We carried out a review of the data available to us about Hillbrow Residential Care Home Limited 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 Hillbrow Residential Care Home Limited, you can give feedback on this service.
We found the following examples of good practice:
The staff were following infection control procedures to help keep people safe. The registered manager ensured staff understood the importance of why infection prevention and control (IPC) measures were in place. Their hands-on practice was regularly checked to ensure they were following the latest guidance. There were suitable risk assessments and an up to date IPC policy and procedure in place. There were emergency plans in place should an outbreak occur at the home
Staff had undertaken recent IPC training and two members of staff had taken extended training. These two staff acted as champions and kept the staff updated on any changes within IPC.
The home was supported by a long standing, small and loyal staff team who knew the people they supported very well. No agency staff had been used since the beginning of the year as staff covered shifts if necessary. This meant people were supported by staff who knew them well. Two members of staff had been specifically trained to undertake people's Covid-19 testing which took place regularly.
Staff supported people in their well-being during lockdown. Staff offered one to one activities with people in their rooms and smaller groups in the communal areas. Some planned activities had taken place in a safe way. Recent photographs showed how much people had enjoyed their recent bonfire night treat with a small firepit bonfire, sparklers and snacks. The service facilitated people to keep in touch with their relatives and friends. Electronic tablets had been purchased to support these online meetings which people appreciated.
The director and registered manager clearly valued the importance of the dedicated staff team. They had given support treats to show their appreciation with other treats planned for Christmas. They were proud of their staff team and considered staff morale good.
The service booked named visitors in at specific times that suited people. Each family member had been informed by letter of the process they should expect when entering the home during the Covid-19 pandemic. There was a clear visiting procedure in place. Visiting took place in a completely self -contained pod which was accessed by patio doors from the garden. The pod had floor-to-ceiling perspex which meant both people and their visitors were completely protected. The pod was easily washable after each visit. There was a microphone system in place which supported those people who may be hard of hearing. Visitors to the home had their temperature taken and were asked a series of questions to ensure they had no symptoms of Covid-19 and were safe to visit the home.
Relatives who were visiting their family members at the end of their lives had a separate designated room which was accessed directly from the outside. This meant they did not have to travel through the home. Staff ensured these visitors followed recommended practice and used the appropriate Personal Protective Equipment ( PPE) with a change of clothes.
The service had received compliments about how well they were managing during the pandemic. These included, "Many thanks for all you are doing to keep our family members/your residents safe and happy", "We cannot thank you enough for your amazing and unstinting and cheerful and warm care. You guys are amazing" and "I personally know how gruelling and testing these times in care are … I salute you … heartfelt thanks to each and every one of you."
Hillbrow 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. Hillbrow provides accommodation and personal care to a maximum of 24 people who may have a physical condition or are living with dementia in one adapted building. At the time of our inspection there were 23 people living at the service.
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.
Staff were highly skilled and had a natural aptitude to give reassurance and comfort. They treated people with the utmost dignity and respect when helping them with daily living tasks.
Staff were highly motivated to ensure people received care which was compassionate and kind. The atmosphere in the home was warm and very friendly. People had developed strong relationships with staff, and it was evident that this was an important part of the ethos of the service. Staff spent quality time chatting and building interpersonal relationships with people and saw this as a vital part of their role. They recognised how this gave people a sense of overall well-being and ensured the family feel of the home.
People received exceptionally personalised care and support specific to their needs and preferences. There was an excellent understanding of seeing each person as an individual, with their own social needs.
The service strived to provide people and those that matter to them with rich and fulfilled lives. They had actively sourced new opportunities for people to connect with the world and with others. The activities coordinator had linked up with a national retailers’ Community Team who engaged in outreach work with people living in the local community. As a result, themed cafes had been developed at the home, where people were able to experience cooking and dining on food from different countries.
People were encouraged to socialise, pursue their interests and hobbies and try new things in a wide variety of inspiring and innovative ways. There was a focus on wellbeing and having a sense of purpose. The organisation, including all staff involved ensured people had access to as many opportunities as possible to aid their physical and mental health well-being. Activities formed an extremely important part of people’s lives and had a positive impact on their wellbeing.
People were supported to have a peaceful, comfortable and dignified end of life care in line with national best practice guidance.
The management team were forward thinking. They provided strong leadership; were good role models for all staff and drove up excellent practice to provide people with opportunities. They had established a service where staff were clear about the values and ethos of the service. It had a positive culture that was person-centred, open, inclusive and empowering. Staff were supported to reach their true potential.
People, relatives and staff described the service in outstanding terms. Relatives spoke fondly of the provider, registered manager and their staff team. They felt the service was an inspiration due to how it was run. Comments included: “The registered manager is fabulous”; “Exceptionally well run” and “Hillbrow is the best place in town, great reputation for years.”
People felt safe and staff demonstrated a good understanding of what constituted abuse and how to report if concerns were raised. Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.
There were effective staff recruitment and selection processes in place. Staffing arrangements were flexible in order to meet people’s individual needs. Staff received a range of training and regular support to keep their skills up to date in order to support people appropriately.
There were regular opportunities for people and people that matter to them to raise issues, concerns and compliments.
There was evidence of quality monitoring leading to continuous improvement and people were actively involved in the running of the service. For example, through regular resident meetings where both people living at Hillbrow and their relatives were able to have their voices heard and actions taken.
The management team strived to provide the best possible service for people. A number of effective methods were used to assess the quality and safety of the service people received and changes and improvements were made in response.
This inspection took place on 26 and 28 November 2015. The first day of the inspection was unannounced.
Hillbrow is located close to the centre of the small market town of Crediton. It consists of a large main house with the addition of single storey extensions. Hillbrow provides personal care and accommodation for up to 24 older people, some of whom are living with dementia. There are 22 single rooms and one double room, over two floors and there is a passenger lift in place. There is a large enclosed garden, with a pond. At the time of the inspection there were 23 people living at the home. At the last inspection of 19 September 2013, the service was meeting all of the standards inspected.
There was a registered manager at the home. 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.
There were sufficient numbers of staff to provide support and care for the people living at the home. Staffing numbers had recently been increased to meet increased needs of people. Risk and safety was managed well at the home. Staff supported people to keep safe, whilst still encouraging independence and freedom to do what they wanted. For example, by people being able to leave the home by themselves and staff observing them unobtrusively to ensure they were safe. Any accidents or incidents were investigated thoroughly and lessons learned would be shared with the staff team. Staff received training to keep their skills up to date and felt well supported by the registered manager and provider.
The building was well maintained, clean and hygienic. Staff took great pride in the cleanliness of the home. There had been investments recently in new carpets throughout some communal and corridor areas. A bathroom was to be converted into a new wet room, after full consultation with the people living at the home. People’s bedrooms were individually furnished; with many people bring their treasured items of furniture and belongings to the home. This made them feel settled and the room ‘ their own’.
Without exception people spoke to us in about the outstanding caring nature of the staff. Relatives told us that they were always made to feel very welcome and cared for when they visited. They said that staff always took time to talk to them and offer them drinks and so on. Comments included “Hillbrow has been so incredibly kind to my relative. They have been absolutely brilliant. They couldn’t have made us more welcome. They have done so much to help her, they are amazing. I can’t sing their praises enough. Our experiences are that it’s incredible.” Another relative said “I think it’s brilliant. Right from the first call to them, to x moving in.’’ We read a poem written by one of the people living at the home about the kindness shown to him and how happy at Hillbrow life could be. Another person told us “They don’t refuse me anything. They are very kind and I couldn’t ask for a better crowd.”
Health care professionals told us that staff always contacted them when they needed advice and they followed instructions well. There were good systems in place to record any health or social care professional advice and any visits were always discussed at the staff handovers. This meant that care staff were kept up to date about people’s current needs and care. Staff encouraged people to make choices about their everyday lives, and this was also recorded in peoples care plans. Care plans were reviewed at least every month and where possible people were also involved in discussing their care needs.
The Care Quality Commission (CQC) is required to monitor the operation of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection, applications had been made to the local authority in relation to people who lived at the service. The registered manager told us these were waiting to be approved.
Staff received regular training, supervision and annual appraisals. Staff told us that they were able to attend external training, as well as in house provision. The following week four staff were attending a dementia training course at the local hospital. There were regular activity sessions at the home, coordinated by an activities organiser who worked four days a week. People told us they enjoyed the quizzes and entertainment. There was a range of games, books, puzzles, crafts and so on for people to use. People told us they were looking forward to Christmas and all the events that had been planned with them.
There were systems in place to quality assure the standards and safety at the home. These included regular audits, surveys and resident and staff meetings. Where there were areas that needed to be improved, the provider and registered manager made sure that they made the changes and monitored them.
People were well cared for with their views, suggestions and experiences being taken into account and acted on. People told us that the home was "excellent" and that the staff were "very kind", "cheerful" and "jolly". We saw lots of laughter and interactions between people sitting and chatting together in the lounge.
People said they were consulted about everything that happened in the home. Staff were observed to be respectful toward people, to offer choice and to protect individual's dignity.
We spoke to ten people who lived at the home. All of them were positive about their life at the home and were confident that if any further care or support was needed it would be provided.
A varied nutritious balanced diet was provided and everyone we spoke to said they enjoyed the variety of food offered. People told us the food was "excellent" and complimented the cook on the choices offered. Special diets were catered for including vegetarian and diabetic options. Snacks, drinks and fresh fruit were available at all times.
People living at the home were encouraged to live as independently as possible with support provided as required. We were told that one person used their motorised scooter to maintain visits and contacts within the local community.
The home had a new computerised system for recording their records which were secure and confidential. We found that records were up to date and accurate with methods in place for monitoring changes. Staff said that " wouldn't want to go back to paper records".
Risks were well documented, alongside procedures to prevent occurrence.
We spoke to a person visiting the home who represented the interests of a person living at the home. They told us they had visited the home for over six years and had never had any concern for the safety and wellbeing of people. They said "improvements were constantly being made" and that they were always warmly welcomed by the owner and staff whenever they visited.
The owner and manager encouraged comments on the service provided. We saw a folder which contained many complimentary and thoughtful written observations from relatives and friends. Comments on the service were also made online through the home's website, which the owner encouraged. Visitors were welcomed at the home at any time. On the day of our inspection unexpected visitors arrived to view the home. We saw that they were welcomed and immediately showed around the home.
The home was clean. There were information packs and notices in the communal areas.
People were well cared for and they told us that they were happy. They said "It's nicely decorated, there are nice staff and the atmosphere is good." We were introduced to a person who lived at the home who was the representative for people there. A formal peer representative demonstrated the views of people were taken seriously. There were regular 'residents' forum meetings. Relatives said that their concerns were listened to and responded to appropriately.
In the management of medication we found that there were some security concerns which the manager assured us would be addressed the following week.
We saw that staff were checked before they started employment. One relative commented to us "I think they get good training here."
At the time of the inspection Mrs Gurr was the registered manager having been in post for one year. Mrs Heard having left the location. Mrs Gurr stated she had not needed to report any incidents to CQC.