Archived: Hillcrest Residential Home

Updated 22 September 2018

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This unannounced inspection took place on 3 August 2018 and was undertaken by one inspector.

Prior to the inspection, we reviewed information we had received about the service such as notifications. This is information about important events which the provider is required to send us by law. We also looked at information sent to us from other stakeholders, for example the local authority and members of the public.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This had not been returned. The provider did not meet the minimum requirement of completing the Provider Information Return at least once annually. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we made the judgements in this report.

During our inspection, we looked at the care records of four people, recruitment records of four staff members and records relating to the management of the service and quality monitoring. We also looked at staffing rotas and other documents regarding the running of the service including medicine records. We spoke with all eight people living at the service and three relatives. We observed the staff interactions with the people at the service. We spoke with the registered manager, partner and two members of staff.

Updated 22 September 2018

Hillcrest Resident 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.

Hillcrest Residential Home is a care service for up to 13 older people who may be elderly, have a physical disability or could be living with dementia. The service does not provide nursing care.

There were eight people living in the service when we inspected on 3 August 2018. This was an unannounced inspection.

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 2008 and associated Regulations about how the service is run.

At our last inspection of March 2017, we identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service had failed to ensure the safe and proper administration of medicines. The service did not have an effective quality assurance monitoring process in place. There were no policies and procedures regarding the MCA and consent in place. The service had not informed us of important information as it is required to do.

In the key line of enquires questions for safe, effective and well-led we rated the service as ‘requires improvement’. In the key line of enquires for care and responsive we rated the service ‘good’. This resulted in the overall rating of the service for that inspection being ‘requires improvement’.

At this inspection of August 2018, we noted there have been improvements to the service but further improvements are necessary as the service remains at a rating of ‘requires improvement’. There were no breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. In the key line of enquiries question for effective the rating has improved to ‘good’ but safe and well-led were still rated as ‘requires improvement’.

The administration of medicines had improved since our last inspection but still required further improvement to be safe. Medicines were now administered individually and staff completed the medication administration record (MAR) chart after each administration.

The formal monitoring and audit systems now in place continued to require further operational evidence to show how the registered manager and senior staff assessed the quality of the service, identified shortfalls and ensured that these were addressed promptly. This resulted in a lack of oversight of the whole service from the registered manager and identification of areas that required improvement. People using the service did not have a Personal Emergency Evacuation plan.

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 relation to the Mental Capacity Act 2005 (MCA) were up to date.

The service had sent notifications to the Care Quality Commission of important events that had happened at the service.

There were sufficient numbers of staff employed at the service to care for the people living in their home. The rota was clear with regard to which staff were working. The registered manager or senior staff on duty were cooking the meals for people to cover a vacancy in the catering team.

The recruitment process for the employment of staff was clear and safe procedures were followed.

There remained some gaps in training records but staff had received some training and supervision since our last inspection and further training and supervision was planned.

People had sufficient amounts to eat and their dietary nutritional needs were met. People were encouraged to attend appointments with health care professionals to maintain their health and well-being.

There were strong and caring relationships between the people using the service and the staff that supported them. People were encouraged to be as independent as possible by a staff team who knew them extremely well. People were not always able to call for assistance if needed by the use of their call bells due to their capacity but we saw staff checking upon people to determine their well-being on regular occasions.

The service had a complaints system and also recorded compliments. The service worked with other professionals providing multi-agency support to enable people to stay in their own home as long as they wished.