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Inspection Summary


Overall summary & rating

Good

Updated 22 May 2018

The inspection visit took place on 16 and 17 April 2018. The first day of the inspection was unannounced.

Hillcroft Slyne Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Hillcroft Slyne Nursing Home is situated in the parish of Slyne-with-Hest close to the city of Lancaster. It provides accommodation for up to 48 people in three ground floor units, supporting people with general nursing needs, dementia and complex behaviour that may be challenging. At the time of our inspection 46 people lived at Hillcroft Slyne Nursing Home.

There was a registered manager employed at Hillcroft Slyne Nursing Home. 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 inspection on 17 April 2017 we asked the registered provider to take action to make improvements around the auditing of records related to the application of topical creams, and this action has been completed.

At the last inspection, there was a breach of Regulation 12 HSCA RA Regulations 2014 (Safe care and treatment). Staff did not always follow policies and procedures on the administration of medicines. We asked the registered provider to complete an action plan to show what they would do and by when to improve the key questions of Safe and Well – led to at least Good.

At this inspection we found the registered provider continued to provide a good standard of care to people who lived at the home.

We observed medicines administration and reviewed documentation around the administration and management of medicines. We looked at documentation related to the application and recording of topical creams. We found medicine protocols were followed correctly by staff trained to administer medicines. Documentation we viewed guided staff clearly on where to apply prescribed creams. We did not find any missed signatures within medicine and topical cream recording charts which indicated people had received appropriate treatment in accordance with their care plan and clinical guidance.

People who lived at Hillcroft Slyne Nursing Home had care plans that reflected their complex needs and these had been regularly reviewed to ensure they were up to date. The care plans had information related to all areas of a person’s care needs. Staff were knowledgeable of people’s needs and we observed them helping people as directed within their care plans.

Relatives told us staff treated their family members as individuals and delivered personalised care that was centred on them as an individual. Care plans seen and observations during our visit confirmed this.

Staff delivered end of life care that promoted people’s preferred priorities of care.

The registered provider had refurbished the home to ensure people living with dementia were living in an environment that promoted their safety, independence and positive wellbeing.

We saw staff were responsive to each person’s changing needs. They worked together to ensure people who became agitated were offered a selection of person centred interventions to meet their needs and soothe their agitation.

There were systems to record safeguarding concerns, accidents and incidents and corrective action took place as required. The service carefully monitored and analysed such events to learn from them and improve the service.

Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices. The registered provider had reported incidents as required.

People are supported to have maximum choice and con

Inspection areas

Safe

Good

Updated 22 May 2018

The service has improved to Good.

The registered provider had systems to ensure medicines were managed and administered safely and properly.

Accidents and incidents were monitored and managed appropriately, with an emphasis on learning when things went wrong.

Systems were in place to protect people against the risks of abuse or unsafe practice. Staff had been recruited safely and had been trained to safeguard people who may be vulnerable.

Effective

Good

Updated 22 May 2018

The service was effective.

Staff received a thorough induction and a good level of training and support. We observed positive interactions showing staff were knowledgeable on how to support people effectively.

People were supported to have positive dining experiences. Staff provided appropriate support to people managing complex needs and prompting people’s independence.

People had as much choice and control over their lives as possible. The service empowered people to make their own choices.

People’s health and wellbeing was monitored and they were supported to access healthcare services when they needed them.

Caring

Good

Updated 22 May 2018

The service was caring.

People and their relatives praised the caring approach of the staff that supported them.

The service had policies and procedures which took into account people’s human rights and helped to prevent discrimination.

People and, where appropriate, others acting on their behalf were involved at each stage or the care and support planning process, including review meetings.

Observations during our inspection visit showed people were treated with kindness, respect and compassion.

Responsive

Good

Updated 22 May 2018

The service was responsive.

The registered provider developed personalised care plans to guide staff to provide highly responsive support.

The registered provider ensured people were supported to engage in activities they enjoyed and valued.

The registered provider had arrangements to manage complaints and concerns.

The registered provider held information on people’s preferences on how they would be supported with their end of life care. Staff were able to share strategies on how to provide people with a comfortable dignified death.

Well-led

Good

Updated 22 May 2018

The service has improved to Good.

People we spoke with, their relatives and staff all told us they felt the service was well-led. Everyone we spoke with felt there was a positive person centred culture throughout the home.

The registered provider had comprehensive systems to assess, monitor and improve the service.

We found the registered provider had high standards and a great desire to work in partnership with other agencies to maintain and enhance the care and support delivered to people.

The provider had improved their systems to ensure CQC were notified of all reportable incidents.