We carried out a review of the data available to us about Hillcroft Residential Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Hillcroft Residential Care Home, you can give feedback on this service.
Hillcroft Residential Care Home is a care home providing personal care to up to 34 people. The service provides support to older people, people living with dementia and younger adults. At the time of our inspection there were 30 people using the service.
The home is set over 3 floors and there is a secure unit for people with dementia. There are communal areas for people to use and parking facilities for visitors.
People’s experience of using this service and what we found
People were supported to take their medicines and staff assessed risks to people’s health and wellbeing. We have made recommendations regarding storage of some medicines, and fire safety. People were supported by enough staff to meet their needs, and staff knew people well. The home was clean and comfortable, and we observed staff wearing PPE. People were protected from the risk of abuse and from the risk of mistakes being repeated due to effective systems and processes. People told us they felt safe; 1 person said, “The staff are wonderful and give me reassurance. Staff are always around so I feel safe and don’t get lonely.”
Staff completed person centred care plans that included detailed information about people’s needs, choices and preferences. People spoke highly of the food, and we observed a range of healthy choices. People could personalise their bedrooms, and communal areas were fit for purpose. People were supported by well-trained staff who had the right knowledge, skills and experience.
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.
We found a positive culture at the home. People and their relatives spoke highly of the staff, and staff told us they loved their jobs. Staff said the current registered manager had made a lot of changes which had improved the service, and said they felt supported in their roles.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at the last inspection
The last rating for this service was good (published 10 December 2019).
Why we inspected
We received concerns in relation to the management of safeguarding issues, and cleanliness and hygiene. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has remained good based on the findings of this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Hillcroft Residential Care Home (Hillcroft) is a residential care home registered to provide accommodation and personal care for up to 34 people. At the time of the inspection 28 people were living in the service.
People's experience of using this service and what we found
The practices adopted by the home and the opportunities made available to those who lived at Hillcroft clearly had a positive and encouraging impact on their physical, social and emotional well-being. This was confirmed by everyone we spoke with and was evidenced through our observations and reviewing of records.
People were safe living at Hillcroft. The practices adopted by the home protected people from harm. Enough staff were on duty to meet the needs of people and robust recruitment practices were in place. Potential risks were handled well and medicines were managed safely. People looked relaxed in the company of staff and relatives confirmed they felt people were safe living at Hillcroft.
An extensive range of training had been provided for the staff team, which helped to ensure people received the care and support they needed. Community health and social care professionals had been involved in the care and support of those who lived at the home and people's dietary needs were being fully met.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People received good care. Their preferences and wishes were respected by the staff team. People were treated with dignity and respect and were involved in the decision-making process. Care files were extremely person-centred. Clear guidance was available about how to communicate with people effectively and independence was consistently promoted. An excellent range of activities were provided. One person who lived at Hillcroft told us, “Staff are kind and caring. They all walk the extra mile to accommodate me.” Another said, “I get on really well with all the staff; they are kind and caring to everyone. They always have time for a chat and they bend over backwards to help you.”
The management and staff team were open and transparent during the inspection process. There was evidence of community engagement taking place. A wide range of regular audits and monitoring was evident. We received positive feedback about the manager of the home and the staff team.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection: The service was rated overall good at the last inspection (Published on 27 April 2017). However, the area of well-led was rated as requires improvement with recommendations being made around care planning and reviewing of policies and procedures. At this inspection we found improvements had been made in both these areas.
Why we inspected: This was a scheduled inspection based on the previous ratings.
Follow up: The service will be re-inspected as per our inspection programme. We will continue to monitor any information we receive about the service. The inspection may be brought forward if any risks are identified.
The last inspection of this location was conducted on 19 January 2015. Although an overall rating of ‘Good’ was awarded at that time, we did find two breaches of the previous Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. These were in relation to the management of medicines and the recruitment of staff. We asked the provider to tell us what they were going to do in order to address the shortfalls identified. The provider submitted an action plan, as requested.
This inspection was conducted on 31January 2017 and it was unannounced, which meant that people did not know we were going to visit the home.
The registered manager was on duty at the time of our 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 of the Health and Social Care Act and associated regulations about how the service is run.
At our last inspection on19 January 2015 we found that the registered person had not implemented robust procedures for the safe keeping of medicines. Therefore, this area was in need of improvement. We made a requirement about this. The provider sent us their action plan, which showed that actions would be completed by 20 March 2015.
During the course of this inspection we assessed the management of medicines. We found that on this occasion improvements had been made in this area, which helped to protect people from any risks associated with the unsafe use of medicines. Therefore, the previous breach of the Health and Social Care Act regulations had been met.
At our last inspection on 19 January 2015, we found that recruitment practices were not always sufficiently robust, in order to ensure that people employed were fit to work with this vulnerable client group. Therefore, this area was in need of improvement. We made a requirement about this. The provider sent us their action plan, which showed that actions would be completed by 20 March 2015.
At this inspection we looked at the personnel records of four staff members, who had been recruited since our last inspection on 19 January 2015. We found that on this occasion new staff had been appropriately appointed and therefore people who lived at Hillcroft were protected by the recruitment practices adopted by the home. Therefore, the previous breach of the Health and Social Care Act regulations had been met.
We found that a varied training programme had been provided for the staff team, which helped them to keep abreast of current practices and any changes in legislation. Regular supervision sessions for staff and annual appraisals were also being conducted.
At this inspection we found the environment to be warm and well maintained throughout. However, we did note an unpleasant smell in one area of the home. We observed staff members interacting well with those who lived at Hillcroft. People looked happy and comfortable in the presence of staff and were enjoying their company.
Records showed that although a wide range of risk assessments were established at the home, in relation to people’s health, safety and welfare, these had not always been fully completed and did not always accurately reflect people’s needs. Staff we spoke with were able to discuss people's needs well and it was quite clear that they were able to provide the care and support each person required in a kind and caring manner. However, people's plans of care were not always reflective of their current needs. The recording of information could have been better in some areas and documentation could have been more accurate. We made a recommendation about this.
Fire procedures were easily available, so that people were aware of action they needed to take in the event of a fire and records we saw provided good information about how people needed to be assisted from the building, should the need arise. Records showed that equipment and systems within the home had been serviced in accordance with the manufacturer’s recommendations. This helped to protect people from harm.
People's privacy and dignity was consistently respected. Records showed that Mental Capacity Assessments had not always been conducted, in order to determine capacity levels, prior to important specific decisions being made. We made a recommendation about this.
The service had reported safeguarding concerns to the relevant authorities and suitable arrangements were in place to ensure that staff were deployed, who had the necessary skills and knowledge to meet people's needs safely. A range of health and safety training was provided for the staff team.
People we spoke with were aware of how to raise concerns, should they need to do so. A complaints procedure was in place at the home and a system had been implemented for the recording of complaints received.
The service worked well with a range of community professionals. This helped to ensure that people's health care needs were being appropriately met. Meals were being well managed.
People we spoke with were complementary about the staff team. They felt that they were treated in a kind, caring and respectful manner. People expressed their satisfaction about the home and the services provided.
Regular meetings were held for the staff team. This enabled those who worked at the home to discuss topics of interest in an open forum.
Hillcroft is situated in a residential area of Ormskirk. The home is on three floors, with passenger lift access. Accommodation is provided in both single and shared rooms for up to 34 adults, who need assistance with personal care. En-suite facilities are installed in all bedrooms, 25 of which have wet rooms and 9 having bathrooms. Communal bathrooms and toilets are available throughout the home. There are some amenities, such as shops, a post office, church and pub within a short distance and Ormskirk town centre is easily accessible by car or public transport. Some car parking spaces are available at the home.
This unannounced inspection was conducted on 19th January 2015 and was carried out by two Adult Social Care inspectors from the Care Quality Commission. The registered manager was on duty when we visited Hillcroft. She had managed the day-to-day operation of the service for eight years. 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 of the Health and Social Care Act and associated regulations about how the service is run.
At the time of this inspection there were 32 people who lived at Hillcroft. We spoke with eight of them and two of their relatives. We asked people for their views about the services and facilities provided. We received positive comments from everyone. We spoke with nine staff members and the registered manager of the home. We looked at a wide range of records, including the care files of four people, whose care we ‘tracked’ and the personnel records of two staff members. We observed the activity within the home and looked at how staff interacted with people they supported.
Staff members were well trained and had good support from the management team. They were confident in reporting any concerns about a person’s safety and were competent to deliver the care and support needed by those who lived at the home.
The recruitment practices adopted by the home did not consistently ensure that only suitable people were appointed to work with this vulnerable client group. Necessary checks had not always been conducted before people were employed and this created a potential risk for those who lived at Hillcroft.
This was a breach of Regulation 21 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.
The home had been tastefully refurbished throughout since our last inspection and a new well-designed 11 bedded unit had been added. The premises were safe and maintained to a high standard. Equipment and systems had been serviced in accordance with the manufacturers’ recommendations, to ensure they were safe for use. This helped to promote people’s safety.
The planning of people’s care was based on an assessment of their needs, with information being gathered from a variety of sources. Regular reviews were conducted with any changes in circumstances being recorded well. A range of assessments had been conducted within a risk management framework and strategies had been implemented to promote people’s safety and well-being.
People were helped to maintain their independence. Staff were kind and caring towards those they supported and interacted well with the people who lived at Hillcroft. Assistance was provided for those who needed it in a dignified manner and people were enabled to complete activities of daily living in their own time, without being rushed.
Staff we spoke with told us they received a broad range of training programmes and provided us with some good examples of modules they had completed. They confirmed that regular supervision sessions were conducted, as well as annual appraisals.
Staff spoken with told us they felt exceptionally well supported by the registered manager of the home. They spoke in a complimentary way about her management style and described her as being, ‘approachable’, ‘lovely’ and ‘an excellent manager’.
The management of medications did not always promote people’s safety. Medication records were well maintained and detailed policies and procedures were in place. However, we noted the treatment room door was left unlocked whilst the room was vacant. The medicine storage cupboard was also unlocked, which created a potential risk for those who lived at the home.
This was a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.
Comments from those living at the home and a relative included:
"I have no complaints whatsoever. My husband is always clean and comfortable."
"I like living here. The staff are smashing and very caring."
"The only problem here is that there's not much going on. I do get bored sometimes."
During our inspection we assessed standards relating to care and welfare and how people were supported to be involved in the planning of their own care. We also looked at how medicines were being managed and how people were supported to consent to care and treatment. Standards relating to complaints and monitoring the quality of service provision were also inspected. We did not identify any concerns in any of the outcome areas we assessed.
We found staff to be well supported and appropriately trained and those living at Hillcroft looked comfortable in their presence. We also spoke with several relatives who were all very complimentary about the staff team and the managers of the home.
Methods for monitoring the quality of service provided had been established and systems had been developed in order to protect the health and safety of those living at the home.
Comments from those living at the home and some relatives included:
"I am very content living here. I didn't like living on my own, so made the decision to move to Hillcroft many years ago and I haven't regretted it."
"I am more than happy with the care Mum receives. The staff are very kind."
"We had a lovely Christmas lunch with Turkey and all the trimmings."
"I had my Christmas lunch here with my husband. It was really nice."
Hillcroft. We also spoke with some relatives, staff members and external professionals. Everyone provided us with positive feedback.
People told us they were able to make decisions about what they wanted to do and said their privacy and dignity was maintained at all times. They felt independence was always promoted and they had confidence in the staff team, who supported them in the way they wanted to be.
Comments from people living at the home included:
"I can always talk things over with the staff if I am anxious about anything."
"Even if I won the lottery I wouldn't move from here. I love it and to think I didn't want to come here or anywhere else in the first place."
"The staff are just great. They all go the extra mile."
Comments from relatives included:
"I visit regularly and as soon as I walk through the front door I am given a cup of tea, even without asking. The staff are so welcoming."
"I am always offered a meal if I am here when food is being served."
"The staff are excellent. They are very friendly and nothing at all is too much trouble."