Archived: Hillcrest

Hillcrest is a residential care home providing personal care for one person with learning disabilities.

The service is a detached two-story property with enclosed gardens. It is located within walking distance of the town centre of Redruth, Cornwall.

The service was designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. The person received personalised support in an environment that had been adapted to their individual needs.

People’s experience of using this service and what we found

The person was comfortable, relaxed and at home in the service. Staff respected the person’s wishes and responded promptly to the person’s request for support or reassurance.

The service was short staffed. Staff had completed additional shifts to ensure the person’s safety at all times. However, low staffing levels had adversely impacted on the person’s ability to access the community, engage with activities they enjoyed and achieve recognised goals and ambitions. This meant the care provided was not constantly person’s centred and represented a breach of the requirements of the regulations.

This issue had been identified by the provider prior to the inspection and a recruitment campaign was underway and additional staff were in the process of being appointed. Records showed that recruitment practices were safe and that all necessary pre-employment checks had been completed.

Staff had understood local safeguarding procedures and there were safe systems in place to support the person with medicines and finances. Risks were managed appropriately, and staff had been provided with guidance on how to support the person if they became upset of anxious.

Following our previous inspection, the service had correctly identified that the person lacked capacity and was the subject of continuous monitoring and control. They had appropriately applied to the local authority for the authorisation of the person’s potentially restrictive care plan. When additional restrictions had been introduced as a result of changes in the person’s support needs this had also been reported.

Staff had the skills necessary to meet the person’s needs and their training was regularly updated. All staff new to the care sector were supported to complete the care certificate and the provider encouraged and supported staff to achieve diploma level qualifications.

The care plan was detailed and provided staff with enough guidance to enable them to meet the person’s support needs. This included details of routines that were important to the person and information about their specific communication needs and preferences.

At the time of our inspection there was no registered manager in place. The previous register manager had left the service in early 2019 and a new manager had only recently been appointed. Staff spoke positively of the new manager were confident they could make the changes necessary to improve the service performance.

There had been a number of significant changes at provider level since our last inspection. Solar Care had been taken over by The Regard Partnership who in turn had subsequently merged with another care provider to become Achieve Together. These changes meant staff and the new manager had access to additional managerial support when required.

The provider’s quality assurance systems were not entirely effective. They had recognised prior to the inspection that the service was short staffed but timely action had not been taken to prevent staffing issues from impacting on the person’s ability to access the community.

Rating at the last inspection

The last rating for this service was good. (Published 16 August 2017.)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We carried out this announced inspection on 19 and 20 July 2017. At the last inspection, in June 2015, the service was rated Good. At this inspection we found the service remained Good.

The service was not fully meeting the requirements of the Mental Capacity Act (2005) and the associated Deprivation of Liberty Safeguards regarding making applications to the supervisory body for the use of restrictions in place for people. Following discussions with the provider immediate action was taken to rectify this. We have made a recommendation in the report regarding this.

The people using the service were well cared for, relaxed and comfortable in the service. They readily communicated with staff when they wished to be supported and when they wished to be on their own. Their privacy and dignity was respected. One person told us, “I tell them when I want them here or not. It’s my life and I do what I want.” A relative told us said, “They have chosen support workers who get on really well with our [relative] and as a result [Person] has been really enthusiastic about living there.”

Support was provided by a small, consistent, motivated and well trained staff team. The registered manager had recognised the importance of staff consistency for the persons who were supported as well as respecting their wishes to have a mixture of different care staff. Staff told us, “I love working here. It’s not like work really, I want to be here and get a lot of satisfaction from seeing people live such fulfilling lives.”

Care records were up to date, had been regularly reviewed and accurately reflected the people’s care and support needs. Care plans were presented pictorially to enable people to read their plan and be involved in any changes or updates. Details of how people wished to be supported with their care needs were highly personalised and provided clear information to enable staff to provide appropriate and effective support. The service’s risk assessment procedures were designed to enable people to take risks while providing appropriate protection.

The service was well led and all of the staff were highly motivated and keen to ensure the care needs of the person they were supporting were met. Staff told us, “I couldn’t ask for more support from the management here. I can go to [registered manager] at any time”, “We are really supported by management and all of the staff group here” and “This organisation has developed me personally since I started here. They want the very best for the people who live here and all of the staff who support them.”

There were sufficient numbers of suitably qualified staff on duty to keep people using the service safe and meet their needs. Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. Staff knew how to recognise and report the signs of abuse.