Hillcrest Care Home

Updated 22 September 2018

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 was an unannounced inspection which was completed on 3 September 2018. The inspection was completed by one inspector. This involved inspecting the service against all five of the questions we ask about services: is the service safe, effective, caring, responsive and well-led.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they planned to make.

We reviewed the information included in the PIR along with information we held about the home. This included notifications, which is information about important events which the service is required to send us by law.

We contacted three health and social care professionals to obtain their views on the service and how it was being managed. This included professionals from the local community learning disability team and the GP practice. You can see what they told us in the main body of the report.

During the inspection we looked at two people’s records and those relating to the running of the home. This included staffing rotas, policies and procedures, quality checks that had been completed, supervision and training information for staff. We followed up the breaches from the last inspection and found improvements had been made to ensure people were receiving a safe, effective and well led service.

We spoke with three members of staff and the registered manager. We spent time observing and speaking with three of the four people living at Hillcrest. We contacted three relatives after the inspection.

Updated 22 September 2018

This was an unannounced inspection, which meant the staff and the provider did not know we would be visiting. One inspector carried out the inspection on the 8 August 2017.

Hillcrest provides accommodation, personal care and support for up to 4 people. There were four people living in the home at the time of the visit. People who live at the home have a learning disability. People had their own bedroom and shared the lounge and kitchen with the other occupants. The home was close to the shops and other amenities.

People in care homes receive accommodation and 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.

There was a registered manager in post. The registered manager was also one of the owners of the business. 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 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.

The previous inspection was completed in July 2017. The service was rated as requires improvement. This was because staff were not taking part in a fire drill, hot water temperatures were not being checked at appropriate intervals and there had been no checks on the first aid box in line with the service’s policy. We also found that there were no individual risk assessments in relation to exposed radiators and window restrictors. The registered manager had failed to ensure appropriate applications in respect of people’s deprivation of liberty had been submitted. This was because the registered manager had submitted these to the local authority but had not ensured they had received these. The provider's quality assurance checks had not identified these shortfalls. At that time there were three breaches in regulation. The provider sent us an action plan shortly after the last inspection. These areas have now been addressed to ensure people’s safety. The service was rated as good at this inspection.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow the procedures. Systems were in place to ensure people were safe including risk management, and safe recruitment processes. People received their medicines safely. Sufficient staff supported people and this had been kept under review. The registered manager worked alongside the staff team to cover any shortfalls and agency staffing was never used.

People were involved in making decisions about their care. People had a care plan that clearly described how they wanted to be supported. People had opportunities to take part in activities in both the home and the local community. People were encouraged to be independent as they were able. Other health and social care professionals were involved in the care of the people living at Hillcrest.

People were treated in a dignified, caring manner, which demonstrated that their rights were protected. Where people lacked the capacity to make choices and decisions, staff ensured people’s rights were protected by involving relatives or other professionals in the decision making process. Information was accessible to help people make decisions and express their views about the service. Staff recognised the importance of effective communication enabling them to respond to people in a person-centred way, Appropriate applications had been made to in respect of deprivation of liberty safeguards. Staff ensured that any restrictions that were in place were the least restrictive and kept under review.

Staff were knowledgeable about the people they were supporting. They were caring in their approach to people. Staff told us they were supported in their role and met with the registered manager regularly to discuss their performance and any training needs.

The registered manager regularly visited the service to speak with staff and people and to work alongside the team. They were knowledgeable about the people living at Hillcrest. Relatives were very much part of the care of their loved ones and consulted regularly.