Updated 10 May 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by two inspectors, an assistant inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type:
Hilderstone Hall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Care and support is provided in one adapted building. There is a smaller area of the home called ‘Memory Lane’ which has its own communal areas, though people living on Memory Lane are free to access all areas of the building if they choose. The service is registered to provide care and support for up to 51 people. However, some bedrooms are not in use as they are not easily accessible so the provider told us they would accept up to a maximum of 45 people. There were 38 people using the service at the start of the inspection.
The service did not have a manager registered with the Care Quality Commission at the time of the inspection. Registered managers and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The provider had taken appropriate steps to recruit a new registered manager and provide suitable management arrangements in the interim period. There was an acting manager in place.
Notice of inspection:
The inspection was unannounced.
What we did:
We used the information we held about the service to formulate our inspection plan. This included statutory notifications that the provider had sent to us. A statutory notification is information about important events which the provider is required to send us by law. These include information such as safeguarding concerns and deaths. We also sought feedback from commissioners of the service and looked at information we had received from the local safeguarding adults’ team and members of the public.
Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information is called the Provider Information Return (PIR) and helps support our inspections. We considered this information as part of the inspection.
During the inspection, we spoke with nine people who used the service and four people’s visiting relatives and friends. We did this to gain their views about the care and to check that standards of care were being met. We observed how staff interacted with people in communal areas and we looked at the care records of six people who used the service, to see if their records were accurate and up to date. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.
We spoke with five members of staff including a nurse. We also spoke with the acting manager and deputy manager and looked at records relating to the management of the service. These included staff recruitment files, staffing records, complaints records and quality assurance records.