This unannounced inspection took place on 24, 26 and 31 January 2018.Hillside 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.
Hillside is a purpose built 55 bed service providing accommodation and nursing care for older people, including those living with dementia. The service is accessible throughout for people with mobility difficulties and has specialist equipment to support those that need it. For example, hoists and adapted baths are available. 47 people were using the service when we visited.
The service did not have a registered manager but a new manager has been in post since November 2017 and had started the process to register with CQC. 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.
At the last inspection on 17 and 18 May 2017, we found three breaches of regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The lack of consistent and specific information about people's needs placed them at risk of not receiving the care they required and wanted. Systems in place did not always ensure safe equipment and staff competency. People were not consistently safeguarded from the risk of abuse. After the inspection the provider sent us an action plan detailing the action they were taking to meet these requirements.
At this inspection, we found action had been taken and the breaches with regard to safe equipment, staff competency and safeguarding were met. Systems were in place to check equipment and staff competencies. Staff were aware of their responsibilities to ensure people were safe and action was taken if there were any concerns or possible abuse.
People’s care plans were not sufficiently personalised or detailed and did not contain the necessary information to ensure their needs were effectively met.
Staffing levels and deployment were not sufficient to meet people’s needs and to enable them to be supported in a way that they wished. Staff received the support and training they needed to give them the necessary skills and knowledge to meet people’s assessed needs.
Systems to monitor the service provided had been changed and strengthened. However, further work was needed to ensure people received a good quality of service and legal requirements met.
People were encouraged to do things for themselves and staff provided care in a way that respected people's privacy but their dignity was not always maintained.
People were supported to receive the healthcare they needed.
Systems were in place to ensure that decisions made in people’s best interest protected their human and legal rights.
People received their prescribed medicines safely. Medicines were administered by staff who were trained and assessed as being competent to do this.
Staff supported people to make choices about their care and systems were in place to ensure they were not unlawfully deprived of their liberty.
Staff and relatives were positive about the changes implemented by the new registered manager.
We saw that staff supported people patiently, with care and encouraged them to do things for themselves. People told us they felt safe at Hillside and were supported by kind and caring staff.
Systems were in place to minimise risk and to ensure that people were supported as safely as possible.
People’s nutritional needs were met but we have recommended the lunchtime arrangements be reviewed to ensure people were fully supported and that mealtimes were a pleasurable experience.
People were protected by the provider’s recruitment process, which ensured that staff were suitable to work with people who need support.
Staff provided caring support to people at the end of their life and to their families. This was in conjunction with the GP and the local hospice.
Staff felt the registered manager was approachable and supportive and gave them clear guidance.
Ongoing work was taking place to improve the environment and make it more homely and dementia friendly.
Complaints and feedback were taken seriously and action was taken to address any concerns.
We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.