Background to this inspection
Updated
27 October 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 a comprehensive inspection which took place on 23 July 2018 and was unannounced. The inspection team consisted of two inspectors and an expert by experience. An expert by experience is a person who has experience of using, or caring for a person who uses this type of care service.
As part of the inspection we reviewed information we held about the service including statutory notifications that had been submitted. Statutory notifications include information about important events which the provider is required to send us by law. We reviewed the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also contacted the local authority to gather their feedback about the service.
During the inspection we spoke with 13 people using the service and four family members. Some people using the service were unable to speak with us so we completed a Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We also spoke with the registered manager, two nurses, three care staff and the cook. We looked at three care files, four medicine records, accidents, incidents and complaints records. We sampled the provider's audits to monitor the quality of the service and looked at people’s feedback on the service.
Updated
27 October 2018
The inspection took place on 23 July 2018 and was unannounced. At the last inspection in November 2016 we rated the provider as Good overall with but requires improvement in respect of the key question; Is the service Well-led? At this inspection we found the evidence continued to support the rating of good and there was improvement that meant the Well led domain was rated good. 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.
Hillcroft Nursing Home 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. Hillcroft Nursing Home is registered to provide accommodation and personal care to a maximum of 28 people who may have a physical disability or diagnosis of Dementia. At the time of the inspection, there were 20 people living at the home.
There was a registered manager in place. 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 provider had made improvements to their systems to ensure that they informed us of events or accidents that occurred at the service. We saw that accidents and Deprivation of Liberty (DoLS) authorisations were notified to us as is required to meet the legal requirements of their registration with us. People were happy at the way the home was run and their views were regularly sought. The provider continued to review the quality of care via their own audits and checks which were effective in identifying improvements which we saw they had made. The registered provider has worked in partnership with other organisations and the registered manager has taken part in training with the local hospice to provide best practice initiatives for people needing end of life care.
People told us they felt safe living at the home. We saw staff understood how to recognise and report harm or abuse. Risks to people’s safety continued to be assessed, monitored and managed to keep people safe. There were enough staff to meet people’s needs and people’s medicines were managed safely. The home’s environment was kept clean and hygienic.
People received effective care to meet their assessed needs because staff had relevant training and support to help them in their role. Staff sought people’s consent and any restrictions on people’s liberty were understood. People continued to be happy with the quality and choice of meals. People’s health was maintained with access to a range of healthcare professionals.
People described staff as caring and kind in their approach and remained happy that staff treated them with respect and protected their privacy and dignity. People continued to be involved in decisions about their care and their choices were respected.
People continued to receive care that was responsive to their needs and they were involved in deciding their care. The range of activities would benefit from improvement, for example including opportunities for people to go out into the community. The registered manager had raised this with the provider. People felt happy to approach staff with any concerns or complaints. People’s end of life needs were being taken into account to ensure they had appropriate professional support and that their wishes are known.
Further information is in the detailed findings below