We carried out a review of the data available to us about Hill House Care Home 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 Hill House Care Home, you can give feedback on this service.
We found the following examples of good practice.
• The provider had appropriate arrangements for all visitors to help prevent the spread of Covid 19. Visitors were required to have their temperatures taken, complete a Covid 19 risk assessment which included screening for symptoms of Covid 19 before being allowed to enter the home. They were required to wear a face covering when visiting, and wash hands before and after mask use.
• The provider made good provision for people using the service to maintain links with family members, relatives and friends. People were supported to have visits from their relatives and friends in sheltered areas of the garden where two metre social distancing was observed. Visits were staggered and restricted to twenty minutes and these areas were cleaned between visits.
• So as to enable relatives and families to visit people receiving end of life care without having to enter the home, the provider has made ground floor 'ensuite' rooms available with doors directly accessing the garden.
• The provider was one of the first participants in the 'whole home testing' research commissioned by the Department of Health and NHS Digital. The findings of which were used to inform the national picture on testing in care and nursing homes.
• The provider had appropriate arrangements to test people and staff for Covid 19 and was following government guidance on testing. This ensured that people and staff were tested for Covid 19 so that appropriate action could be taken if any cases were identified.
• The provider ensured that all their staff received appropriate training and support to understand and to manage Covid 19. This included best practice for infection control and the use of PPE.
• Staff also received appropriate guidance on how to support people with dementia to understand the pandemic and Covid 19. Staff were grouped to work in specified areas of the home including domestic and housekeeping staff.
• The provider made appropriate support services available to staff in order to support their mental wellbeing through the pandemic and if they became unwell and when they returned to work.
• The provider recognised the disproportionate impact of the virus on health and social care workers from black, asian and minority ethnic (BAME) backgrounds. In response they have put in place a risk assessment process in line with guidance from the Workforce Race Equality Standard. This has enabled BAME colleagues to raise concerns and be heard.
Further information is in the detailed findings below.
Hill House is a care home which provides personal and nursing care. Hill House accommodates up to 60 adults some of whom were living with dementia. At the time of the inspection, there were 52 people living at Hill House which is located on a residential road in Kenley.
People’s experience of using this service and what we found:
People felt safe and were supported by staff who knew how to protect them from abuse and avoidable harm. People received their medicines when they were due. All areas of the home were clean, tidy and well maintained. People were protected from the risk and spread of infection. There were enough staff to support people safely and meet their needs.
People were supported by staff who were well trained and received regular performance reviews. Staff were kind and caring and treated people with respect. People received support to maintain their health and had access to external healthcare professionals. People had a choice of healthy meals and enough to eat and drink. People had the opportunity to take part in organised activities.
People's needs were assessed and they received care which met their needs. People were satisfied with the quality of care they received. They were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
All areas of Hill House were clean, well-furnished and well-maintained. The home was fully accessible and people moved freely around the home regardless of any mobility difficulties.
The registered manager and staff understood the responsibilities of their role. There were systems in place to obtain people's views and people knew how to make a complaint. There were appropriate systems in place to assess and monitor the quality of care people received.
For more details, please see the full report.
Rating at last inspection:
The last rating for this service was good (the last inspection report was published in November 2017).
Why we inspected:
We inspected Hill House on 4 June 2019. This was a planned inspection based on the previous rating.
Follow up:
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Hill House Care Home is registered to provide nursing and personal care for up to 58 adults. At the time of our inspection there were 53 elderly adults living in the home many of whom were living with dementia.
We previously inspected Hill House Care Home in September 2015 and found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to there being an insufficient number of staff to meet people’s needs, the lack of consistency with staff supervision and appraisal, the lack of person centred care and the lack of effective systems to assess the quality of care people received. We asked the provider to tell us how and when they would make the required improvements. These actions have now been completed.
The manager had applied to the Care Quality Commission (CQC) to be a registered manager for the service. A registered manager is a person who has registered with the CQC 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. At the time of our inspection, the manager's application was being processed.
People felt safe. Risk assessments were conducted and management plans were in place to minimise the risk of people facing avoidable harm. Staff had been trained in safeguarding adults. They knew how to recognise the signs of abuse and how to report any concerns.
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The provider recruited staff using an appropriate recruitment process which was consistently used. The provider carried out thorough checks on staff and they received an induction before they began to work with people. The staff were experienced registered nurses and care workers who had the skills, knowledge and experience to care for people effectively.
There was a sufficient number of staff on duty to help care for people safely. Staff understood their roles and responsibilities and were supported by the management through relevant training, supervision and performance reviews.
There were procedures in place to ensure that people received their medicines safely. People’s healthcare needs were met by suitably qualified staff. Regular checks were carried out to maintain people’s health and well-being. People also had access to healthcare professionals and staff liaised well with external healthcare providers. People were supported to plan their end of life care which was provided with consideration and compassion.
Staff asked for people’s consent before delivering care. People were involved in their care planning and felt in control of the care they received. Staff understood the main provisions of the Mental Capacity Act 2005 and how it applied to people in their care.
People were satisfied with the care they received and told us they were treated with respect and kindness. Staff ensured people received a nutritious, balanced diet. People were given enough to eat and drink although there was not as much variety and choice as people would have liked.
There were activities for people to participate in and the provider had started to implement plans to improve the variety and frequency of activities on offer inside and outside the home.
People were supported to express their views. The management and staff used their learning from accidents and incidents to improve the safety and quality of care people received. There were a variety of systems in place to assess and monitor the quality of care people received and these were consistently applied by staff.
We inspected Hill House Care Home on 24 and 25 September 2015. The inspection was unannounced.
Hill House Care Home is a service which provides nursing and personal care to elderly adults. At the time of our visit there were 51 people using the service.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The registered manager was not at work on either day of our inspection.
People felt safe. There were procedures and risk assessments in place which staff implemented to reduce the risk of harm to people. Staff had been trained in safeguarding adults. They knew how to recognise the signs of abuse and how to report any concerns.
There were procedures in place to ensure that people received their medicines safely which staff consistently followed. People were protected against the risk and spread of infection.
Appropriate checks were carried out on staff and they received an induction before they began to work with people living in the home. Staff understood their roles and responsibilities. However they were not adequately supported by the management through regular supervision and performance reviews.
There was not a sufficient number of staff on duty to meet people’s needs. Some people told us staff did not have time to speak to them.
People’s care records were not person centred and did not focus on people’s individual needs, personal preferences and dislikes.
Staff asked for people’s consent before delivering care. Staff understood the main provisions of the Mental Capacity Act 2005 and how it applied to people in their care.
Regular checks were carried out to maintain people’s health and well-being. People also had access to healthcare professionals and staff liaised well with external healthcare providers. People were supported to plan their end of life care.
People were treated with kindness and respect. Staff ensured people received a nutritious, balanced diet. People were happy with the quality of their meals and said they were given enough to eat and drink. There were a variety of group activities for people to participate in inside the home but few if any opportunities for people to leave the home unless they had the support of their relatives.
Comprehensive internal audits were conducted to check the quality of care people received. However, where areas for improvement were identified and an action plan put in place, management did not always implement the action plan.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to there being an insufficient number of staff to meet people’s needs, the lack of consistency with staff supervision and appraisal, the lack of person centred care and the lack of effective systems to assess the quality of care people received. You can see what action we told the provider to take at the back of the full version of the report.
People's care and treatment was carefully assessed to ensure their personal needs and preferences were addressed. One person who was due to go home soon said ''Oh dear how will I cope, I have been so spoilt.'' Another person using the service said ''Nothing in life is perfect, you have to be realistic. The food is very good and if you don't like what they serve you can get something else. The chef even goes round the dining room to speak to people to see if they are happy.''
People using the service and staff were protected from infection through the use of safe clinical practice and thorough cleaning procedures.
Through effective recruitment procedures staff were appropriately appointed so that people using the service could be confident they would be cared for by the right people. One person using the service said '' Matron has high expectations of her staff and she makes sure she gets what she expects.''
Essential records were safely stored and maintained to ensure provision of safe care and effective communication.
During this visit we looked at the care records of three people and found them to be comprehensive. The care plans were reviewed regularly and any changes that were identified were addressed. Care plans showed that where formal consent had been required the relatives and families of people had been involved in the process.
People told us that they felt safe and if they had concerns they would speak with a staff member, matron or the provider.
One person told us, 'They are good to me and look after me well'; another person said 'Staff are very good' and 'I have no concern'. Everyone spoke positively about their care workers and felt that they fully supported their care needs.