HF Trust Hythe

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question inadequate. At this assessment the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

People’s care records had not always been followed or completed consistently. Therefore, we could not be assured that all relevant information regarding people’s safety had been reported to the management team. Although risks to people had been assessed and mitigated, we could not be assured that guidance was always followed by staff to ensure people’s risks were reduced. Records showed that some people’s medicines had not always been managed safely. Guidance had not been consistently followed in relation to the monitoring of a person with a specific health need. Therefore, we could not be assured that records were accurate.

Information was available when people moved between services. People felt safe with staff and knew what to do if they had any concerns or worries. Staff had been trained and knew the action to take if they had any concerns. People were supported to maintain a safe and clean environment which had been adapted where required to meet people’s physical needs. There were enough staff to ensure people received their commissioned hours of care and support.

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. The provider was previously in breach of the legal regulation in relation to need for consent. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

People’s needs were assessed with them and others involved in the person’s life prior to moving into a service. Staff worked alongside healthcare professionals to ensure people remain as healthy as possible. People’s communication needs were supported and recorded. Some people’s health care records were incomplete, and work was still ongoing to ensure everyone’s care records were outcome focused. People were supported to attend regular appointments with their healthcare professionals. People’s capacity to consent to care and treatment had been recorded, and people were given choice and control over their lives.

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

People received support from staff that were kind and caring whilst respecting their privacy and dignity. People’s individuality was promoted and respected by staff who knew them well. People’s independent living skills were encouraged and developed. Information was available to enable staff to meet people’s needs at times of distress and anxiety. Some staff felt their feedback was not always listened to and acted on.

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

The management and staff team made sure people were at the centre of their care and treatment choices. The service decided in partnership with people how to respond to any relevant changes in people’s needs. People were provided with consistency and continuity of care from staff they knew. People were supported to maintain and develop relationships with people that mattered to them. Documents were available in accessible formats to meet people’s individual needs. People were given opportunities to raise concerns and to make suggestions however, records were not always clear whether any action had been taken as a result.

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question inadequate. At this assessment the rating has changed to requires improvement. The provider was previously in breach of the legal regulation in relation to the governance systems. Improvements were not found at this assessment, and the provider remained in breach of this regulation. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The governance and auditing system in place had failed to identify and act on the concerns that were found during this assessment. We could not be assured that the provider had robust oversight of the service. Incomplete record keeping due to issues with connectivity to the services electronic systems meant the provider could not have effective oversight of care being delivered. There was a risk that concerns with people’s care or accidents and incidents may not be recorded or identified. This was a continued breach of regulation.

Staff were given the opportunity to raise any concerns they had or to make suggestions however, some staff felt that action was not always taken as a result of their feedback. At the time of our assessment there was not a manager registered with the Care Quality Commission. However, a number of improvements and changes had been made since the last inspection and the staff felt this had made a positive difference to people using the service.