2 Hill Close

Updated 5 December 2023

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by an inspector and a regulatory co-ordinator.

Service and service type

2 Hill Close is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. 2 Hill Close is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 24 October 2023 and ended on 17 November 2023. The inspection visit took place on 24 October 2023.

What we did before the inspection

We reviewed information we had received about the service since it had been registered with us. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 2 people who used the service and 3 members of staff including the registered manager and support workers. We observed people in their rooms and in their home. We reviewed a range of records including 2 people's care records and various medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A range of records relating to the management of the service including audits, analyses of data and policies and procedures were reviewed.

After the inspection visit, we continued to seek clarification from the provider to validate evidence found. We received additional information, which was used as part of our inspection. This included service audit records regarding maintenance and fire safety and risk management and records regarding staffing and staff training, and policies and procedures. We spoke by phone with 2 staff members and sought feedback from the local authority who commission the service.

Updated 5 December 2023

About the service

2 Hill Close is a small residential care home providing support and care for up to 3 people at the time of the inspection. On the day of our inspection there were 3 people using the service. There are also 1 Hill Close and Hillcrest which are registered separately but form part of one complex with many elements such as staffing and policies shared across all three buildings. We inspected these services in a 2-week period because much of the evidence we needed to gather was common to all 3 services.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

Right Support

Systems were not robust enough to demonstrate people’s safety was always effectively managed. There were shortfalls in cleanliness and in the assessment and management of risk. There was a lack of clarity in relation to staff deployment. These shortfalls had not been picked up through the provider's governance arrangements.

The location of the service in an ordinary residential area provided good access to local amenities and services which helped support people’s independence and autonomy. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care

People told us they were happy living at 2 Hill Close and we observed that people were relaxed in the company of staff and others they lived with. Support was available when needed and people were able to join in with activities within their local community. People’s care was person-centred and enabled them to live independent lives.

Right Culture

Overall, there was a positive culture in the service and people were happy with the support they received. However, the terminology and definitions used by the provider were not always respectful or empowering. People told us they were happy in their home and with the support they received from staff. Staff knew their responsibilities and were confident to report concerns that might arise. Staff felt well supported by the management team who worked at the service. The management team was responsive to the inspection findings and keen to deliver a high-quality service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (report published 8 November 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service, specifically, the time elapsed since the last full inspection.

We undertook a focused inspection to review the key questions of safe, caring and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, caring and well-led sections of this report.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

We made recommendations about staffing and the use of respectful terminology and definitions.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.