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Inspection carried out on 6 March 2017

During a routine inspection

The Hillings is registered to provide accommodation and personal care for up to 72 people. There were 66 older people living in the service at the time of the inspection.

This unannounced inspection took place on 6 March 2017.

There was a registered manager in post at the time of this inspection. 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.

Risk assessments did not always provide sufficiently detailed information for staff about how to manage risks to people. Where quality monitoring systems had identified that improvements were required, action plans were in place to monitor the improvements.

Accidents and incidents were reviewed to reduce the risk of any reoccurrence.

People received their medicines as prescribed and medicines were stored and disposed of in a safe way. Staff who administered medicines had received appropriate training.

The provider had a recruitment process in place and staff were only employed within the service after all essential safety checks had been satisfactorily completed. Staff were knowledgeable about reporting any incidents of harm. People were looked after by enough staff to support them with their individual needs.

People were provided with a choice of meals. When necessary, people were given any extra help they needed to make sure that they had enough to eat and drink to keep them healthy.

Staff referred people appropriately to healthcare professionals.

The service was acting in accordance with the requirements of the MCA including the DoLS. The registered manager was able to demonstrate how they supported people to make decisions about their care. Where people were unable to do so, there were records showing that decisions were being taken in their best interests. DoLS applications had been submitted to the appropriate authority. This meant that people did not have restrictions placed on them without the correct procedures being followed.

Staff knew how to meet people’s current needs. Staff were trained, supported and supervised to do their job. Staff treated people with dignity and respect.

People were encouraged to maintain hobbies and interests and join in the activities provided at the service and in the community.

People’s views were listened to and acted on. People received care and support in the way they preferred.

Quality assurance procedures were in place and these were effective in identifying areas for improvements.

Inspection carried out on 21 June 2016

During a routine inspection

The Hillings provides accommodation and personal care for up to 72 older people including those living with dementia. The home comprises of seven units and is a single storey building. There were 72 people living in the home when we visited.

This inspection was unannounced and took place on 21 June 2016.

The home had a registered manager in post. 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 and associated Regulations about how the service is run.

The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) which applies to care services. Not all staff spoken with during this inspection were able to demonstrate that they were aware of the principles of the MCA or DoLS and their obligations under this legislation.

There were adequate staffing although staff deployment in one unit was not effective and people’s needs were not always being met in a timely way.

Care plans contained all of the relevant information that staff required so that they knew how to meet people’s current needs. We were confident that people would receive the care and support that they needed.

Risks had been managed to keep people as safe as possible. Risk assessments had been completed when necessary. This meant that staff had the information they required to ensure that people received safe care.

The provider had a recruitment process in place and staff were only employed within the home after all essential safety checks had been satisfactorily completed.

People’s privacy was respected at all times. Staff were seen to knock on the person’s bedroom door and wait for a response before entering. People’s dignity was not always protected because there was information on display that contained people’s personal information.

People were provided with a varied, balanced diet and staff were aware of people’s dietary needs. Staff referred people appropriately to healthcare professionals. People received their prescribed medicines in a timely manner and medicines were stored in a safe way.

The provider had a complaints process in place and people were confident that all complaints would be addressed. Although not all complaints had been documented

The provider had an effective quality assurance system in place to identify areas for improvement. Therefore they were able to demonstrate how improvements were identified and acted upon.

Inspection carried out on 28 May 2015

During a routine inspection

The Hillings is registered to provide accommodation and non-nursing care for up to 72 older people. Some of the people accommodated in the home were living with dementia. The home comprises of seven units and the home is a single storey building. There were 70 people living at the home at the time of our inspection.

This unannounced inspection took place on 28 May 2015. At our previous inspection on 14 May 2014 we found the provider was meeting all the regulations that we looked at.

At the time of this inspection the home 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 and associated Regulations about how the service is run.

Staff treated people in a way that they liked but sufficient numbers of staff were not deployed to safely meet people’s needs. People received care which had maintained their health and well-being. Relatives were very happy with the care provided although they were concerned about staffing levels.

Medicines were stored correctly and records showed that people had received their medicines as prescribed. Staff had received appropriate training for their role in medicine management and had their competency regularly assessed.

Staff had a good understanding of how to protect people from harm. They were knowledgeable about safeguarding procedures and had received appropriate training.

Staff supported each person according to their assessed needs. This included people at risk of malnutrition or dehydration who were being supported to receive sufficient quantities to eat and drink.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found that people who used the service had their capacity to make day-to-day decisions formally assessed. At the time of our inspection no one in receipt of care had been deprived of their liberty.

Staff respected people’s privacy and dignity. They knocked on people’s bedroom doors and waited for a response before entering. Staff ensured doors were shut when they were assisting them with their personal care.

People’s personal and health care needs were recorded in their plans. Risk assessments were in place and staff knew people’s needs. Care plans were regularly reviewed to ensure that they accurately reflected people’s current needs

People confirmed that they were offered a variety of hobbies and interests to take part in and that they were able to change their minds if they did not wish to take part in these.

The provider had a complaints procedure in place which people had access to. Advocacy support information was available if.

Effective quality assurance systems were in place and people’s views were sought and used to improve the service.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 14 May 2013

During a routine inspection

We spoke with a number of people who lived at the Hillings. People told us they were happy with the service being provided. One person said, “It’s very nice here. Everyone’s very friendly and we’re looked after well.”

On the day of our inspection there was a very relaxed, homely atmosphere. Staff treated people with respect and supported them to remain as independent as possible.

Care records gave staff clear guidance on meeting each person’s individual needs. Potential risks to people had been assessed and plans put in place to minimise the risks.

The environment of the home was well maintained and there were various outside areas for people to enjoy.

The provider had a recruitment procedure in place to ensure that the staff employed were suitable to work at the home.

People told us they knew how to complain, but had never had to.

Inspection carried out on 29 August 2012

During a routine inspection

People made positive comments about their care and the staff who supported them. One person who shared their care plan with us said they had signed their agreement to their care plan and had made decisions about their care arrangements.

One person said, "I have no complaints, they (staff) are always kind, caring and polite”. Another person told us, “The staff are kind and helpful. Staff answer my call bell but not always very quickly and nothing seems too much trouble”.

All the people we spoke with told us they felt safe living at the home.

Inspection carried out on 14 October 2011

During a routine inspection

People told us that they liked living at The Hillings. One person told us that they could not think of any better place to live in. They advised that this was because they liked the staff, who treated them well and that their care and support needs were always met when they wanted the assistance from the staff. We were told that, "They (the staff) are really good. They can't do any more for us".

Another person, when viewing the progress of the ongoing building and refurbishment work, said, "They're doing a good job".

Reports under our old system of regulation (including those from before CQC was created)