Hillbrook Grange

Updated 22 February 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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector, one pharmacist inspector and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Hillbrook Grange 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. Hillbrook Grange 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 on day one.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and the local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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 11 people who used the service and 3 relatives about their experience of the care provided. We spoke with 12 members of staff including the registered manager, deputy manager, the chair of trustees, administrator, kitchen/dining staff, laundry staff, care workers and senior staff.

We reviewed a range of records. This included 4 people’s care records and 8 medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 22 February 2023

About the service

Hillbrook Grange residential care home providing accommodation and personal care to up to 41 people. The service provides support to older people. At the time of our inspection there were 35 people using the service. Accommodation is provided across two floors accessible via a lift. There are a range of shared facilities including adapted bathrooms, lounge and dining areas and a secure outside space.

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

Improvements have been made to the management of medicines since the last inspection; however, we found people were still at risk of not receiving their medicines safely. Staff had undergone safe recruitment checks prior to working the home. People were cared for by staff who understood how to safeguard people and how to report any concerns. The home was clean and tidy, and people were supported to receive visits from family and friends.

We have made a recommendation about the implementation of individual risk monitoring charts and a recommendation about maintaining up to date staff training.

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.

Systems and processes to ensure oversight of the service were not always effective. Audits completed had not always actioned the concerns we found on inspection. We identified a repeated breach and a new breach of regulations. The management team were helpful and quick to investigate and provide assurances when we fed back our findings during and after the inspection. Staff were complimentary about the manager and people gave positive feedback about the care provided by staff.

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

Rating at last inspection and update

The last rating for this service was requires improvement (26 August 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations. This service has now been rated requires improvement or inadequate for four consecutive inspections.

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We previously carried out an unannounced inspection of this service on 11 July 2022. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.

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 remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hillbrook Grange on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to medicines management and managerial oversight at this inspection.

Please see the action we have told the provider to take at the end of this report.

We have made recommendations in relation to monitoring records and maintaining up to date staff training.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.