Hillbrow

Updated 13 September 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection team consisted of one inspector.

Service and service type

Hillbrow is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This is because we wanted people to have time to prepare for our visit to reduce the risk of people feeling anxious whilst we were there.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection-

We spoke with three people who used the service and a relative about their experience of the care provided. Other people were not able to talk to us about their care, we observed the care provided to other people in the communal areas and interacted with people using signs and gestures.

We spoke with five members of staff including the operations manager, deputy manager and support workers. The registered manager was away from the service during the inspection, we returned on a second day to speak to them. We reviewed a range of records. This included two people’s care records and multiple medication records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 13 September 2019

About the service

Hillbrow is a residential care home providing care and accommodation for nine people with learning disabilities or mental health needs. Some people living at the service had lived there for a long time and now have dementia care needs. The care home accommodates a maximum of nine people in two adapted buildings. Six people living in one three storey building and three others live in a separate bungalow on the same site.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service received planned and co-ordinated person-centred support that is appropriate and inclusive for them. People were encouraged and supported to be active within their community and be independent.

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

People were happy living at the service. People were supported by staff who were kind and compassionate. Staff understood the importance of providing consistent support for people to enable people to reduce their anxieties and increase their independence.

People continued to be safe living at the service. Risks to people from health conditions and the environment were well managed. Medicines were administered well, and people received their medicines on time and as prescribed. The service was clean, and people were protected from the risk of infection.

When things went wrong staff responded appropriately and took action to reduce the risk of incidents occurring again.

There were enough staff to support people and staff were recruited safely. Staff were appropriately managed and supported and had the skills and training they needed. Staff applied their learning from training to improve people’s lives.

People’s needs were assessed, and support plans were updated when appropriate. The support people received was personalised and met their needs. They were supported to take part in activities of daily living such as going shopping, making meals and managing laundry. Where appropriate people were involved in the running of the service through assisting with audits and undertaking gardening.

People were encouraged to maintain their health and had access to healthcare services when needed. They were provided with support to eat and drink well and safely where there were risks such as diabetes and difficulties swallowing.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The building was designed and adapted to meet people’s needs and promote independence. Adaptations to the environment had been made to ensure that the building remained suitable for people as they grew older as some people had lived there for a long time.

There was an open and transparent culture at the service. Staff were motivated and appropriately managed and supported. Regular checks on the quality of the service were undertaken and action was taken to make improvements where these were identified.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of the thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

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 6 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.