Archived: Hilltop

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. We spoke with three people who used the service and one family member. We spoke with the registered manager, the deputy manager and with one care worker. We also spoke with managers from two day centres. We looked at five care records and five staff records.

If you want to see the evidence which supports our summary please read the full report.

Is the service safe?

A family member told us 'I know my relative is in safe hands.' Members of the senior management team were on call 24 hour hours a day, seven days a week in case of an emergency. The service was staffed at all times. The provider ensured their staff had the skills and experience needed to support those who used the service. Care workers were trained in safeguarding awareness and demonstrated their knowledge of this to us. They also had an understanding of the Mental Capacity Act 2005 and how it applied to those who used the service. We saw there were risk assessments in place for those who needed them and these were regularly reviewed.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager had applied for, and the local authority had granted four DoLS. Policies and procedures were in place to provide staff with guidance about legal requirements. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

It was clear from what we saw and from speaking with staff they understood people's care and support needs. A family member told us how 'my relative has done so well there.' We saw a comment made by a person who used the service in response to the satisfaction survey, 'I can make simple meals.' We saw from staff records they had received training to meet the needs of the people living at the home. A day centre manager told us, 'I have seen this person become more and more stable over the years. The team at Hilltop is a good one.'

Is the service caring?

We were told by a care worker how respect and dignity of people were observed and how permission was sought before any personal care was given. Care plans were developed to meet identified needs, which were reviewed every year, or more frequently as required. It was clear from speaking with staff they understood people's care and support needs and how to deliver them. We saw a comment made by a person who used the service in response to the satisfaction survey, 'I love everything about my support'. We observed how care workers were patient and gave encouragement to people to engage in activities. They responded quickly to calls for support and ensured their explanations were understood before moving on.

Is the service responsive?

Records confirmed people's preferences, interests, and diverse needs had been recorded and care and support had been provided which met their wishes. A care worker told us how, 'all risk assessments must be changed when the service user's needs change.' We saw on the daily record where a member of staff had observed a person who used the service looked unwell. We subsequently saw how this person was accompanied to the GP for a check-up.

Is the service well-led?

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. We saw surveys which asked for feedback on the service. We were told the provider carried out an audit of the service every three months and in addition, the registered manager did an audit of records each month in order to produce a monthly report to the provider. Staff told us they were clear about their roles and responsibilities. They also told us management support was very good and there was a manager on call 24 hours a day. One care worker told us, 'the manager responds straight away if I express any concerns about my work.'

Care plans were person centred and were updated regularly. People's strengths and needs were identified and when goals reached praise was given. Risk was identified and was monitored by staff. Staff knew the people they cared for well and were able to tell us what they liked to do on a daily basis. We spoke to one person at the home and they said "I'm alright."

The home was clean and tidy and staff used personal protective clothing appropriately. There was antibacterial gel and hand washing facilities.

Appropriate checks were carried out by the home to ensure staff were suitable to work. The home had a clear complaints policy for both people in the home to use and for external visitors.

Care was planned in a way that took into account peoples past experience, life history, likes and dislikes.

People told us they were able to make themselves a drink or snack when they wanted to and described how they helped with choosing their meals and with preparing them. One person said, 'I like the food and we get to eat what we want. If we change our mind the staff don't mind.'

People told us they felt happy in the home and that they would "tell the manager" if they felt something was wrong, if they experienced being treated badly or if they saw someone else being treated badly.

We saw evidence that the organisation provided staff with regular internet based 'e learning' and in house training. Topics covered included infection prevention and control, food hygiene, safeguarding, equality and inclusion and health and safety.

We saw the organisation carried out a comprehensive quarterly audit which covered areas such as service user files, service user issues, health and safety, staff issues, medication and personal care. We saw the last audit carried out in November 2012.