Hillcrest Residential Home

•During times visiting was permitted in line with local policy, the service was booking visitors in at a time that suited people and was spaced out to avoid potential infection transmission with other visitors. Visitors were screened on arrival and provided with PPE and handwashing facilities. A summerhouse had been constructed in the garden to offer additional flexibility to visits and activities.

•The service had worked hard to meet people’s social needs to compensate for the lack of family visitors and entertainers. This included a ‘pen pal’ scheme with the local community. We saw staff working hard to keep people occupied and stimulated.

•The service had bought portable sinks to ensure staff and visitors were able to wash their hands in the exact vicinity of the PPE stations to reduce the risk of cross-contamination.

Further information is in the detailed findings below.

Hillcrest Residential Home 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.

Hillcrest Residential Home is situated in the Armley suburb of Leeds. The service is a large detached property which has been adapted to accommodate 19 people, some of whom are living with a dementia. At the time of the inspection there were 13 people who used the service.

Staff understood the procedure they needed to follow if they suspected abuse might be taking place. Risks to people were identified and plans were put in place to help manage the risk and minimise them occurring. Medicines were managed safely with an effective system in place. Staff competencies around administering medicines were regularly checked.

Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety was maintained. However, we did note that some windows that were not secured as safely as they should be. This was pointed out to the provider who took immediate action to address this.

People told us there were enough staff on duty to meet their needs. We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

The home was clean and tidy. Communal areas were well maintained. Appropriate personal protective equipment and hand washing facilities were available. Staff had completed infection control training. However, we did note that pull cords from lights did not have a protective plastic covering so that they could be readily washed to prevent the spread of infection. The provider told us they would take immediate action to address this.

People were supported by a regular team of staff who were knowledgeable about people’s likes, dislikes and preferences. A training plan was in place. The registered manager told us some refresher training was a little overdue, however this training would be completed by the end of December 2018.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. There were some mental capacity assessments and best interest decisions in the care records we looked at, however, these were not decision specific. We pointed this out the registered manager and provider who told us they would take immediate action to address this.

People had a choice of meals and staff supported people to maintain their health and attend routine health care appointments.

People who used the service told us that staff were kind and caring. Care plans detailed people’s needs and preferences. Care plans were reviewed on a regular basis to ensure they contained up to date information that was meeting people’s care needs. People had access to a range of activities. The provider had recruited a staff member with a background in dementia and with their input intended to improve on the activities available for those people living with a dementia. The service had a clear process for handling complaints.

Staff told us they enjoyed working at the service and felt supported by the registered manager. Quality assurance processes were in place and regularly carried out by the registered manager, senior staff and the provider, to monitor and improve the quality of the service. Feedback was sought from people who used the service through meetings and surveys. This information was analysed and action plans produced when needed.

At the last inspection in October 2014 we found the provider had breached two regulations associated with the Health and Social Care Act 2008. This was in relation to staffing and the management of medicines.

We told the provider they needed to take action and we received a report in March 2015 setting out the action they would take to meet the regulations. At this inspection we found improvements had been made with regard to these breaches.

Hillcrest is situated in the Armley suburb of Leeds. It is a detached, period property which has been adapted to provide accommodation, without nursing, for nineteen older people.

There was a registered manager in post. 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 and associated Regulations about how the service is run.

People told us they felt safe at the home and that overall there were enough staff to meet their needs. Recruitment was underway to ensure the home was fully staffed. Staff showed a good understanding of safeguarding vulnerable adults and knew what to do to keep people safe. There were systems in place to record accidents and incidents and monitor for any patterns or trends.

We saw the home was overall, clean, tidy and homely. However, a feature stained glass window on the staircase in the home posed a potential risk to people as this did not have any safety guard in place.

Overall, people were now protected against the risks associated with medicines because there were appropriate arrangements in place to manage medicines safely. People told us they got the support they needed with meals and healthcare.

Staff training and support provided staff with the knowledge and skills to support people and meet their needs well. Staff were trained in the principles of the MCA and could describe how people were supported to make decisions; and where people did not have the capacity; decisions were made in their best interests.

People were happy living at the home and felt well cared for. People were supported by staff who treated them with kindness and were respectful of their privacy and dignity. Some people’s relatives thought activity in the home could be improved upon.

There were systems in place to ensure complaints and concerns were fully investigated. People had the opportunity to say what they thought about the service and the feedback gave the provider an opportunity for learning and improvement.

People were not put at risk because systems for monitoring quality were in place. However, the records of these systems were not yet fully embedded in the service.