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Inspection carried out on 29 August 2017

During a routine inspection

Hillcrest is home for up to 20 adults with learning disabilities. On the day of our inspection there were 18 people using the service. There are also 2 smaller houses, 1 Hill Close and 2 Hill Close, which are registered separately but form part of one complex with many elements such as staffing and some management functions shared across all three buildings. We inspected these services on the same day as much of the evidence we needed to gather was common to all three. For this reason some parts of each report will be the same.

At our last inspection in February 2015 we rated Hillcrest ‘Good’, and did not identify any breaches of regulations. At this inspection we found the service remained Good.

Why the service is rated ‘Good’.

People told us they felt safe, mainly due to the staff being present. Risks associated with care and the environment in and around the home were well assessed.

Staff were recruited safely, and understood how to recognise and report any safeguarding concerns they had. There were enough staff on duty in the home.

People’s medicines were managed safely.

Staff had a thorough induction and had access to on-going training and support. The registered manager carried out checks to ensure training was effective.

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. The provider asked for people’s consent to care and treatment. Some key information relating to this was in accessible formats.

People enjoyed their meals and were asked what they wanted to be on menus. We saw some innovation in the approach to nutrition which had a positive impact on people’s health. The provider supported people to access health and social care professionals when needed.

We saw relaxed and good natured interactions between people and staff. People had access to activities which reflected their interests. Staff understood how to respect people’s privacy and dignity.

There was person-centred information in people’s care plans. Accessible formats had been used effectively to enable people to write detailed plans for end of life care.

Staff told us they enjoyed working at the provider’s services within the complex and said they had a good relationship with the registered manager. They told us the registered manager was supportive and approachable.

The provider was monitoring quality in the service. People were consulted and the registered manager undertook regular audits to ensure areas for improvement were identified and addressed. We received good feedback about care standards from a visiting health professional we spoke with.

Inspection carried out on 13 February 2015

During a routine inspection

We inspected Hillcrest on 13 February 2015. The visit was unannounced. Our last inspection took place in June 2013 and there were no identified breaches of legal requirements.

Hillcrest provides personal care and accommodation for up to 20 adults with learning disabilities. It is part of a care complex owned by Hillcrest and Lyndale Care and Support Services Ltd that also includes 1 and 2 Hill Close.

The home had 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 we spoke with told us they felt safe living at the home. We saw risks to people were managed appropriately whilst ensuring people were safe and given their freedom. Training records showed staff were trained in safeguarding. We spoke with six staff who told us they understood how to recognise and report any abuse. Staffing levels were sufficient which meant people were supported with their care and enabled to pursue interests of their choice in the community.

No-one at the home was subject to the Deprivation of Liberty Safeguards (DoLS). Staff had been trained and had a good understanding of the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

We saw that medicines were managed safely at the home. We looked at medication administration records (MAR) which showed people were receiving their medicines when they needed them.

We saw staff had developed good relationships with people and were kind and caring in their approach. People were given choices in their daily routines and their privacy and dignity were respected. People were encouraged to be as independent as possible in all aspects of their lives.

People’s nutritional needs were met and they received additional health care support when required.

From our observations it was clear the staff knew people well. We saw they staff were trained, skilled and competent in meeting people’s needs. Staff told us they were supported and supervised in their roles. We saw records which confirmed this.

People we spoke with told us they were happy living at the home. We saw there was good evidence in place to show the home had care plans in place for people which were individually tailored to meet their needs. We also saw people were involved in the planning and reviewing of their care and support.

Records we looked at showed there were systems were in place to assess and monitor the quality of the service and the focus was on continuous improvement. People and staff were actively involved in developing the service. There was strong leadership which promoted an open culture, which put people at the heart of the service.

We saw there was a complaints procedure in place which was displayed in the home. People we spoke with told us they knew how to complain but had never needed to. The home had not received any complaints since our last inspection in June 2014.

Inspection carried out on 28 June 2013

During a routine inspection

Hillcrest is a care home for up to twenty people with learning disabilities. The home is part of a care complex that includes 1 and 2 Hill Close, which belong to the same organisation, and all three services work closely together.

We spoke with people living in the home, staff and the registered provider. We found staff involved people in decisions about their care and daily lives. We saw staff supported people to maintain their independence. People told us they went out regularly and enjoyed the different activities that were available.

We found the home was homely and comfortable and saw that staff had a good rapport with people. We saw staff gave people the support and assistance they needed. The care records we reviewed were person-centred, holistic and provided detailed information. We saw people�s nutritional needs were met. We found there were sufficient staff to meet people�s needs. There were systems in place to deal with complaints.

Inspection carried out on 4 January 2013

During a routine inspection

People who used the service could not communicate clearly so we observed staff providing support and we spoke with staff about the people who used the service. We spoke with the relatives of people who used the service. This gave us assurances that staff knew the needs of people and knew how to deliver the care and support effectively.

Our observations of the service showed that care staff spoke with and interacted with people who used the service in a patient and pleasant manner. Care staff supported people in a sensitive way using differing methods of communication to ensure that people understood what was going to happen.

The people who used the service appeared happy and comfortable with the surroundings. They appeared to be relaxed with the staff in their interactions with them. We noted that people who used the service had access to a wide range of activities which were personalised to their individual needs.

Relatives we spoke with during our visit were very satisfied with the care and activities within the service. They told us the care was very good and the staff were very nice. One said that the care was �Brilliant� and another �I cannot speak too highly of the home.�