We carried out a review of the data available to us about Hilton House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Hilton House, you can give feedback on this service.
Hilton House is a residential care home that is registered to provide personal care for up to three people who have a learning disability and/or autism. There were two people living at the service at the time of the inspection.
People’s experience of using this service:
Staff understood their responsibilities to protect people from abuse and discrimination. They knew to report any concerns and ensure action was taken. The registered manager worked with the local authority safeguarding adults team to protect people.
Staff were supported in their roles and received an effective level of training. They told us they were happy with the level of training and support they received and we observed them supporting people in a competent and caring manner.
People were protected from harm by the provider having effective systems in place to monitor medicine management, staffing, infection control and upkeep of the premises.
Staff promoted people’s dignity and privacy. Staff provided person-centred support by listening to people and engaging them at every opportunity. Staff were caring and understanding towards people. People using the service appeared comfortable in the presence of staff working in the service.
The premises provided suitable accommodation for people with communal areas and bedrooms which were personalised to peoples individual interests.
Support plans were detailed and reviewed with the person and their relatives when possible. Staff worked with and took advice from health care professionals. People’s health care needs were met.
People had a variety of internal activities and external activities, which they enjoyed on a regular basis.
The registered manager ran a well organised service. People’s views were sought, and opportunities taken to improve the service. Formal supervision meetings were carried out and staff were also supervised informally. They told us they were supported and clear about what was expected of them. Audits and checks were carried out, so any problem could be identified and rectified.
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.
The care service supported people in line with the values that underpin the Registering the Right Support and other best practice guidelines. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
Rating at last inspection:
The service was rated as Good at the last inspection. The inspection report for the last inspection was published on 09 February 2016.
Why we inspected:
This was a scheduled inspection based on the previous rating.
Follow up:
We will continue to carry out ongoing monitoring and will inspect the service in line with its rating.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The registered manager was present during our inspection. 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.
People told us that they were safe living at the home. Staff understood their responsibilities to protect people from harm. Risks to people had been assessed and managed appropriately to ensure care and support was provided safely and in the least restrictive way. Staff had been recruited appropriately, but actions taken during pre-employment checks had not always been recorded. People received their medicines as prescribed.
Staff told us that they were given the opportunity to develop their knowledge and skills in order to carry out their roles effectively. Staff received a planned induction and felt supported when they started to work at the home. Staff understood the principles of The Mental Capacity Act 2005 and how best to support people who were subject to restrictions. People told us that they had enough to eat and drink. People and their relatives told us that they were involved in accessing health care professionals to maintain their well-being.
We observed positive and caring relationships between people who lived at the home and staff. People told us that they were treated kindly. People were involved in making decisions in all aspects of their lives. People were communicated with different methods that met their individual needs. People and relatives told us that they were supported with dignity and respect. Staff described examples of how they promoted independence and maintained confidentiality when supporting people.
People’s care and support was planned around their individual preferences. People were supported by staff who knew them well and supported them to make decisions and to live as full as life as possible. People were supported to participate in activities that interested them whilst respecting their independence. A complaints procedure was in place and people felt confident to raise any concerns.
People, relatives and staff were happy with how the service was managed. People and their relatives had the opportunity to express their opinions on the service that was provided. The home had developed a positive culture that enabled staff to deliver person centred care that people wanted. Staff told us they felt valued and well-supported by the registered manager. There were effective systems in place to monitor the quality of the care and support provided to people.
We saw that people were consulted about the care and support they received. They also told us they could make choices and one person said, 'I pick what I want'.
One person told us they were happy with the care and support they received from staff. They told us that the support they received was as they wanted it to be. They said, 'Always love it here'.
Arrangements for people's medication were managed well meaning people were protected from the risk associated with medicines.
We saw that the home was designed so that it was of a suitable design for meeting the needs of people that lived there and promoting their safety.
The provider had an effective system to regularly assess and monitor the quality of the service that people received.
People's decisions were well recorded in their records, with their signatures on consent forms to show they had understood any decisions made. We saw a relative had commented that 'Staff are always encouraging and supportive of (their) personal choices'. This meant that people were supported by staff to make informed decisions.
People said they liked the home and got on well with other residents. One person said the staff "Are so kind and have really helped me a lot'. We saw people had regular contact with health professionals. People's records set out how their health was to be promoted. A health professional said 'Staff are proactive in meeting the health needs of residents'. This meant that people's health care was promoted.
One person said that 'The meals are great' and 'I can choose what I want to eat each day'. People were discussed food choices in meetings with staff. This meant that people had involvement in their food choices.
The staff we spoke with said they were 'Well supported". This meant that they were helped to do their jobs well.
One person said they can 'talk to the staff about anything when you want to, you know, if you are worried or upset or something'. A relative said that 'The manager is always available to discuss any issues that may arise". This meant that people knew how to raise any concerns and were confident they would be listened to.
People told us about the care they receive. We found that this reflected their needs and choices as recorded in their care plans, and books that were titled 'all about me'. One person informed us that the 'all about me' book was owned by them. We saw it contained lots of photographs of them and their life. Some people told us they were not bothered about their care plans but said staff had spoken to them about it. Other people told us that they had seen their care plans. Most people we spoke with told us about choices they had made and how staff had involved them in making decisions.
We spoke with a health professional at the Hilton House and they told us that staff had asked for help in ensuring a person understood the care options available to them due to refusal of a specific treatment. The home has since worked with other health professionals. This has given the individual a chance to have a better understanding about what would be involved in respect of the treatment, so they can make a better informed choice.
People told us that they are supported to live their life as they choose and participate in activities that they enjoy. People told us that they are given an opportunity to pursue their individual interests and they informed us that they 'Decide what [sic] going to do every day' 'come and go like manager does if feel like it' and 'Like staying here, playing on games'. Some people told us about the day centres and other places in the community they go to such as the local pub, theatre, cinema and shops. People said to us that staff are flexible and take them out by ring and ride or taxi. Some people used ring and ride to go out independently (subject to risk assessments that we saw) and others are supported by staff as needed. People told us they have access to a telephone and are able to keep in touch with family and friends.
People told us that they liked the staff as they were approachable and listened to them. Interaction that we saw between staff and people living at the home was relaxed and positive. People told us that they are encouraged to be independent with staff only offering assistance when needed with tasks they could not complete. We saw that people are able to move around the houses as they wish and are able to go to their rooms for privacy whenever they want.
Risks to people are recorded and steps taken to reduce any potential dangers. The only notable exception was the lack of recording to how staff would deal with one individual's epilepsy in the event of a seizure. This related to a person living at Hilton House. The individual in question had not had a seizure recently though, but staff would need to be aware of what was expected in the event they did. We saw in Walton and Welbeck House that people's plans included such guidance for people who have epilepsy.
People we spoke to told us that they had contact with health services as and when needed. One person told us 'If need to see anyone staff sort' in respect of health services. People told us about seeing opticians, dentists and their GP. Some people were out attending GP appointments on the day we visited Hilton House.
People told us that staff listen to what they say and deal with issues that may arise. One person told us they 'Talk to staff, if not happy, do something about it' and another said 'Can complain and staff listen to me'. Other people told us that they are 'Safe in here'. Some people told us that they meet with managers from the day centres they use and know they could raise concerns with them as well as their families. No one we spoke to had any worries about where they lived or the staff that supported them.
We spoke to staff about what they thought abuse was, and they showed us they had a good awareness of what should be reported. This meant that abuse would be investigated and people would be protected. Staff confirmed that the provider has a no restraint policy and this reflected what people told us.
People we spoke to told us that they get their medication on time. They told us they consent to the staff managing their medication. One person at Welbeck house said that their GP had reviewed their medication recently. They also told us that their medication is stored safely, and that when staff give them their tablets they can take these themselves.
All the houses we visited are adapted semi- detached buildings that blend in with the surrounding housing. There is nothing to indicate that they are anything other than a family home. We also saw that there is sufficient communal space in all the houses to allow people privacy when needed. We saw that people have access to keys to their bedroom doors, although most told us they are not to bothered about having these.
People from all three houses told us about how they are involved in the running of the home and their choices are listened to. They told us how redecoration of their rooms was chosen by them. They also told us about how changes within the service are discussed with them. People have meetings to discuss developments at their respective homes; minutes of these were seen and signed by people living at the homes. We also heard that people can speak to the managers or staff on a one to one basis should they wish.
They told us 'Its alright I love it here', 'Happy here' and 'Love it here, would be no where else'.
People told us that they like and have confidence in the staff team at their respective homes. One person told us 'they are pleasant helping out and all that'.
Staff told us that they have sufficient training to do their job and usually have refresher training every year.