Hillswood Lodge

We found the following examples of good practice

• A visiting policy was in place, which had been shared with relatives. This contained details of the system to book visits, timescale and sanitising procedures completed between each visit.

• Relatives were supported to spend time with people who were being cared for at the end of their life, whilst wearing Personal Protective Equipment (PPE) to ensure their visits were safe.

• Staff helped people to utilise technology to ensure they continued to have contact with their loved ones such as, video calls and a private social media platform.

• Staff continued to provide activities to help reduce social isolation and to promote people’s mental wellbeing.

• Additional cleaning had been implemented to lower the risk of cross transmission and changes had been made to the environment to encourage social distancing in communal areas.

• Staff were supported by the registered manager during periods of anxiety and had signposted staff to wellbeing services where needed.

Further information is in the detailed findings below.

Hillswood Lodge is a residential care home providing personal care to 19 people aged 65 and over at the time of the inspection. The service can support up to 21 people in one building. The service is registered to support people with needs such as dementia.

People’s experience of using this service and what we found

People were protected from the risk of potential abuse and risks to people were assessed and planned for. People told us they felt safe, medicines were stored safely and there were enough staff to meet people’s needs.

People had their needs and choices assessed and were supported by trained staff. The service ensured people had enough to eat and drink and catered for different dietary requirements. People were supported to access healthcare services when necessary. 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 told us they were treated with kindness by staff who knew them well. People were referred to advocacy services where appropriate and had their privacy and dignity respected.

People received personalised care that was responsive to their needs. The provider was working in line with the Accessible Information Standards and people were able to complain. There were plans in place to support people with end of life care.

The service had a positive person-centred culture. Both people and staff told us the registered manager was approachable, the service worked in partnership with others and engaged people and staff. The service was displaying its current rating as required and had sent us notifications when necessary.

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 5 January 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.

This inspection visit took place on 12 December 2016 and was unannounced. At the last inspection on 6 October 2015, the service was rated as Requires Improvement overall with specific concerns that there were not enough staff to meet people’s needs and manage the risks associated with their care and to ensure people who needed help with decision making were appropriately supported. The provider sent us an action plan on 30 October 2015 which stated how and when they would make improvements to meet the legal requirements. At this inspection, we found that some improvements had been made but further action was needed to ensure people's mental capacity to consent to care or treatment was always correctly assessed and recorded.

Since our last inspection, refurbishment works have been carried out to extend Hillswood Lodge and the home now provides accommodation and or personal care for up to 21 people. At the time of our inspection, 19 people were living at the home, some of whom were living with dementia. There was a registered manager at the service. 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.

We found that people’s capacity to make decisions was being considered. Staff sought people’s consent before providing care and supported people to make choices over their daily routine. However, the provider still needed to make improvements where people lacked the capacity to make certain decisions for themselves to fully demonstrate that their rights were being upheld. We have recommended the provider seeks advice on best practice in this area. Where people were being restricted to the home’s environment in their best interests to keep them safe, the appropriate approvals had been sought.

We found the required improvements had been made and risks to people’s health and wellbeing were assessed and managed; staff understood the actions they should take to minimise any identified risks. The provider had taken action to ensure there were sufficient, suitably recruited staff to keep people safe and promote their wellbeing and staffing levels were kept under review to ensure they continued to meet people’s changing needs. There were effective systems in place to ensure people’s medicines were administered, recorded and stored safely.

People felt safe living at the home and staff understood their responsibilities to protect people from the risk of abuse. Staff received training so they had the skills and knowledge to provide the care people needed. People were encouraged to eat and drink enough to maintain a healthy diet and were able to access the support of other health professionals to maintain their day to day health needs. People were encouraged to keep in contact with family and friends and visitors were able to visit without restriction. Relatives they felt involved in people’s care and were kept informed of any changes.

Staff had caring relationships with people and respected their privacy and dignity. Staff knew people well and people received personalised care. People’s care was regularly reviewed to ensure it continued to meet their needs. Improvements had been made and people were offered opportunities to take part in social activities and follow their hobbies and interests.

There was an open and inclusive atmosphere at the home. People and their relatives were asked for their views on the service and were positive about the improvements made by the provider. People felt able to raise concerns and complaints and were confident they would be responded to. Staff felt supported by the provider and manager and were encouraged to give their views on the service to improve people’s experience of care.

The manager carried out a range of checks and audits to continually assess monitor and improve the quality and safety of the service.

We saw people received the care and support that met their individual needs. We saw that people looked relaxed and comfortable in their home and staff interacted with people in a positive and respectful manner. People told us they were treated with care and compassion and the staff responded well to their needs or concerns. One person using the service said, 'You can't fault it.' Another person told us, 'I am happy and content.'

We looked at the suitability of the environment to ensure people lived in a home where the d'cor and environmental standards were appropriate. We found the home was clean, safe and well maintained.

We saw the provider regularly liaised with other agencies to ensure people's health and wellbeing needs were met.

The provider had systems in place to check on the quality of the care people received. The service was well led because the manager supported the staff team, had quality monitoring systems in place and managed risks effectively.

Sixteen people were in residence when we undertook our inspection. We spoke with seven people living in the home, three visitors, two staff and the registered manager. We were informed by a visitor that the staff were, 'Obliging and responsive.' People using the service expressed their satisfaction and one person said, 'I love it here, they look after you and it's comfortable.'

Staff we spoke with were enthusiastic about their jobs. They knew about the people they were caring for and they felt that the management of the home was supportive and encouraging.

We looked at the way medication was managed and saw that medication systems and practices were safe and suitable.

We looked at the recruitment procedures for staff and found that appropriate systems were in place to protect people using the service.

We found there were systems in place to deal with complaints quickly and appropriately.