Archived: Hillside Resource Centre

At the time of inspection, consultations were in progress to change the use of the building and close the service. This was because the service was large and did not meet the requirements in Registering the Right Support. Registering the Right Support is CQC guidance on how to register learning disability services in line with accepted best practice. However, the provider had taken steps to ensure people and relatives were involved in the process and adaptations had been made to ensure people received personalised care.

At our last inspection in January 2016 we rated the service Good. We identified a breach of the legal requirements in relation to notifications and rated the service as ‘Requires Improvement’ in Well-led. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. We also found evidence of improvement in the Well-led domain to achieve a ‘Good’ rating. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good

People were kept safe because staff understood and responded to risks. Where incidents occurred, action was taken to keep people safe and staff knew what to do if they suspected harm or abuse had occurred. People’s medicines were managed safely and administered by trained staff. People lived in a clean home environment where the risk of the spread of infection was reduced. There were enough staff present to keep people safe and checks had been carried out on staff to ensure they were suitable for their roles.

People were supported to eat foods they liked, in line with their dietary needs. Staff supported people to meet their healthcare needs and people lived in a home environment that was accessible to them. 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. Staff had the right training and support for their roles.

Staff were observed to be pleasant and caring and they knew people well. People spoke positively about the staff who supported them and we saw evidence of people being supported to develop skills and independence. Care was delivered in a way that was dignified and people’s privacy was respected by staff.

People were supported to access a variety of activities, outings and holidays. Care plans contained person-centred information about people which staff were knowledgeable of. Regular reviews took place and people’s wishes regarding end of life care had bene documented. There was a complaints policy in place which was accessible to people and staff regularly provided opportunities for people to make suggestions or requests about their care.

Further information is in the detailed findings below

There was a registered manger in place that was present on the day of the 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Services that provide health and social care to people are required to inform the Care Quality Commission (CQC) of important events that happen in the service. The registered manager had not informed the CQC of significant events.

Although records were kept securely people’s records were not always easy to review due to the number of places they were stored. We recommend that the provider reviews how they maintain records for people.

People told us that they felt safe at the service and that there were enough staff to meet their needs. One visitor told us “I haven’t heard of anything bad that’s happened when I’ve been here. It’s very safe.”

Staff had knowledge of safeguarding adult’s procedures and what to do if they suspected any type of abuse and there were enough staff deployed around the service to meet people’s needs quickly. During our inspection we saw that people were supported by staff when they needed. Appropriate checks were carried out on staff to ensure they were suitable to support the people that lived at the service.

People received their medicines safely and medicine management and administration of medicines was appropriate. One relative said “When we took (the family member) away on holiday the medication was very well-organised with plenty of clear instructions.”

Risk assessments were managed in a variety of ways and there was guidance to staff on how to safely support people. Accidents and incidents to people were recorded and action taken to reduce the risk of something happening again. In the event of an emergency, such as the building being flooded or a fire, there was a service contingency plan which detailed what staff needed to do to protect people and made them safe.

Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA), and the Deprivation of Liberty Safeguards (DoLS) that ensures that people’s rights are protected. Staff understood the importance of gaining consent from people and people confirmed that this took place.

People were receiving care from staff that were competent in the role. Training had been provided to staff around the needs of people and staff’s competencies were reviewed regularly.

People told us that they were able to have the meals that they wanted and staff supported people to have healthy and nutritious meals. One person said “I eat anything. There’s always enough to eat and drink. They keep an eye on checking we have a balanced diet. They cook nice dinners.”

People weight was monitored and everyone had access to health care professionals where needed.

People felt that staff treated them with kindness and dignity. One person said that staff were caring and kind and showed them dignity and respect. Relatives told us that they were able to visit whenever they wanted.

We observed staff to be kind and considerate during the inspection and treat people with dignity and respect. People’s care plans included information about the life history and their ‘goals’ and ‘dreams’ and there was guidance for staff on how best to communicate with people. People were encouraged and supported to live as independently as they could.

People and relatives told us that they felt that the staff responded to their needs well. One person told us “Staff is there to help you. They’re doing their best.” One relative told us that since being at the service their family member’s mobility had improved. Health care professionals told that staff responded to people’s individual needs.

Care and treatment was provided that met people’s individual and most current needs. Assessment of people’s needs were undertaken regularly that ensured that staff had the most up to date information. Staff communication information about people that informed them of any changes.

People participated in a variety of activities both at the service and outside. People were supported to live their lives to the full.

There was a complaints procedure in place for people to access which was in picture format to help people understand. Complaints were dealt with appropriately.

People and staff told us that they felt supported by the manager at the service. One person and their family members told us that staff promoted a transparent and open culture, and that they had seen ‘massive changes.’

There were effective systems in place to assess and monitor the quality of the service through regular audits and feedback obtained.

During the inspection we found one breach of Regulation 18 of the Care Quality Commission (Registration) regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.

We found that people who used the service were always being asked by staff if they consented to their care, and their right to refuse care was being respected. One person told us that if they chose not to get up staff would respect that decision. We also found the provider had a process in place to deal with situations where decisions had to be taken in a person's best interest.

We found that people were happy with their care and that staff engaged with people in an appropriate and sensitive manner. People said things like: 'The staff are very kind and loving'. We also found that people's needs were being properly assessed, managed and reviewed.

We found that people were being properly protected against abuse and staff were able to identify, respond to, and report abuse. All the people we spoke with said they felt safe from harm in the home.

We found that there were enough staff to provide proper staffing cover at all times. However, relatives and some staff we spoke with said they thought sometimes staffing was an issue.

We found that the provider was regularly obtaining feedback from people and staff. We also found that the provider monitored and assessed the whole service on a regular basis.

We saw that people's individual needs were assessed before admission and that they or their relatives had been involved in planning their care and support. We noted that staff both supported and documented people's changing needs and development.

We noted that people looked well cared for and they were treated with dignity and courtesy by staff. The service had a calm atmosphere and we spoke with two people from a number who had been participating in community based activities. One relative told us, 'The service has mature staff. I think the care is very good and it far exceeds what I expected'.

We saw that guidance regarding safeguarding people from abuse was available to staff and they had all received recent training. One person that we spoke with told us, 'I always feel safe. The staff are nice and they wouldn't let anything happen to us'.

We noted that staff recruitment processes were thorough and that the required checks had been carried out before staff were engaged.

We saw that there was an effective complaints system in place and that people who used the service were aware of it. One person told us, 'If I wasn't happy I'd go straight to the manager or the staff, but I am".