Archived: Gittisham Hill House

Gittisham Hill House is registered to provide accommodation for a maximum of 39 people who require nursing and personal care. The home is situated near Honiton, Devon. The service specialises in the care of older people, most of whom are living with dementia. When we visited 36 people lived at the home, 19 of whom were receiving nursing care.

The service has 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, relatives and health and social care professionals were impressed with the service and how people were treated. One relative said, “We are extremely satisfied with the care, she is looked after really well.” A health professional said, “A very nice place with nice people.”

People received effective care, based on best practice, from staff that had the knowledge and skills needed to carry out their role. Health and social care professionals consistently gave us positive feedback about the kindness, care and support provided for people. A visiting professional said, “The residents provided with a safe environment and their care is effective.”

People gave us very positive feedback about the food choices at the home. One person said, “We are well looked after with food.” People were supported with nutrition and hydration, although improvements were needed in adding up fluid records of what people at increased risk of dehydration had drunk each day.

The environment of care was adapted to meet the needs of people with physical disabilities and those living with dementia. The buildings have been significantly improved and refurbished with further improvements planned. The home had lots of areas of interest for people to sit, enjoy and spend time in. Some people who were restless were freely able to access all communal areas on the ground floor and go upstairs whenever they wished.

There was a calm and relaxed atmosphere in the home on both days we visited. The ethos of the service was that it was people’s home and staff respected people’s individual choices. Staff interacted in a kind and respectful way with people. For example, when a person became upset, staff noticed immediately and intervened to reassure them. Staff were friendly and cheerful and they knew each person well, what they liked to be called, their preferred routines; and their social and family history.

Staff understood their responsibilities in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity, relatives and health and social care professionals were consulted and involved in decision making about people in their 'best interest’.

People said they felt safe living at the home. Staff were aware of signs of abuse and knew how to report concerns, any concerns reported were investigated. A robust recruitment process was in place to make sure people were cared for by suitable staff. People knew how to raise concerns and were confident any concerns would be listened and responded to.

The service was well led. People, relatives and staff said the home was organised and well run. The culture of the home was open and friendly. Staff said they worked well as a team and felt supported and valued for their work. Senior staff acted as role models to support staff to achieve high standards of care.

The provider had a range of internal and external quality monitoring systems in place, which were well established. There was evidence of making continuous

improvements in response to people’s feedback, the findings of audits, and of learning lessons following accidents and incidents.

Gittisham Hill House is a bright and clean care home set in lovely grounds and surrounded by purpose built bungalows where older people were able to live independently. The home had recently benefited from a large extension which had enabled them to register for the provision of nursing care in addition to residential care services. We were told that the old part of the building was due to be extensively refurbished in the near future.

We were told that generally people received prompt and good care appropriate to their needs. People spoke about the quality of the staffing, saying "staff are lovely, caring, I think they really do care about the residents". The quality of activities was commented on by nearly everyone we spoke with. During our visit we observed that many people participated in the different activities that were provided. In people's rooms we saw evidence of art work and we saw several people drawing or painting as we toured the building. During the afternoon we saw a basketball game in progress and later we were introduced to the "champion".

Some people were very unwell. We saw that they spent most of their time in bed or in special chairs. The chairs were designed to be moved, so that people could experience a change of environment. Staff explained that they would talk and chat with people whilst providing personal care.

There were 31 people living at the home on the day of this inspection; we saw or met with the majority of them. We spoke with six people about their experiences. Some people were unable to fully verbally communicate their views to us due to degrees of confusion, dementia and memory loss. We spent time observing the care and support provided to them. We found that people were treated with respect; their consent was sought and staff responded sensitively to people's needs and preferences. People told us they were happy and well cared for. Comments included, 'No words can explain how kind they are', 'staff are excellent' and 'I am lucky to be here'.

We also spoke with eight staff members, two relatives and four health and social care professionals. Relatives told us they were happy with the care and support provided to their family member. Their comments included, 'We are very happy. Nothing is too much trouble for them' and 'I go home with no worries. The home is well managed and run'. Professionals spoke highly about the care provided. Comments included, 'I have been very impressed with the support they provide. They manage complex care well' and 'They always go the extra to meet people's needs'.