1 Hill Close

There are also Hillcrest and 2 Hill Close care homes which are registered separately but form part of 1 complex with elements such as staffing and policies shared across all 3 buildings. We inspected these services in a 2-week period as much of the evidence we needed to gather was common to all 3 services.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: Systems were not robust enough to demonstrate people’s safety was always effectively managed. There were shortfalls in cleanliness and in the assessment and management of risk. There was a lack of clarity in relation to staff deployment. These shortfalls had not been picked up through the provider's governance arrangements although prompt action was taken once we brought this to the attention of the management team.

It was clear the service had been established on the principal of promoting people’s self-direction and self-reliance. The location of the service in a residential area provided good access to local amenities and services which helped support people’s independence and autonomy. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care: People told us they were happy living at 1 Hill Close and we saw people were relaxed in the company of staff and others they lived with. Support was available when needed and people were able to participate in activities within their local community.

Right Culture: Overall, there was a positive culture in the service and people were happy with the support they received. However, the terminology and definitions used by the provider were not always respectful or empowering.

Staff knew their responsibilities and were confident to report concerns that might arise. People were encouraged to make their own decisions in their daily lives and had opportunities to share their views. Staff felt well supported by the management team. The management team was responsive to the inspection findings and keen to deliver a high-quality service.

Rating at last inspection

The last rating for this service was Good (published 10 November 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service, specifically, the time elapsed since the last full inspection. We undertook a focused inspection to review the key questions of safe, caring and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for 1 Hill Close on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

We made recommendations about staffing, radiators, and the use of respectful terminology and definitions.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

At our last inspection in February 2015 we rated 1 Hill Close as ‘Good’, and did not identify any breaches of regulation. At this inspection the service remained good.

Why the service is rated ‘Good’.

People told us they felt safe at 1 Hill Close. 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.

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. The provider supported people to access health and social care professionals when needed.

We received some good feedback about the staff who worked at 1 Hill Close. 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.

We spoke with people living in the home, staff and the registered manager. 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 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 safe systems were in place to manage people's medicines. People told us the staff were 'nice' and 'kind'.

We found the home to be comfortable and well maintained. People told us they liked living there. There were sufficient staff to meet people's needs. There were systems in place to deal with complaints. People told us they would speak to staff if they were unhappy about anything.