Hillside

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Managers completed staff competency assessments to ensure they knew how to support people safely in relation to specific aspects of their care. We found these lacked detail. The service did not have effective governance processes to monitor the quality and safety of the service and learning and improvements was not always clearly evidenced. The service did not always share information with other organisations as required. Staff were able to raise concerns and felt supported by managers and their colleagues.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff described positive working relationships between colleagues and managers. A staff member said, “My teammates are very supportive. Especially when I first started, I must say they were tremendous in getting me settled in with the day-to-day process.”

The service had an equality and diversity policy. This included guidance for staff for who to escalate concerns to.

Staff felt supported by managers. A member of staff told us, “Our managers are very supportive and are always willing to provide any additional information or support.” Another staff member described feeling supported by managers in most areas but felt they needed better guidance in relation to how to support one person. They said, “Our manager is very supportive. You have a problem you go to [registered manager]; [they] will help you out as best [they] can. We feel in terms of [person] adequate support is not given enough. Outside of that [registered manager] is a very good manager.

The provider gained feedback from staff via a survey. This was not service specific, so it was difficult to identify how this reflected the views of staff at Hillside. Although the provider had retained external accreditation for 20 years from an internationally recognised standard for people management we did not see evidence of how they were monitoring staff feedback and wellbeing at a low level to make a difference.

Staff mostly felt able to raise concerns and were aware of the procedure. A staff member said, “When reporting an issue, we can go to our managers, and we can record everything easily on our online logging system. We also have forms for complaints that can be sent to head office anonymously, left in our Hillside office or given straight to our managers.” Another staff member said, “If l am concerned about something I will raise it with my manager and will also follow the in-house procedures on how to raise concerns”. However, we were also told by a staff member they would not feel comfortable raising concerns to a specific member of the leadership team as it may lead to them being treated differently.

The service had a whistle blowing policy. This included guidance for staff for who to escalate their concerns to, including if the concerns were about senior leaders.

Staff felt supported by their managers. They told us their personal needs were accommodated, where possible, for example amendments to the staff rota.

Staff received regular supervision. We reviewed some and found this included support with personal circumstances.

The registered manager had processes for monitoring the service. In response to some of the issues we found they acknowledged they needed to improve their systems to better identify themes.

The provider’s governance processes were not always used effectively to monitor the quality of the service. Trackers to monitor incidents, and safeguarding concerns were not always completed/updated fully, and we found not all safeguarding concerns had been reported to CQC. Staff competency assessments lacked evidence of how the judgement of competency was made. Managers completed various audits with actions added in to the overall service improvement plan. We found some actions were very old and some had lengthy timeframes for completion. Some of the issues we found during the assessment had not been identified by the audits.

People’s relatives were confident staff consulted other health and social care providers as necessary. A relative said, “They arrange everything like that for [them].” People told us, and we saw, they went out regularly and participated in events in the local community and at specialist services frequently.

Staff told us they were involved in discussion with other professionals about people’s care. For example, they met with a psychologist to support with development of a support plan.

Some professionals involved with people at the service described positive relationships with staff and managers at the service. Another professional gave some examples where information has not been shared with them. However, they went on to say there had been increased contact with the team in relation to the support needs of 1 person and they were now working effectively together.

Managers met with other professionals involved in people’s care. We reviewed Multi-Disciplinary Team meeting minutes and found they included input from various teams with actions identified. However, we also found referrals to other professionals had not always been made as required.

The registered manager advised all improvements to the service were collated in their service improvement plan. These were identified at audit; staff also had the opportunity to raise suggestions. For example, the registered manager told us, “This week, when the weather has been nice, one of the staff wanted to do the garden and is encouraging the residents to get involved.”

Staff attended team meetings. These included general updates and reminders as well as update on each person and an opportunity for staff to make suggestions. We reviewed information related to incidents and found it was not easy to clearly see what had happened, who was involved, action taken, and learning identified or how it was shared. Whilst improvements were identified in the service improvement plan, we found these were not always actioned in a timely way.