• Care Home
  • Care home

Archived: Hillgreen Care Limited - 14 Colne Road

Overall: Inadequate read more about inspection ratings

14 Colne Road, London, N21 2JD

Provided and run by:
Hillgreen Care Limited

All Inspections

22 January 2016

During an inspection looking at part of the service

14 Colne Road is a residential care home providing care for up to six younger adults with learning disabilities. On the day of the inspection there were five people using the service.

This focused inspection took place on 22 January 2016 as we had received serious concerns from the local authority as part of a food safety inspection that had taken place. We checked whether the provider was in breach of legal requirements in relation to Regulation 15 and 17 concerning premises and equipment and good governance.

At the time of the inspection there was no registered manager in place. 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.

At the last comprehensive inspection which took place on 19 November 2015, the provider was found to be in breach of Regulations 9, 12, 16, 17, 18 and 19. These covered safe care and treatment, fit and proper persons employed, staffing, person centred care, receiving and acting on complaints and good governance. Not all of the above Regulations were looked at as part of this focused inspection. However, the provider was found to be in continued breach of Regulation 17.

On 19 January 2016 a food safety inspection had been carried out by the local authority. This had highlighted serious concerns around the safe management of food, health and safety risks and infection control issues. The inspection made reference to certain issues which included out of date food, cross contamination and appropriate storage of foods. The report also highlighted health and safety issues which included structural concerns of the building, pest control, cleanliness of the home and certain pieces of equipment within the home and the poor condition of the kitchen and the cupboards within the home and also raised concerns about the knowledge of staff in relation to food safety.

At our inspection, we found that the provider had implemented some improvements in response to the recommendations that the local authority had made. However, at the time of this focused inspection we noted that certain remedial actions which could have been implemented immediately had not been applied.

There were inadequate arrangements in place to prevent and control the spread of infection and ensure that the premises and equipment were clean. There was no infection control policy in place and staff were not adhering to a cleaning schedule. We saw evidence of poor infection control practice. This included overflowing bins, unclean areas and inappropriate storage of clinical waste. The storage of hazardous substances was not safe and presented a risk to people using the service. The premises were not being properly maintained.

There was ineffective management oversight of the home and the service it provides. The provider had failed to appoint someone to the role of manager since early December 2015. The deputy manager was not being provided with sufficient support to ensure that the service was being effectively run. The provider had failed to identify serious issues in relation to the running and management of the service. The systems in place to identify issues were either ineffective or had not been implemented. In relation to a number of issues, action appeared to be taken by the provider only when external independent agencies identified issues. Some of these issues potentially placed people and staff at risk of harm. When action was taken, it was not always effective or addressed all of the issues that had been highlighted.

Certain issues around the structure and condition of the building had been highlighted to senior managers by staff working within the home. However, no action had been taken.

During this inspection we found the provider to be in breach of Regulation 15 and 17. This report only covers our findings in relation to these breaches. We are in the process of taking enforcement action against the provider. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for 14 Colne Road on our website at www.cqc.org.uk.

We will undertake another unannounced inspection to check on all other outstanding breaches of regulations identified for this service.

7 March 2016

During an inspection looking at part of the service

This focused inspection took place on 7 March 2016 and was unannounced. This inspection was carried out by a single inspector. We undertook this inspection because we had concerns about the safe management of epilepsy for people using the service. This report only covers our findings in relation to the management of risk and medicines within the safe section. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Hillgreen Care – 14 Colne Road on our website at www.cqc.org.uk

14 Colne Road is a residential care home providing care for up to six younger adults with learning disabilities. On the day of the inspection there were three people using the service.

Protocols to keep people safe in the event of an epileptic seizure were not always being followed which was putting people at risk of unnecessary and, potentially, significant harm.

Staff had not been provided with specific training in the use of an emergency epileptic medicine so this potentially lifesaving drug could not be administered if required.

During this inspection we found the provider to be in breach of Regulation 12 (1)(2)(a)(b)(g) in relation to assessing risk and the safe management of medicines.

This report only covers our findings in relation to these breaches. We are in the process of taking enforcement action against the provider.

We will undertake another unannounced inspection to check on all other outstanding breaches of regulations identified for this service.

19 November 2015

During a routine inspection

14 Colne Road is a residential care home providing care for up to six younger adults with learning disabilities. On the day of the inspection there were five people using the service. This inspection took place on the 19 November 2015 and was unannounced. At the previous inspection carried out in February 2014, the service met the required standards in care and welfare of people who use services, management of medicines and supporting workers.

At the time of the inspection there was no registered manager in place. However, a manager was in post that planned to apply to register with the Care Quality Commission (CQC) as the 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 were positive about the service and liked living at the home. They were happy with the care and support they received from the staff. We observed people being treated with dignity and respect. Staff were aware of people’s needs and the action they should take to meet those needs.

The service had a number of systems in place in order to monitor and maintain people’s safety but these were not always effective. Improvements needed to be made to the management of medicines.

We looked at the process of the recruitment of staff and found that not all staff files could evidence that criminal record checks had been undertaken and references had been requested and received.

Staff supervisions were being completed but these were not consistent and were not in line with the company policy which stated ‘monthly or six weekly’. Annual appraisals had not been carried out. The manager appointed at the time of the inspection was able to demonstrate that these issues had been identified and a tracker for supervisions was in place to enable the manager to monitor and track the frequency of supervisions. The manager had also begun completing appraisals for those staff members who were completing one year of their employment.

We found that people’s health care needs were assessed, although in one case we found that a health action plan had not been updated since January 2014. People using the service had a range of needs and we found that the information and guidance provided to staff was clear. Any risks associated with people’s care needs were assessed and plans were in place to minimise the risk as far as possible to keep people safe, although there was one exception. Not all risk assessments and care plans had been signed by all staff to verify they had read and understood them.

A copy of the provider’s complaints policy was not available. Systems to collect and act on feedback were not robust.

We saw that there were policies, procedures and information available in relation to the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) to ensure that people who could not make decisions for themselves were protected.

The staff of the service had access to the organisation’s policy and procedure for protection of people from abuse. Staff were in receipt of regular training which included training about protecting people from abuse. Staff that we spoke with also confirmed that they had received training in a number of areas including safeguarding and were able to explain the action they would take if a concern arose.

People were encouraged and supported to take part in day to day activities. These included attending a day centre during the week and taking part in leisure activities during the weekend.

People knew who the manager was and were confident that they could raise any issues or concerns with any staff member.

We found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

7 February 2014

During an inspection looking at part of the service

People we spoke with were positive about the care and support provided at the home. We observed staff supporting people in a friendly manner and people appeared comfortable and at ease with the staff.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We saw that these plans were being reviewed on a regular basis with input from the person using the service where possible.

Appropriate arrangements were in place in relation to the recording of medicine. Medicines were being kept safely, were being safely administered and were being disposed of appropriately.

Staff had undertaken training that was appropriate and relevant to the needs of the people using the service. Staff were able to describe how training had improved their understanding of the issues faced by people they supported and how it had benefited their working practices.

10 September 2013

During a routine inspection

Because people at the home were not always able to communicate verbally with us, we spent time observing interactions between staff and people using the service to see what effect those interactions had on people's well-being.

People we spoke with were positive about the care and support provided at the home. We observed staff supporting people in a friendly manner and people appeared very comfortable with the staff at the home. One person commented 'I'm happy.'

Staff we spoke with understood the importance of obtaining the consent of the person before any care or treatment took place. People we spoke with confirmed that staff asked for their permission before any care and support was provided.

People told us that they were happy at the home and had no concerns or complaints about their care. We saw that there were regular house meetings so that people could raise any issues or concerns with the manager.

People's healthcare and social care needs were not always being recorded in sufficient detail to ensure their safety and welfare. People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

Records showed and staff told us there were gaps in the essential training they needed to ensure the safety and welfare of people they supported.

14 February 2013

During a routine inspection

People who use the service told us that staff were kind and respected their privacy. They confirmed that staff treated them with respect and dignity. One person commented, 'they treat me good.'

We saw evidence that people who use the service were able to go out to the local community. People attended day centres, colleges and voluntary work experience. One person told us, 'I go to college.'

Staff had a good understanding of the needs of the people they supported and people's care plans and risk assessments were being reviewed and updated with the person's involvement where possible.

People who use the service told us that they felt safe with the staff who supported them. They said they had no concerns or complaints about their care but would speak with their relatives, the manager or their key worker if they needed to.

Staff told us they felt supported by the management and that there were good training opportunities available within the organisation.

There was evidence that the manager and provider spoke with people using the service to gain their views about their care as well as identifying any areas for improvements. One person told us, 'they ask if we're happy.'

12 July 2012

During an inspection looking at part of the service

During the inspection we met and spoke to three people using the service. The atmosphere was friendly and relaxed. People told us they were happy with the care and support they received at the home. They also told us that they had confidence in the staff and felt safe with the way that staff supported them to take their medication. Medication records were accurate and up to date.

26 November 2011

During a routine inspection

Not everyone in the home can communicate verbally so we spent time observing people who use the service to see what effect the environment and staff interactions had on peoples' wellbeing. We observed staff supporting people in a friendly and professional way and saw that people were being offered choice with regard to menus and activities.

People told us that staff were kind and respected their privacy. One person commented, 'Everything is going alright'.

People told us that staff would knock on their door before entering their room.

People also confirmed that they attended regular meetings with the manager to talk about any issues in the home.

Staff we interviewed were able to give us examples of how they maintained peoples' dignity, privacy, independence and how they offered choices to people on a daily basis.

People who use the service said they enjoyed going out of the home and told us about recent trips to the shops, local parks and restaurants.

One person commented, 'They take me out. We do all kinds of things'.

People who use the service confirmed that they help out around the home. A person told us, 'I wash up, hoover and wash my own clothes'.

We asked people who use the service what they thought about the care and treatment they receive at the service. They generally responded positively and said they felt supported by the staff team and that they were included in decisions about their care as far as possible. One person commented, 'I want to be more independent'.

We observed that the way staff were supporting people in the home had a positive effect on their well being.

Staff we interviewed had a good understanding of the needs of the people they supported.

People who use the service indicated to us that they felt safe with the staff at the home.

Comments included, 'They treat me OK' and 'I would talk to the manager if I was worried about anything'.

Staff we interviewed were aware of the different types of abuse that can happen to people in a care setting. Staff were also able to give us examples of signs they would look out for that may indicate a person may be being abused.

Staff told us that if they ever suspected abuse was taking place they would inform the manager immediately.

The service was not always following their own medication policies and procedures and this was putting people who use the service at unnecessary risk.

People who use the service indicated that they were happy with the staff who supported them. We observed friendly and supportive interactions between staff and people living at the home.

We observed staff being appropriately supported by the management so that they could provide for the care needs of the people who use the service.

People who use the service confirmed that the staff asked them how things were going and if they were happy with the care provided at 14 Colne Road.

One person commented, 'We have meetings together so we can talk about things'.