Hill House Nursing Home

Updated 29 January 2022

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.

We received information of concern about visiting arrangements at this service. This was a targeted inspection looking at the infection prevention and control measures the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 6 January 2022 and was unannounced.

Updated 29 January 2022

Hill House Nursing Home is registered to provide accommodation, personal and nursing care for up to 44 older people who may be living with a dementia. At the time of our inspection there were 41 people living at the home. The home offers both long stay and short stay respite care.

This inspection took place on 4 and 5 April 2018 the first day was unannounced.

Hill House 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. Accommodation was provided over three floors.

The last inspection was carried out in January 2017 and the overall rating for the service was 'requires improvement.' The provider was in breach of two regulations. These related to 'safe care and treatment' (Regulation 12) and 'good governance' (Regulation 17). We issued requirement notices in relation to these breaches. We asked the provider for an action plan which they provided telling us how they were going to make the necessary improvements.

During this inspection we found improvements had been made.

A registered manager was 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.

People told us staff treated them properly and they felt safe. One person said, “I feel safe and am happy here.” People were protected as staff had received training about safeguarding and knew how to respond to any concerns. There were systems in place to protect people from abuse. There was an up to date safeguarding policy in place and contact details for the local safeguarding adult’s team were displayed around the home.

Risk assessments were in place to help protect people from the risk of harm. People's risk assessments were reviewed regularly and provided guidance for staff in how to keep people safe and minimise the risks. Where people had been identified as at risk, records directed staff on the actions to take to reduce this risk. For example, some people were assessed as being at high risk of pressure damage to their skin and appropriate pressure relieving equipment was in place to minimise these risks.

People, relatives and health professionals were consistently positive about the caring approach of staff. Staff were kind, compassionate and caring toward the people they supported and spoke about people positively and with affection. The atmosphere in the home was calm and relaxed. People's privacy and dignity was respected by staff and people were encouraged to be as independent as possible, without compromising their safety.

People, relatives and staff told us they thought there was enough staff available to meet people's needs in a timely manner. One person said, “When I ring the call bell I never have to wait long.” People were supported by staff that had been safely recruited. Recruitment checks were in place and demonstrated that the staff employed had satisfactory skills and knowledge needed to care for people.

Staff were receiving appropriate training and they told us the training was good and relevant to their role. Staff told us they felt supported by the registered manager and were receiving formal supervision where they could discuss their on-going development needs.

Staff respected people's rights to make their own decisions and choices about their care and treatment. People's permission was sought by staff before they helped them with anything. When people did not have the capacity to make their own specific decisions these were made in their best interests by people who knew them well. Where people may need restrictions on their liberty and freedom in order to keep them safe applications had been made to the local authority to make sure people were not unlawfully restricted.

Staff were knowledgeable about people's needs and how to meet those needs. Care records were person centred and written in a respectful, sensitive and personalised way. They were well-organised and included information about each person. However, we found that some improvements could be made to ensure that all care plans included accurate detailed guidance on specific health needs to ensure people received responsive care at all times. We made a recommendation about reviewing the accuracy of care plans.

Medicines were managed safely and in line with current regulations and guidance. Staff had received appropriate training to help ensure safe practice. There were systems in place to ensure that medicines had been stored, administered and audited appropriately.

Quality assurance systems were in place to assess and monitor the service people received. Families were consulted so that their views could be gained. A survey of people's views was carried out in 2017 and showed people were very happy with the care delivery at the home. People told us they could raise concerns or complaints if they needed to because the registered manager and staff were always available and approachable and people were confident they would be listened to.