Archived: Hillcrest House Care Home

Updated 19 May 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection was unannounced and took place on 22 February 2017. At the time of the inspection there were 11 people living at the service

The inspection was conducted by two inspectors and two Experts by Experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.’

Before we visited, we looked at previous inspection reports and notifications we had received. Services tell us about important events relating to the care they provide using a notification. We used a number of different methods to help us understand the experiences of people who use the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with seven people who use the service and one relative about their views on the quality of the care and support being provided.

We looked at documents that related to people's care and support and the management of the service. We reviewed a range of records which included five care and support plans, staff training records, staff duty rosters, staff personnel files, policies and procedures and quality monitoring documents. We looked around the premises and observed care practices for part of the day.

During our inspection we spoke with the regional manager, the registered manager, and two care staff, which included agency workers

Updated 19 May 2017

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

At the last comprehensive inspection found breaches of the legislation. We took enforcement action, served warning notices and imposed conditions on the registration of this service. Following the inspection the provider developed a comprehensive action plan to meet the imposed condition of registration and to address the warning notices and other requirements where there were breaches of the regulations.

This inspection was unannounced and took place on the 22 February 2017. Hillcrest House can provide accommodation and personal care for up to 34 people living with dementia. At the time of our visit there were 11 people accommodated.

People told us they felt safe with the staff and we observed that people’s behaviours indicated they were happy for staff to approach them. The staff knew the aims of the safeguarding of vulnerable adults procedures. The staff knew the types of abuse and the responsibilities to report abuse where it was suspected.

Contingency plans and individuals evacuation procedures in the event of an emergency were in place. The contingency plans needed reviewing to ensure the contact details of staff currently employed were included. The plans detailed the contact details of the registered manager and contractors in the event of an emergency.

Mental Capacity Act (MCA) assessments for some people needed reviewing to ensure the best interest decisions were relevant to the specific decisions that was being made. We saw for example, that consent for photographs to be taken was gained from a relative without power of attorney. The MCA assessments lacked detail and action plans on the best interest decisions reached were not always in place.

Care plans were overall person centred and provided insight that people were living with dementia. However, action plans lacked detail on how staff were to meet the identified needs. We found information was duplicated and at times was not consistent and was contradictory. This may mean that staff were not provided with clear guidance on how to meet the needs of people. Activities were not taking place consistently to ensure people were able to pursue their interests.

The staffing levels met the basic needs of the people living at the service. Staff said that agency staff were used to maintain staffing levels. We were told that the same agency staff were used which improved consistency to people. Staff said staffing levels did not allow for staff to take people out in the community.

The provision of training had improved. This ensured that staff had the skills to meet people’s needs. There were opportunities for staff to undertake vocational qualifications. Staff were registered onto the Care Certificate. Staff told us there were opportunities for career progression within the organisation.

People’s dietary requirements were met. There were choices of meals and refreshments and in between meals there were snacks and refreshments available. We observed the lunchtime meal and we observed staff helping people to eat and drink and encouraging others to eat their meal.

Relatives told us where there were concerns these were raised with the unit manager. Where people were able they told us concerns were raised and addressed.

Quality assurance systems were in place. Feedback from relatives was being sought on the quality of the service. Social care professionals told us there had been improvements in the quality of the service. Members of staff told us the team worked well together and they were supported to meet the requirements of their role. An agency worker told us information was more accessible.

You can see what action we told the provider to take at the back of the full version of the report.