Background to this inspection
Updated
7 November 2019
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 Care Act 2014.
Inspection team
The inspection was carried out by two inspectors and an assistant inspector.
Service and service type
37 Hilltop View is a ‘care home’. People in care homes receive accommodation and 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.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure the provider or registered manager would be in the office to support the inspection. We also wanted to ensure the people living at the service would be available for us to meet with.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
We observed the three people living at the service. Due to people’s complex needs we observed how they interacted with the staff team and how their care was delivered throughout the day. We spoke with five members of staff including the register manager, quality lead and care staff. We reviewed a range of records. This included two people’s care records, medicine records and activity plans. We looked at two staff files in relation to recruitment and staff supervision and a variety of records relating to the management of the service.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
7 November 2019
About the service
37 Hilltop View is a small residential home providing personal care to three people with learning disabilities at the time of inspection. The service can support up to three people.
The home is located on a cul-de-sac close to local amenities and is neighboured by another home registered with the commission and managed by the same provider. The home is an ordinary residence that has had some adaptations to meet people’s needs.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.
People were supported by sufficient numbers of staff who had been recruited safely and had an understanding of safeguarding procedures. Risks to people’s safety were considered and lessons were learnt when things went wrong. People received their medicine as prescribed and effective infection control measures were in place.
People’s care plans contained detailed information that ensured care was delivered to the standard required. Staff received training to enable them to meet people’s care and support needs. People were supported to maintain a balanced diet and had access to drinks throughout the day. The service worked well with other agencies and ensured people had access to healthcare services. The building was adapted to meet the needs of the people living there.
People 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.
People were well treated, and the team supported people to express their views as far as reasonably possible. People’s independence was promoted, and people’s privacy and dignity was maintained.
People had access to personalised activities and were supported to maintain important relationships. The provider understood the Accessible Information Standard and a complaints procedure was in place. While no one was in receipt of end of life care the home had considered people’s advanced wishes.
The service promoted a positive culture and the management team was described as supportive and approachable. People were clear of their roles and understood their responsibilities under the duty of candour. The service engaged people and worked in partnership with others. The service could demonstrate continuous learning and how this improved the care people received.
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 4 April 2017).
Why we inspected
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.