Hill House

Updated 30 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 27 November 2018 and was unannounced. The inspection team consisted of two inspectors and an expert by experience. The expert by experience was a person who has personal experience of caring for people with learning disabilities.

This service was selected to be part of our national review, looking at the quality of oral health care support for people living in care homes. The inspection team included a dental inspector who looked in detail at how well the service supported people with their oral health. This includes support with oral hygiene and access to dentists. We will publish our national report of our findings and recommendations in 2019.

Before we carried out this inspection we reviewed the information we held about this service including notifications. A notification is information about events that the registered persons are required, by law, to tell us about. We also made contact with the local authority quality assurance team to aid with our planning of this inspection.

We looked at the care records of two people in detail to check they were receiving their care as planned. We also looked at other records including training records, meeting minutes, medicines records and quality assurance records.

Many of the people who used the service had complex communication support needs. We spoke with staff and looked at care plans to help us communicate with people who used the service. We observed how people were cared for and how staff interacted with people to help us understand their experience of the support they received.

We spoke with five members of staff, including the domestic support worker. We also spoke to the registered manager. We tried to make contact with some relatives of people living at the service to seek their feedback but we were unable to. We provided our contact details to the registered manager in order that he share them with relatives so they had the opportunity to contact us if they had wished to.

Updated 30 January 2019

This comprehensive inspection was carried out on 27 November 2018 and was unannounced.

Hill House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Hill House is registered to provide accommodation and personal care for up to eight people who have a learning disability. There were six people living at the service when we visited on 27 November 2018. The service is situated in a rural area in the village of Pulham St Mary near Diss in Norfolk. People who lived in the service had differing levels of communication including people who used non-verbal communication.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There continued to be sufficient staff to meet people’s needs. Risks continued to be appropriately assessed and mitigated to ensure the people safety was considered. Medicines were managed safely and records evidenced that people had received their medicines as prescribed.

Staff worked well with external health care professionals and people were supported to access health services when required.

Staff received ongoing support from the management team through a programme of regular supervisions and appraisals and they had received trained to ensure they had the knowledge and skills to care for people effectively. Staff treated people with dignity and respect and were caring towards them.

The service continued to be well led. Staff enjoyed their job roles and were clear on the expectations of them to support people in a person centred way. Quality assurance processes are used to continuously improve the standard of care and support people received.