Hilton House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had systems in place to learn when things went wrong, and lessons were learnt to continually identify and embed good practice.

The registered manager was passionate about learning from safety incidents and ensured staff reported and learned from incidents to prevent avoidable harm. They used a tool they had devised to record, investigate and analyse incidents at this service and the other local service they managed so that learning could be shared amongst the whole staff group. They were also in the process of rolling this tool out in other services owned by the provider and had shared the tool with other local providers at a forum arranged by the local authority where they presented how they used the tool to promote a positive learning culture. The registered manager did not only focus on incidents to learn about safety. They also identified and focused on positive events and how these could be replicated to prevent safety incidents and improve people’s care experiences and outcomes.

Minutes of staff meetings showed this learning was shared with all members of the staff team and staff told us there was a strong focus on lessons learned at the service.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People were supported to safely transition into the service through individualised approaches that included preadmission assessments and multiple visits to the service to meet the other people who used the service and the staff. Communication and hospital passports were in place to ensure other services had access to the information needed to keep people safe as they moved between services.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe at Hilton House. One person said, “I feel safe. I have friends here and the staff are nice”. A relative also confirmed their loved one felt safe. They told us, “Yes [Person] is safe, the staff are bang on with them.” Staff told us how they would identify and report abuse and we saw the registered manager made safeguarding referrals when required. Training records showed staff had received safeguarding training.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found no concerns and Deprivation of Liberty Safeguards (DoLS) were in place for people when needed.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People told us that staff helped them to keep safe. For example, 1 person described how staff helped them to keep safe when accessing the shower. Staff told us about people’s risks and how they managed them. The information staff and people told us matched the information recorded in their care records where risks and guidance to manage these risks had been recorded.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People told us they used their prescribed equipment to keep them safe. Staff told us when they used equipment and the information staff told us matched the information contained in people’s care plans. This included the use of a mobility aid and wheelchair for a person who required these in order to access the community safely.

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs.

Staff completed a robust and structured induction that focused on people’s individual support needs. As part of their induction, staff had to demonstrate they understood people’s needs by completing documentation about each person’s needs. This included recording people’s individual needs and preferences, allergies and relationships that were important to them. The registered manager told us, “If they don't know the answers, then they haven't read the care plans. It's to find gaps in knowledge”. Staff also completed reflective diaries during and following shadowing shifts where they reflected on what they had experienced and learned.

Regular comprehensive, holistic and structured staff supervisions took place that focused on people’s outcomes and staff development. There was a strong learning culture at the service where staff were given the opportunity to complete additional trainings such as management qualifications for aspiring future leaders. One staff member told us, “The training has been spot on. [Registered manager] makes sure we never miss training. I also do additional training too on social care TV.”

People told us there were always enough staff to keep them safe and support them when needed. One person said, “There are always staff here to help me.” Staff confirmed that agreed staffing levels were consistently met and the registered manager explained how staffing levels were planned around the activities people wished to participate in. Safe recruitment systems were in place.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff told us and we saw that they followed safe infection prevention and control (IPC) practice. Personal protective equipment was readily available and used. Regular audits were completed by senior staff to ensure IPC standards were consistently met. A recent visit from the local IPC team recorded 100% compliance with IPC standards.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People told us they received their medicines as prescribed. One person told us how the staff supported them to take an inhaled medicine. We saw that medicines were ordered, stored, administered and recorded safely. Where people were prescribed medicines on an ‘as required’ basis, guidance was available to staff to know when and how to administer these. People received regular medicines reviews by health professionals to ensure their medicines were meeting their needs. Systems were in place to monitor compliance with safe medicines management. This included regular competency checks and checking of storage temperatures.