Hillside

Updated 9 March 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.

Inspection team

This inspection was completed by one inspector.

Service and service type

Hillside 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. Hillside 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a manager in post who had started the process of registering with the CQC.

Notice of inspection

This inspection was unannounced. Inspection activity started on 08 February 2023 and ended on 16 February 2023. We visited the home on 08 February 2023.

What we did before the inspection

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 spoke with the local authority to gain their views of the home and we reviewed the records we hold. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people who lived at the home, but some people were unable to talk with us, so we spent time seeing how staff supported people in their day to day lives at the home. We spoke with four members of the care staff, the manager, operations manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We looked at a series of documents on each visit to the home. These related to fire safety checks, risk assessments, care plans, and medicine records for five people who lived at the home.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 9 March 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Hillside is a care home providing personal care and accommodation to seven people. The home is a house with a garden and access to the local town. Most people who were living at Hillside had physical and learning disabilities, including autistic people. The home can support up to eight people.

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

Right Support:

People did not consistently receive safe care at the home. New and changing needs were not managed in a safe way for people, which put them at risk. Medicines were poorly administered which meant sometimes people did not get their medicines. Managers and staff did not seek advice when one person was possibly having too much of one of their ‘as required’ medicine, or when they were being given this medicine for the wrong reasons. People did not have care plans in place to support staff to look after them. Their personal documents were not protected. People’s independence was not always encouraged at the home. There was enough staff on duty to support people.

Right Care:

No meaningful or effective work had been completed to check if people were happy with the care provided. No work had been completed to look at people’s life goals and aspirations and make plans to try and make these happen. Staff were polite with people, but they did not routinely chat with people as friends and help them follow their interests. Staff did not promote the home as people’s own home. Parts of the home looked tired and were uncared for. Some people’s bedrooms needed decorating and items replaced, to promote their dignity and make it an enjoyable space to be in.

Right Culture:

The leaders of the home had not created a culture which established a safe and person-centred experience for people to live in. Managers had planned for a new person to move into the home in a way which made them and others feel comfortable about this. But managers had not made plans to ensure there were systems to check they were safe and staff had the knowledge and skills to meet their needs. The provider was not effectively assessing the quality of the care at the home. They were not looking at what people’s experiences were like. The provider had made some improvement plans but these lacked detail and no actions had been taken to improve people’s experience of living at the home.

Based on our review of safe and well led the service was not able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

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

Rating at last inspection

The last rating for this service was good (published 7 August 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to people’s safety, management’s response to safeguarding concerns, person-centred care and failures in the leadership of the home at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.