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Hillside Farm Care Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 2 October 2019

About the service

Hillside Farm Care Home is a residential care home providing accommodation with personal and nursing care to eight people aged 65 and over at the time of the inspection. The majority of people living at the home are older people living with dementia. The service accommodates up to 10 people in one adapted building and is in a rural setting outside the village of Bunny in Nottinghamshire.

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

People did not always receive their prescribed medicines safely. Risks associated with the service environment were not always assessed and mitigated.

We recommend that the manager ensures that risks relating to people’s health and safety are reviewed. We also recommend that the manager ensures that their management system identifies and manages risks.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Although the manager understood the principles of the Mental Capacity Act, they had not ensured that they had consistently followed these principles.

The manager understood their role and responsibilities in relation to managing a registered care home. The manager undertook audits of all aspects of the service to review the quality of care, and identify areas where improvements were needed. However, these audits and checks did not always identify areas for improvement.

People and their relatives felt the service was safe. Staff understood how to recognise and report concerns or abuse. People were protected from risks associated with their assessed health needs. There were enough staff to keep people safe, and people were protected from the risk of infections. Accidents and incidents were reviewed and monitored to identify trends and to prevent reoccurrences.

People's needs and choices were assessed in line with current legislation and guidance in a way that helped to prevent discrimination. People and relatives felt staff got the right training to meet their needs. People were supported and encouraged to have a varied diet that gave them enough to eat and drink. People were supported by staff to access healthcare services when required. The manager had taken steps to ensure the environment was accessible for people.

People and relatives spoke positively about the staff who supported them. People and relatives were involved in making decisions about care. People said staff always treated them with respect. Staff had a good understanding of dignity in care and had training in this. Staff respected people's right to confidentiality.

People were regularly asked for their views about their care. Relatives were also involved in reviewing family members’ care with them. Staff were proactive in responding to people’s individual needs and encouraged them to do things which were meaningful to them and made them happy. The manager had a system in place to respond to complaints and concerns. People and their relatives were encouraged to talk about their wishes regarding care towards the end of their lives.

People and relatives felt the service was well-led. Staff felt supported in their work, and there was a positive team attitude.

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 31 January 2019).

Why we inspected

The inspection was prompted in part due to concerns received about how medicines were managed. A decision was made for us to inspect and examine those risks. We found evidence during this inspection that people were at risk of harm from this concern. Please see the Safe section of this full report.

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

Inspection areas

Safe

Requires improvement

Updated 2 October 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 2 October 2019

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 2 October 2019

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 2 October 2019

The service was responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 2 October 2019

The service was not always well-led.

Details are in our well-Led findings below.