The Care Quality Commission
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Archived: Hillside Care Home

Overall: Good read more about inspection ratings

Hillside Avenue, Huyton, Liverpool, Merseyside, L36 8DU (0151) 443 0271

Provided and run by:
Bupa Care Homes (ANS) Limited

Important: The provider of this service changed. See new profile

All Inspections

08 January 2015

During a routine inspection

This was an unannounced inspection, carried out on 08 January 2015.

Hillside Nursing Centre is a purpose built care home over two floors, which provides accommodation for up to 119 people. All bedrooms have en-suite facilities. Access to the upper floor is via a passenger lift or stairs. Local shops and other amenities are a short distance away from the service and there are good public transport links close by.

At the time of our inspection there were 43 people living at the service.

The service has a registered manager. 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.

The last inspection of Hillside Care Centre was carried out in June 2014 and we found that the service was not meeting all the regulations that were assessed.

People told us they felt safe at the service and that staff treated them well. Family members raised no concerns about the safety of their relatives and they said they would speak up if they had any concerns at all. Staff were able to describe the different types of abuse and the signs which indicate abuse may have occurred. Staff also knew what their responsibilities were for protecting people from abuse and for reporting any concerns they had.

Although people had a care plan for their assessed needs they did not reflect people’s wishes about how they wished their care and support to be provided. Care plans were regularly reviewed with the involvement of the person they were for and other important people such as family members and relevant health and social care professionals.

People told us there was always enough staff around to provide them with the care and support they needed. We saw that staff responded promptly to people’s calls for assistance and that people had all the equipment they needed to help with their mobility and comfort.

Safe recruitment practices were followed to ensure staff were suitable to work with people in a care setting. There were sufficient qualified, skilled and experienced staff on duty to meet people’s needs. Staff were available when people needed them and people told us that they had confidence in the ability of staff.

Staff worked well with health and social care professionals to make sure people received the care and support they needed. People were referred onto to the appropriate service when concerns about their health or wellbeing were noted. Medication was managed safely and people received their medication at the right times.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. Policies and procedures were in place to guide staff in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Records we saw and discussions held with the registered manager showed how they ensured decisions were made in people’s best interests.

Staff received an appropriate level of support from their line manager and they were encouraged to discuss matters relating to their work and training needs. Staff completed an induction when they first started work at the service. Following on from their induction staff received ongoing training in key topics relevant to the work they carried out and the needs of people who used the service.

The premises were accessible, clean, and safe. Emergency procedures were in place and staff were familiar with them. Staff felt confident about dealing with emergency situations such as if a person’s health suddenly deteriorated or if there was a fire in the building.

The service was managed by a person who was described as being approachable and supportive. The quality of the service was regularly checked and improvements were made based on the findings of the checks and from seeking people’s views about the service.

26 June 2014

During a routine inspection

The inspection team who carried out this inspection consisted of two adult social care inspectors, a specialist advisor and an expert by experience.

During the inspection the team worked together to answer five key questions;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found '

Is the service safe?

People's health, welfare and safety was put at risk because they did not always have access to working call bells and Items which had the potential to cause harm to people were not safely stored away.

Staff lacked knowledge about the Mental Capacity Act and Deprivation of Liberty Safeguards. Staff did not have access to important information about restrictions which had been legally agreed for one person and other people had restrictions placed upon them without the appropriate arrangements in place.

People told us they felt safe living at the home. Any allegations of abuse had been promptly reported to the relevant safeguarding teams and action had been taken to ensure the safety of people who used the service.

People did not receive care and support in a timely way because there were insufficient staff on duty.

The systems in place for assessing and monitoring the quality of the service were ineffective putting people's health, welfare and safety at risk.

Is the service effective?

People were satisfied with the care provided. Comments included: "It's nice and quiet"; "The staff are very good".

People were involved in their care or were appropriate their representatives such as family members had been consulted.

Staff had been trained to an appropriate standard to enable them to meet the needs of the people who used the service.

People had not been provided with appropriate opportunities to access the community which increased the risk of isolation.

Is the service caring?

Relationships between people who used the service and staff were positive. People told us they liked the staff and that staff were caring and polite. People commented: 'They do respect me.' And 'They are so nice and polite.' We observed that people appeared comfortable and confident with the staff who provided their care and support. We saw staff delivered care and support to people in a sensitive and dignified way.

Is the service responsive?

People said they were treated with dignity and respect and they told us were involved in their care and support.

Staff responded promptly to any concerns they had noted about people's, health and wellbeing and we saw that when required appropriate referrals had been made for people with services such as speech and language therapists and dieticians.

Is the service well-led?

Staff knew who their line manager was and they felt that their manager was approachable and willing to listen.

Staff told us they were clear about their roles and responsibilities. However, not all staff received supervision in line with the providers requirements.

People had not always received care and support by the right amount of staff because there was no system in place to determine staffing levels based on the needs of people who use the service.

17 February 2014

During a routine inspection

We had previously inspected this service and had found improvement was required to ensure that individuals were treated with respect and involved in their care. We found the provider needed to improve care records and fully support people to ensure their care and welfare. Improvements were also required relating to the effective monitoring of the quality of service provision.

During this inspection we found that improvements had been made at Hillside Nursing centre. People were positive about the changes. The people living at Hillside told us that in their opinion significant improvements had been made to the manner in which they were supported in recent months. Their comments included:

'It's a lot more homely. I feel safer now.'

'They know what they are doing.'

We found that people received the support they had needed with their care and welfare.

People told us that they felt there were enough staff to support their needs.

The provider had reviewed its systems and process for monitoring the quality of service provision including the systems for recruiting staff.

4, 14 October 2013

During an inspection looking at part of the service

We had previously inspected this service on 12th June 2013 when we found areas of non-compliance for which compliance actions were set. During this inspection visit we found there had been improvements in the level of staffing across the home. However, we found that improvements were required in regards to respecting and involving people who used the service.

One relative told us that her dad always looked smart and clean. They commented that the staff were ‘Brilliant.' Other comments people made about staff included:

“I know their faces.”

“There are changes but I know a lot of them.”

“They interfere in my private life. Ask questions.”

“Staff are too nosy.”

“Confidentiality is not respected.”

We found that the provider did not effectively assess and monitor the quality of the service provided.

12 June 2013

During a routine inspection

We spoke with eight people who used the service and eight of their relatives. They told us that the care they had received had been delivered in a way that respected people’s privacy and dignity and their individual wishes. Their comments included,

"I only waited ten minutes this morning, sometimes it is more".

"The place is great. They look after him really well. He loves it here".

"Sometimes you wait, not always".

"It is efficient, friendly and clean".

"Staff are all very friendly in a strange place".

"I find it alright".

The scheduled inspection was brought forward due to concerns raised about Hillside Nursing Centre in regards to an increase in safeguarding referrals and the care of people with dementia. We found some improvements were required with regards to insufficient staffing being deployed across the home. The provider has been proactive in reviewing their safeguarding processes. People were protected from abuse and systems were in place to monitor the quality of service delivered.

During our visit we saw evidence that care plans were detailed and care was planned in line with individual needs and wishes. Appropriate arrangements were in place to manage medicines.

5 February 2013

During a routine inspection

During our visit we spoke with five people who used the service, three relatives/ carers and also spoke with health care professionals who were visiting the home. The people we spoke with told us they felt safe and had no concerns about the home. They told us the care they received was delivered in a way that respected their privacy and dignity. Comments we received from people included:

"You get looked after excellent".

"Can't fault the carers, they've done everything to help".

"Food is good, get a choice".

"It's very good here".

During our visit we saw evidence that care plans were detailed and contained enough information for people to be cared for safely and effectively. We found that effective staff recruitment and selection processes were in place. We saw evidence that systems had been put in place to carry out regular checks on the quality of service provided which included the review of care records.

29 November 2011

During an inspection looking at part of the service

We spoke with a person who was making use of the home's new computer room. He told us that he had lived at Hillside for about a year and he feels well looked after. He can get up and go to bed when he wants to. He gets a choice of meals and the food is nice. The staff are friendly and helpful, some of them have a moan but nobody has been unpleasant to him. He has a mate who takes him out, and the activities organiser will take him to the shop for ciggies. He can keep his own cigarettes and lighter safely and he uses the smoke room or goes out into garden. He has family who visit him. He is enjoying using the new computer room and can keep in touch with family on Facebook. He has no complaints, and couldn't think of anything he would like to improve.

We spoke with another person in her bedroom. She said that she was scared of coming into the home but the staff made her 'dead welcome' and feel at home. She has settled in and is capable of making her own decisions. She has made friends and they are 'like a little family' on the unit (Ash) and all support each other. The staff and other residents are 'always there for you' and she gets on well with all the staff. They don't tell her what to do. Sometimes she likes to stay up late and when she feels down she stays in her bedroom and staff make sure she is OK and ask her to come out but do not push her. If she rings her buzzer someone comes quickly.

She can have a shower when she wants to. The activities organiser takes her out also her family and other staff. She gets a choice of meals and if she doesn't like what is on the menu they make something else for her. They accommodate her special diet 'brilliantly' and she gets fresh fruit. She feels that staff promote her independence. She can have a rest on her bed at a time she chooses to fit in with any visitors coming and the staff tell her to buzz when she wants to get up. 'I love the fact that I am in control of it'. They keep her informed of any medical matters and give her great emotional support. They also give her family lots of support.

A visitor we spoke with in the lounge said that he comes every day to visit his mother, who has lived here for three years. She has been in two other homes but the staff here are much better and he gets on well with all of them.

A person we spoke with on Cedar unit said that he has no complaints at all. He joins in games of Bingo and went on a trip out to Blackpool. He can please himself what he does and when. He knows the manager and she asks him if everything is OK. Another person told us 'the carers really look after you'. He has never had any problems with any of the staff but he doesn't like the staff being swapped around. He knows the manager and she is 'superb', also the deputy, and they ask him is he OK. He can tell the manager if there is anything he is not happy about. 'It is a superb place, you wouldn't get any better.' He likes to get up early and go to bed early. He also told us 'you can't fault the food and drink'.

12 September 2011

During an inspection in response to concerns

During this visit we spoke with managers about medicines handling throughout the home but spent most of out time talking to people on Ash unit which provides support to younger people with a physical disability.

People we spoke with told us that medicines were given at about the same times every day. One person confirmed 'medicines are administered at set times. They're always given by nurses and handled very securely.' People told us that they had enough information about their medicines and people who had chosen to manage their own medicines were supported to do so. We asked people about treatment for minor ailments such as coughs and colds. One person told us 'they don't keep anything; everything is done through the doctor. It's quite quick, they fax the prescription.' Another person had purchased some painkillers for their own use.

20 January and 28 April 2011

During a routine inspection

People living in the service told us that they were happy living in the service. Comments included "wonderful staff" and "all the staff here were my neighbours".

The service does have some information about how people's preferences and choices are used and has surveyed all the people living in the service. Where people are less able communicate their choices staff make a choice for them. We found that the service does have an understanding of people with changes to their capacity to make decisions. Careworkers were not always able to recognise and record the best way to make sure that people's capacity was taken into account.

Our observations over the visit showed that careworkers were kind and respectful to people at all times. Careworkers were able to explain to people the care and support that they were to deliver, some staff were more skilled at this than others.

We saw that the staff had a caring attitude with the majority having worked in the home for several years. They were not always given clear instructions that would support them to meet people's needs consistently as some records were not as accurate as they needed to be. Training for employees was out of date and needed to be updated in order to support staff. Observations during the day and discussion with staff showed that although they had not all had up to date training the majority of employees had a clear understanding of peoples needs and how to provide a good service. People living in the home described staff as "very good" and "always helpful".

The service undertakes regular checks (audits) to look at how well the service meets people's needs. These and our visit had identified that there were areas of good practice in Hillside Nursing Centre. This was not always consistent and was the services own audits had identified areas of development these had not always been acted on promptly.

Hillside Nursing Centre was undergoing a full redecoration and refurbishment programme. One unit had been completed and the people living on the unit told us that they were very happy with the results. They thought that the home looked, "bright", "clean" and so much nicer.