The Care Quality Commission
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Archived: Hillgreen Care Ltd - 6 Stoke Newington Common

Overall: Inadequate read more about inspection ratings

6 Stoke Newington Common, London, N16 7ET (020) 8806 0303

Provided and run by:
Hillgreen Care Limited

Important: Hillgreen Care Limited is no longer providing care services at 6 Stoke Newington Common. We have cancelled Hillgreen's registration to carry on regulated care activities at this location. This page will be updated to reflect this change shortly.

All Inspections

31 July 2017

During a routine inspection

The inspection took place on 31 July, 2 August and 3 August 2017 and was unannounced. The provider knew we would be returning for the subsequent days. Hillgreen Care Ltd - 6 Stoke Newington Common is a residential home which provides care and support to a maximum of six people with learning disabilities, some of whom may also have mental health conditions. At the time of the inspection there were two people living at the service. Only one of these people was currently residing at the service at the time of the inspection.

There was not a registered manager at the service 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 were not always protected from risks to their wellbeing because there was not a robust staff recruitment process in place. Criminal record checks and references were not always obtained prior to a staff member starting work at the service. People were not always protected from risk of harm because environmental checks and risk assessments were not always completed or up to date.

There was a negative culture at the service and staff morale was low. There was poor communication between the senior management team and the staff at the service. The service was not organised in a way that always promoted safe care through effective quality monitoring. There was inconsistent management at the service as the manager had resigned two weeks before the inspection and the deputy manager was acting as the service manager. As a result, staff meetings were not being routinely held and the acting manager was not aware of the statutory obligation to report all issues that affected the service to the Care Quality Commission.

People were supported to eat and drink enough but people were not protected from the spread of infection because the service was providing people with out of date food to eat. .

People were protected from risks resulting from their specific health and care needs because effective risk assessments were in place to guide staff about how to manage specific risks. People were supported to obtain care and treatment from health care professionals and medicines were managed adequately.

People felt safe and were protected from the risk of potential abuse. Staff were knowledgeable about safeguarding processes and knew what to do if they had concerns about the service. Staff were observed to be caring and promoted people’s independence and dignity.

There were enough staff to meet people’s needs. People were involved in planning their care and care records included information about people's likes and dislikes and promoting their independence.

Staff were trained to carry out their roles and newly appointed staff were supported in their role by an induction period.

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.

We found five breaches of the Regulations around fit and proper persons employed, safe care and treatment, complaints, statutory notifications and good governance. We made one recommendation in relation to meeting nutritional and hydration needs. You can see what action we told the provider to take at the back of the full version of the report.

26 January 2016

During a routine inspection

The inspection took place on 26 January and 3 February 2016. The first day of the inspection was unannounced; the provider knew that we would be returning for the subsequent day. Hillgreen Care Ltd - 6 Stoke Newington Common is a residential home which provides care and support to a maximum of six people with learning disabilities, some of whom may also have mental health conditions. At the time of the inspection there were five people living at the service.

Our last inspection was completed on 12 and 13 March 2015 and breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to medicines management, dignity and respect, good governance and statutory notifications. We checked whether the provider had followed their plan during this inspection to confirm that they now meet legal requirements.

There was a newly appointed manager in post who was going through the process of registering with the Care Quality Commission to become the registered manager of the service. 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 were kept safe from the risk of abuse by well supported staff who felt confident to raise concerns about poor practice. However, not all risk assessments were robust enough to guide staff about how to manage risks to people who had diabetes.

The provider had not ensured that staff had adequate knowledge to meet people’s needs because mandatory training had not been completed by all staff.

The provider had used a robust recruitment procedure to employ enough suitable staff to meet people's care needs. The staff developed caring relationships with people who used the service; They took the time to talk to people and obtain consent for day-to-day tasks. The provider had taken steps to ensure staff were respectful in their treatment towards people living at the service. People were well supported to raise any concerns they held.

The provider was inconsistent in following the latest guidance and legal developments about obtaining consent to care. Care staff were aware of how to support people to express their views about their care. There was evidence that people were involved in planning their care and were supported to develop their independence. However, the manager had not kept abreast of the how the latest legal developments in the field affected their role.

Medicines were stored and administered safely. People were supported to get enough to eat and drink and people had access to healthcare professionals.

There was an open and positive culture at the service and care staff told us the team worked well. There were a range of methods conducted to monitor and improve the service and the new manager was implementing further developments in this area.

We have made one recommendation in relation to risk assessments. We found one breach of regulations relating to staffing. You can see what action we told the provider to take at the back of the full version of the report.

12 and 13 March 2015

During a routine inspection

The inspection took place on 12 and 13 March 2015 and was unannounced. Hillgreen Care Ltd – 6 Stoke Newington Common provides accommodation and personal care to a maximum of six adults with learning disabilities. At the time of the inspection five people were living at the service.

There was 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.

A series of improvements had been made to the service since a new management team was set up and the registered manager was motivated to drive forward developments in the quality of the service.

However, we found people were not always protected from potential harm because staff did not have a full understanding of the role of the local authority with regard to safeguarding and whistleblowing. Furthermore, staffing numbers were not always sufficient to meet people’s individual needs and recruitment processes were not robust because not all references had been validated. The service could not be assured that staff had the skills necessary to meet people’s needs because gaps in training were not addressed in a timely manner.

People were at risk because the service did not always manage medicines safely and one person had not received their medicine as prescribed on two separate occasions in March 2015.

The service demonstrated good practice around supporting people who had behaviour that may challenge the service or others. Staff demonstrated a good working knowledge of how to respond to people’s behaviour and were guided by health and social care professionals and detailed plans.

People experienced good health outcomes and were referred to health and social care professionals promptly when this was required. People were protected from the risk of poor nutrition and dehydration by good monitoring and staff understanding.

The service had acted lawfully when depriving people of their liberty and staff had a working knowledge of the principles of the Mental Capacity Act 2005. Within this context, risks to people’s safety were managed appropriately and people were able to make decisions about their daily care such as bathing preferences and when they got up. People were supported by staff to live as independently as possible. However, the service did not ensure that all people with capacity to make their own decisions received effective support to make informed choices about complex social issues.

There were caring relationships between staff and the people living at the service. People and their relatives were positive about staff attitudes towards them. However, people’s dignity was not always maintained as we observed one person’s weight being referred to in a derogatory manner by one member of staff.

People’s cultural and religious diversity was respected and people who expressed their sexuality were treated with respect. We have made a recommendation about supporting people with regard to relationships and expressing sexuality.

The service demonstrated good practice around providing person-centred care that was responsive to people’s needs. People were appropriately involved in their own care planning and care plans were reviewed regularly with care staff involvement to ensure they accurately reflected people’s current needs.

People were protected from the risk of social isolation during the day because there were a range of day time activities available. However, evening activities were lacking; therefore people were not supported to maintain a full social life.

People felt they could raise issues with staff and there were regular keyworker sessions and residents’ meetings where people could feedback about the service. However, there was not a system to effectively track concerns and relatives felt issues they raised were not always dealt with to their satisfaction.

There was an open culture at the service. People and their relative’s spoke highly of the registered manager and staff felt they could approach him with any concerns. Internal communication systems were effective and staff were aware of their roles and what was expected of them.

However, the service was not always organised in a way that promoted safe care through effective quality monitoring and spot checks of staff were not undertaken. Statutory notifications were not always submitted where necessary. We have made a recommendation about implementing a statutory notification system.

We found breaches of four regulations relating to safe care and treatment, statutory notifications, dignity and respect and good governance. The action we have asked the provider to take can be found at the back of this report.

16 October 2013

During an inspection looking at part of the service

We spoke with three members of staff during our visit. We found that people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

10 April 2013

During a routine inspection

We were able to speak with three people who used the service and also five staff working in the home on the day of our inspection, including the service manager. People who spoke with us told us they liked living in the home and that staff treated them with dignity and respect. One person told us, "I like living here. Staff are good to me." Another person said, "I like my keyworker. He helps me a lot."

People experienced care, treatment and support that met their needs and protected their rights. Staff were aware of people's individual care needs. They also supported people with their cultural and religious needs. This included attending places of worship and restaurants and cafes where people could enjoy meals of their choice. Staff told us they would benefit from attending Makaton sign language course. This would allow them have better communication with some of the people living in the home.

People were not protected against the risk associated with the unsafe use and management of medicines, by means of the making of appropriate arrangements for the obtaining, recording, handling, using, dispensing and safe administration of medicines used for the purposes of the regulated activity.

There were enough qualified, skilled and experienced staff to meet people's needs.

29 May 2012

During an inspection in response to concerns

Most people told us that they were involved in different activities and that they liked living in the home. One of the people told us "I am very happy here. We go out for walks". One person said that they would like to move to a more independent setting.