Archived: Hillingdon House

The service 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 2008 and associated Regulations about how the service is run.

People who used the service were safe. The service had suitable policies and procedures about safeguarding. Staff had received suitable training about how to recognise and deal with any incidences of suspected abuse.

People had suitable risk assessments to assist in protecting them from harm. These were reviewed regularly. Restrictions at the service were kept to a minimum. The staff team had satisfactory understanding of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards. Where necessary suitable action had been taken to safeguard people’s rights so they were not inappropriately restricted.

There were enough staff on duty. Suitable staff recruitment procedures were in place. Satisfactory checks such as references were obtained for new staff. Staff received appropriate training such as about health and safety, medicines management, and infection control.

The service had suitable medicines management systems, and these were operated appropriately. For example administration records were suitably kept, and medicines were stored securely.

The service was kept clean, and was well maintained. The building was appropriately adapted to meet people’s needs. There were plans to upgrade the premises in the near future. Health and safety checks (for example to check the fire system was working) were regularly completed and suitable records were kept.

There were suitable policies and procedures to assess people before they moved into the service. Comprehensive care planning systems were also in place and care plans were reviewed regularly.

People had enough food to eat, and were involved in shopping and preparing food. When people needed assistance with eating, or help with special diets, staff provided appropriate support.

The service had good links with external professionals such as GP’s, social workers, and speech and language therapists. People received necessary support from these services when they needed help. Appropriate records were kept of any appointments people attended.

Staff were seen as caring and respectful. Comments received included: “The staff have always been supportive and helpful,” and “The staff team appear friendly.” The care we observed was professional and supportive. Staff did not appear overly rushed, responded to people quickly if they needed support, and seemed kind and friendly.

People had the opportunity to participate in activities such as swimming, music, cooking and going on social outings. People also had access to day services.

The service had a suitable complaints procedure. Relatives we spoke with said they felt staff and management were approachable, would deal with any concerns appropriately, and did not feel they would face any repercussions if they made a complaint.

Management were viewed positively. The current manager had been in post since the beginning of 2017 and everyone we spoke with felt she had made positive changes to the service. The organisation had a clear management structure and there were clear lines of accountability. Staff said they worked well as a team. There were regular staff meetings, and senior staff were regularly present to give guidance and support. There were suitable policies and procedures to measure and where necessary improve the quality of the service.

The home had a very relaxed and peaceful atmosphere. The staff were very respectful and communicated well with people. We looked at care records for three people who use the service and found that the provider had made efforts to gain consent from people at every stage of the care planning process. Care plans contained detailed instructions for staff to ensure that people were assisted to make as many decisions as they could about their everyday life.

Staff told us that they were confident in understanding people who use the service and their likes and dislikes. They felt that their ability to communicate with people was a strength of the service. We saw that there was a lot of interaction between staff and the people using the service. They appeared happy and enjoy the presence of the staff.

The relative we spoke with told us that their relative had always been 'clean and tidy' whenever they had visited. They told us that when their relative had been unwell, the staff had got the GP to see them promptly and had kept the relative informed at all times. They told us that the home was very good at communicating with them and that they were involved in all decisions about care.

The provider had taken action to address issues identified at our previous inspection.

Staff had received further training in managing medicines. All administration of medicines was carried out by senior member of staff with a second member of staff as witness and counter signatory. The provider ensured processes were in place to record when medicines were delivered to the service and disposed of.

People who could not verbally communicate their needs had plans in place so that staff could identify when they needed medicines.

Medicines were stored appropriately.

We spoke with two staff members who both told us that they felt well supported. When asked about the service, one staff member told us "It's good. We try and give people everything that they want". Another member of staff told us "We provide a good standard of care".

We found that people's needs were assessed and then a care plan was put into place to ensure that their needs were met. We found that people's likes, dislikes and their preferences were included within their care plans along with people's abilities.

We found that the provider had a detailed medication policy in place and a system for staff to follow when medication was received by the service. We had concerns that the stock amounts of medication that were recorded did not always match the actual amount in stock.

We saw that staff received adequate training, regular supervisions and annual appraisals. We found that the provider had a detailed complaints policy in place and that they investigated and responded to any complaints that were made.