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Inspection Summary


Overall summary & rating

Good

Updated 3 January 2019

The inspection took place on 21 November and was unannounced.

Hillsborough House provides accommodation and personal care for up to 14 people with a learning disability. The home is a large converted villa in a residential area of Keynsham. The accommodation is set out over three floors which are accessed via stairs to the front and back of the house. At the time of our inspection there were 12 people living at the home.

The house had a kitchen, dining area, two lounges, an office and a staff sleeping room. Each person had their own bedroom and shared bathrooms.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager. 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.

At our last inspection in November 2017 we rated the service requires improvement and identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to good governance. At this inspection we found improvements had been made.

At this inspection the service has been rated good.

Improvements and changes had been made in staffing deployment, medicine guidance and care records. Staff were supported through an effective induction, regular supervision and training. There were opportunities for additional training specific to the needs of the service, including the care of people with epilepsy and autism.

Care records were not used consistently to ensure staff had easy access to important information that supported continuity of care. We have made a recommendation about this.

Emergency procedures were in place in the event of fire and people knew what to do, as did the staff.

People said the staff made them feel safe because they were kind and reliable. However, some improvements were required. Potential risks to people's health and wellbeing were not uniformly documented to ensure consistency in standard and quality of care plan reviews. Initial assessment care plans were not documented on the provider’s documentation. This meant the quality of the assessment of people's care needs was variable or did not routinely take place before the service began.

People enjoyed participating and achieving individual goals that were inclusive and personal to them. People received care that improved their health, wellbeing, independence and that enabled them to gain new skills and access their local community.

Medicines were managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately. Where errors had occurred, there was a protocol for staff to follow to minimise risk of harm.

People were happy and relaxed with staff and there were sufficient staff to support them. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector.

Staff were knowledgeable and trained in safeguarding adults and what action they should take if they suspected abuse was taking place. Staff had a good understanding of equality, diversity and human rights.

People were being supported to make decisions in their best interests. Consent to care and treatment was sought in line with the Mental Capacity Act 2005. Capacity assessments were untaken where appropriate and decisions taken in people's best interest were decisi

Inspection areas

Safe

Good

Updated 3 January 2019

This service remained safe

Effective

Good

Updated 3 January 2019

This service remained Effective

Caring

Good

Updated 3 January 2019

This service remained Caring

Responsive

Requires improvement

Updated 3 January 2019

The service was not constantly responsive.

People were involved in planning their own care and support. This ensured that care met their individual wishes and aspirations. However not all the documentation was used consistently to support this.

The service supported people to participate in activities, hobbies and holidays that were important to them.

People had access to information so that they could make informed choices about healthy eating and lifestyle choices.

The service supported people to access the local community.

People achieved goals in gaining skills in independence including undertaking their own shopping and managing their own finances.

Well-led

Good

Updated 3 January 2019

The service was well-led.

Improvements had been made since the last inspection.

Actions were taken to resolve concerns raised by people and their relatives.

Records were not consistently recorded on the providers documentation to ensure consistent quality and continuity of care.

The manager was approachable and highly regarded by staff, people and health and social care professionals.

The provider worked proactively with other agencies to ensure a good quality service was provided.