Hill View

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement.

This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to governance at the service.

This service scored 62 (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 shared vision, strategy and culture, based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

We observed people being offered everyday choices such as what they wanted to drink and if they wanted to go to bed. People were offered regular activities including day trips, swimming, the pub, shopping and social groups. People spoke positively about the service and said they enjoyed going out. Staff spoke about people in a kind way, and we observed staff supporting people respectfully. The service had made improvements to the environment in relation to the décor. This meant the service had a more homely feel.

We observed some areas of the home did not always promote independence. For example, the kitchen did not enable people using wheelchairs to access kitchen equipment. The manager told us they felt the kitchen was too small for this but told us they utilised the dining room for food preparation activities.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders were knowledgeable about people and their needs. Staff spoke positively about the manager. Comments from staff included, “[The manager] is a very nice person, she is manageable. She doesn’t just sit on the office, she helps us” and “She always answers when I need something and treats everything seriously”. Leaders had completed a variety of training relevant to their role. People told us they knew who the manager was and spoke positively about them. The manager told us they received regular support from senior leaders.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. People told us they felt able to raise any concerns and knew who the manager was. People also mentioned that their feedback was listened to in resident meetings. Staff said they felt able to raise concerns and that leaders were responsive. One staff member commented, “Managers are very comforting, I would feel like I could confidently raise a concern.” There were opportunities for people to raise concerns anonymously such as through anonymous surveys and a suggestion box situated in a communal area.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff told us there was a diverse workforce and told us different nationalities and religions were respected. One staff member commented, “As a staff team we have different cultures and nationality and religions, I have never seen any discrimination.” Staff told us leaders were flexible in relation to their working hours. One staff member said, “They are very good with that. If some staff need to attend hospital appointment, then they can.”

The manager told us staff completed regular equality, diversity and inclusion training and said this is reinforced through supervisions and team meetings. The manager commented, “We ensure when doing a rota, that we provide individuals with religious events off should they ask. Any concern around discrimination are addressed immediately and appropriately.”

The provider did not act on the best information about risk.

The services governance systems were not effective in relation to ensuring improvements were made and sustained at the service. The service was previously in breach of regulation relating to safe care and treatment at the last 2 inspections, and enough improvement had not been made at this inspection.

Additionally, governance systems were not effective in identifying concerns relating to medicines storage temperatures and the environment. For example, health and safety audits had not identified there were multiple windows where window restrictors were unattached or had keys in meaning these could be detached. This put people at risk of falling from height and at risk of significant harm,

Finally, CCTV was being used in communal areas. This had been decided following an incident which occurred to ensure people’s safety. However, systems and processes were not in place to ensure this was the least restrictive option and was not proportionate in relation to the number of incidents which occurred in communal spaces. This was an infringement on people’s human rights.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement. Leaders explained how they had attended regular multi-disciplinary team meetings to support people.

The manager told us, “We worked closely with [previous service], the learning disability team and [the local authority] when assessing and transitioning [a person] to move to Hillview. This required weekly meeting to discuss behaviours and patterns, and how best to resolve these in a way that supported [the person]. Due to all the shared knowledge, we have been able to minimise behaviours and support [person] with small goals.” Staff also told us they felt they worked well with other professionals.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

Although the service had made improvements in relation to staff practices and the décor of the service, there were continued concerns in relation to risk management. These issues were identified at the last inspection. This meant the service had not effectively learnt from previous inspections.

However, the manager told us how they had improved the service by upskilling staff. The manager said they have come on ‘leaps and bounds’. The service had recently implemented a new online care system for care planning documents and records. This helped leaders have better oversight of the service. The manager commented, “We have also had a new digital system put in place that is far more effective the previous. All staff were given face-to-face training on how to use and record effectively, this also alert them/us to tasks they may have missed, which has led to less tasks being overlooked.”