.

Staff were well supported by a system of induction, training and supervision. Training was refreshed regularly. Staff meetings were an opportunity to contribute to the running of the service. Staff told us they were well supported by the management team and each other.

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.

Information was produced using easy read techniques, e.g. limited text and photographs and pictures. People’s preferred communication styles were identified and respected. However, care plans were not available in an accessible format.

People were supported to understand systems for raising concerns. House meetings were held regularly. Staff encouraged people to use these to voice their ideas and suggestions.

There were clear lines of responsibility in place. The registered manager was supported by a senior support worker. People had been assigned key workers with responsibility for their day to day care. Relatives told us management were approachable and they would not hesitate to approach them with any concerns or suggestions they might have.

Further information is in the detailed findings below

We inspected HF Trust – Trelowen on 18 August 2015, the inspection was announced. The service was last inspected in February 2014; we had no concerns at that time.

HF Trust – Trelowen provides care and accommodation for up to seven people who have a learning disability. At the time of the inspection six people were living at the service. 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 and their relatives told us they believed HF Trust Trelowen was a safe and caring service. We saw people and staff interacting and engaging with each other in a friendly and relaxed manner. During the inspection visit a relative called in and staff and the registered manager chatted with them, updating them as to their family members well-being.

Staff were well supported by a system of induction, training and supervision. Training was refreshed regularly and developed to reflect best practice. Staff meetings were an opportunity to contribute to the running of the service. Staff demonstrated a clear set of visions and values which placed the people they supported at the centre of the service.

People were protected from risk and kept safe while being actively encouraged to develop their independence. People accessed the local community regularly and made use of local amenities. When people‘s behaviour was difficult for staff to manage there were well defined strategies in place and processes to follow. This helped ensure staff took a consistent approach to supporting people.

There was a stable staff team in place. However, it had been necessary recently to use agency staff more frequently due to a shortage of relief staff available to cover staff absences. The registered manager told us HF Trust was continually seeking to recruit new relief staff to address this.

Information was produced using easy read techniques, e.g. limited text and photographs and pictures. People’s preferred communication styles were identified and respected. However, care plans were not available in an accessible format and there was no evidence people, or their representatives, had consented to their general plans of care. Some of the information in care plans was out of date. The registered manager told us they would address this in the near future.

There were clear lines of responsibility in place. The registered manager was supported by a senior. People had been assigned key workers and co-key workers with responsibility for their day to day care. Relatives told us management were approachable and they would not hesitate to approach them with any concerns or suggestions they might have.

On the day of the inspection the registered manager and senior support worker were unavailable. We spoke with three members of staff who were on duty at the time of the inspection. We also spoke with a service manager from another HF Trust service.

We did not speak with anyone who lived at Trelowen due to their communication needs. We observed two people who were at home during the inspection and saw they appeared relaxed and at ease. Following the inspection we spoke with the registered manager.

This was a follow up inspection to check if improvements had been made in the area of non-compliance identified during the last inspection in August 2013.

We spoke with three people who used the service and a relative. People who used the service had limited verbal communication but were able to indicate to us they “liked” living at Trelowen. The relative we spoke with told us they were "happy" with the support. We saw staff interacting with people who used the service in a kind and calm manner. Staff showed, through their actions, conversations and during discussions with us empathy and understanding towards the people they cared for.

We saw people's privacy and dignity was respected by the way staff supported people with their day to day needs.

We examined people’s care files and found the records were up to date and reviewed as the person's needs/wishes changed.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

We found the design and layout of the premises did not always promote people’s well-being.

We brought forward our scheduled inspection of Trelowen because we received anonymous information about how staff spoke to people; this included showing a lack of respect and talking down to people.

During our inspection we met seven people who lived at Trelowen. Comments included, I like being here”, “and I like being with the staff, and “often go out places for lunch”.

One person we spoke to told us, “some of the younger members of staff are bossy and don’t understand what you’re trying to say”.

Staff we spoke with told us,” we are very aware of what people like” and we do well at “supporting seven people with very different needs”.

We found people’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care and people experienced care, treatment and support that met their needs and protected their rights.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening and the provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.