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Inspection carried out on 24 September 2018

During a routine inspection

Unit 14b – Day Lewis House also known as Hillside Care Services, provides personal care services to people in their own homes. At the time of our inspection three people were receiving care from this service.

At our last inspection we rated the service good. 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. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People’s relatives told us their family members trusted staff and felt safe when staff supported them. There were systems in place to help make sure people were protected from the risk of abuse and staff were aware of safeguarding procedures and understood how to safeguard the people they supported.

Staff helped make sure people were safe and knew the risks people faced each day. They took steps to reduce those risks while still encouraging people's independence. Staff followed safe practices when assisting people with their medicine.

There was a 24-hour call system in operation, this made sure support and advice was always available for people and staff.

People were cared for by staff who received appropriate training and support to do their job well. Staff felt supported by managers through regular supervision and appraisals.

People and their relatives were involved in making decisions about their care, treatment and support and the care plans reflected this. 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.

Relatives told us their family members liked staff and thought they were caring. Staff respected people’s privacy and dignity. When required, staff supported people with their activities and interests, both in their own home and in the community.

People were asked about their food and drink choices and staff assisted them with their meals when required.

People's healthcare needs were met through the involvement of external professionals when required.

People’s relatives said they would complain if they needed to and knew who to complain to.

People were contacted regularly to make sure they were happy with the service and spot checks helped review the quality of the care provided.

Further information is in the detailed findings below.

Inspection carried out on 13 March 2017

During an inspection to make sure that the improvements required had been made

We carried out an unannounced comprehensive inspection of this service on 10 March 2017. A breach of legal requirement was found. After our inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to people’s risk assessments and the recording of accidents and incidents.

We undertook this focused inspection on 13 March 2017 to check that they had followed their plan and to confirm that they now met the legal requirements inspected. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Unit 14b - Day Lewis House on our website at www.cqc.org.uk.

Unit 14b – Day Lewis House also known as Hillside Care Services provides personal care services to people in their own homes. At the time of our inspection one person was using the service and one person was due to resume using the service when they returned home from a hospital stay.

The service had a registered manager in post. 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.

At our previous inspection we found risk assessments were not always focused on people as individuals and when an accident or incident occurred these were not always formally recorded so it was hard to see what action was taken to make things better. During this inspection we found improvements had been made, risk assessments were centred on each person’s care and detailed reports were made of any accidents or incidents that had occurred.

Inspection carried out on 10 March 2016

During a routine inspection

This inspection took place on 10 March 2016 and was announced. We told the provider two days before our visit that we would be coming.

Unit 14b – Day Lewis House also known as Hillside Care Services provides personal care services to people in their own homes. At the time of our inspection eight people were receiving care from this service. This was our first inspection of the service.

The service had just appointed a new manager following the resignation of the previous manager. The new manger was applying to be a registered manager with the Care Quality Commission at the time of our 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.

People and their relatives told us they trusted staff and felt safe when staff were there. There were processes in place to help make sure people were protected from the risk of abuse and staff were aware of safeguarding vulnerable adult’s procedures and understood how to safeguard the people they supported.

There was an out of hours on call system in operation, this made sure support and advice was available for staff working outside office hours.

Staff were up to date with training and the service followed appropriate recruitment practices. The provider told us they tried to match care workers with the people who use the service and keep the same staff with the same person. People we spoke with felt they were well matched with care staff.

We saw people were involved in making decisions about their care, treatment and support and the care plans we checked reflected this. People told us their privacy and dignity was respected by staff. Staff we spoke with explained how they would always ask for consent before assisting people and explained the methods they used to help maintain people’s privacy and dignity.

People were asked about their food and drink choices and staff assisted them with their meals when required.

People and their relatives said they would complain if they needed to, they all knew who the management was and felt comfortable speaking with them about any problems.

People were contacted regularly to make sure they were happy with the service and spot checks helped review the quality of the care provided.

Risk assessments were not always focused on people as individuals and when an accident or incident occurred these were not always formally recorded so it was hard to see what action was taken to make things better.

We have recommended that the service refers to current best practice guidance around the management of medicine in social care settings.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to the assessment of risk and the recording of accidents and incidents. You can see what action we told the provider to take at the back of the full version of this report.