Hill View

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff recorded accidents and incidents. The registered manager undertook monthly audits to analyse these and to identify any themes or trends. Minutes from meetings, demonstrated lessons learnt and areas for improvement were discussed and shared with staff.

The registered manager was keen to ensure they were providing good and safe care and were accepting of our feedback and feedback from staff, residents and their families.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Information about people’s care was passed on in the form of a hospital passport.

The registered manager worked closely with commissioners from the local authority to ensure people were well supported when moving into the service.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns with the local authority quickly and appropriately and notified CQC.

People we spoke with told us they felt safe living at the service. One person said, “I do feel safe here. The staff always check on me when I am in my room. I am not worried by any staff or residents.” Another person told us, “I don’t have any worries about anyone else here, so I do feel safe.”

There was a safeguarding policy in place and accessible to staff. Staff undertook training in safeguarding. Staff knew how to report any concerns and felt able to report concerns if they needed to.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

On our first visit to the service, we found that additional information was required to ensure that risks to people had been mitigated. One person’s care record did not document how often they required support with turning when in bed. We also found that the care records for another person’s diet were contradictory and said they were not at risk of choking although they had been assessed as requiring a soft diet. The providers audits had not identified the issues we found. We fed this back to the registered manager.

On our follow up visit additional written information had been recorded in the care plans to ensure that the risks had been mitigated.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

On our first visit we found that water temperature exceeded the recommended safety levels in hand sinks that people had access to. Also, radiators and pipework had not been covered and potentially put people at risk of harm from burns. The provider had arranged and completed some refurbishment, although we found that some areas needed decoration including the entrance to the service. This area was looking very tired, and paintwork was peeling. The provider’s audits had not identified the issues we had found.

At our second visit we found that the provider had responded to our concerns and these areas had been addressed.

Safety checks including fire, moving and handling equipment were undertaken to reduce risks to people. Staff undertook regular fire training and drills to ensure they were able to respond to an emergency.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staffing levels were safe and well managed. One person we spoke with told us, “They do seem to have enough staff. It is only a small home, so it seems to work. At night they have 1 carer and a sleeper in case anything happens.” Another person said, “There are always staff around to help you. I think it is very well staffed.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Infection prevention was well managed. Staff told us they had access to personal protective equipment when it was needed. We saw that staff maintained good hand hygiene. Staff received training in infection, prevention and control and food hygiene as part of their induction.

The provider had policies and procedures in place to reduce the risk to people and staff catching and spreading infections.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Systems and processes were in place to promote safe medicines management. Regular medication audits were undertaken, and actions were taken to address any concerns. People received their medicines as prescribed, including ‘when required’ medicines. Staff had received medicines training and their competency to safely administer medicines was regularly assessed by the registered manager.

Staff were able to explain how they supported people with their medication and how they escalated any concerns. This included a referral for support from other professionals. One person told us, “The staff look after my medication for me. I don’t have to worry about it then. They put all the tablets together in 1 pot. I always seem to get it on time.” A family member said, “Staff have been brilliant with the medication and [name] condition is more under control now. It was bad when they were at home, and we were relying on carers but here they have got it spot on.”