The inspection was carried out on 18 December 2017. The inspection was announced.Hilton Nursing Partners Limited is registered with CQC to provide personal care to people in their own home. The service is provided immediately following discharge from hospital for a limited number of days, supporting and allowing people time to re-adjust to living at home, whilst during this time establishing together what a person’s on-going needs may be. The office for the service is based in Ashford, and services are provided throughout Kent and Essex. At the time of the inspection the service was providing support to between one hundred and one hundred and fifty people, who mostly received a service for three days in Kent or five days in Essex following discharge from hospital. Sometimes the time would be extended as nobody would be left without appropriate support in place. The support provided by staff aims to enable people to live, regain confidence and for them to remain in their own home, as the care provided is uniquely tailored to the individual’s needs to support their recovery. One member of staff told us, “The service gets people home quickly from hospital, as sometimes it can take weeks to get a package of care organised”. They told us that they had known many successful cases, where the person had then become sufficiently independent to remain in their own home.
Information provided to people about what the service provides states, ‘Providing integrated health and social care to deliver innovative services that enable people to continue to live independently. Our success is measured by our ability to get people out of hospital and minimise their on-going social care needs’. The impact on people was summed up by one social care professional who told us, “The service offers a pathway from hospital that sees the person’s dependency upon social care reduced or eliminated”. Discussions with people showed that the impact on many of the people that the service had provided support for meant that people referred to Hilton Nursing Partners on discharge from hospital, had an opportunity with support from the staff team to regain their independence and remain in their own home.
There was a registered manager for 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 and associated Regulations about how the service is run.
The exceptional outcomes people experienced were made possible by the close working relationship between the hospital teams, and the service. The Hilton Nursing Partners teams succeeded by bringing a range of staff skills to people. For example, professional health care managers, clinical team leaders who were registered nurses, specialist assessors, coordinators and health care assistants. Additionally in East Kent, Occupational Therapists work within the multi-skilled teams providing expertise and a person centred approach to people’s care.
People told us they consistently received an excellent service which made a difference to their lives. Those people who used the service expressed satisfaction and spoke very highly of the management team and staff. For example, people said, ‘Thank you all so much for the care, kindness and support you have given to us over the past weeks. We are so grateful to you all for helping to make life more bearable. It was so comforting to know that you were there for us’, ‘Thank you for your care and support over these past days that have really been quite hard for us as a family. You have a gift of helping people and we have appreciated it so much from day one until now’, ‘Thank you so much for taking such good care of X last week, following his discharge from hospital. You were all so cheerful, kind and understanding. You helped him so much through a difficult and anxious time. Each day, he is improving and growing in confidence. You did a brilliant job’, and ‘Thank you for all your help and making a difference’. People and their relatives were extremely happy with the high standards of care they received. People using the service, their relatives, and health and social care professionals commended staff for their compassionate and caring manner. They were consistent in describing the positive impact of the care provided by Hilton Nursing Partners Ltd.
Staff consistently demonstrated they worked to the provider’s key principles of care. Staff delivered people’s care and support with respect for their dignity and privacy. People received all-inclusive care that enhanced their quality of life. Staff in the short time they provided a service developed positive relationships with people using the service and their relatives. People consistently praised staff for meeting their individual needs and preferences and going over and above to make them comfortable and happy. People who used the service felt they were treated with kindness and said their privacy and dignity was always respected.
People received a service that was based on their personal needs and wishes. Changes in people's needs were quickly identified and their support needs amended to meet their changing situation. The service was flexible and responded very positively to people's requests. People who used the service felt able to make requests and express their opinions and views. Management and staff sought ways to continually improve, put changes into practice and sustain them.
People received personalised care that was delivered by trained staff that understood what was important to them. Staff were skilled in meeting their needs and were creative in tackling challenges. People received a responsive and consistent service from a multi-disciplinary team of staff. Staff understood the importance of promoting people's independence and ensuring they retained their self-esteem. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the polices and the systems in the service supported this practice.
People felt safe and secure when receiving care. The safety of people who used the service was taken very seriously and the registered manager, management team and staff were well aware of their responsibility to protect people's health and wellbeing. The service had suitable processes in place to safeguard people from the potential of different forms of abuse. Staff had been trained in safeguarding people and in the whistleblowing policy. There were systems in place to ensure that risks to people's safety and wellbeing were identified and addressed. Risks had been identified for individual people and their circumstances and measures had been put in place to control and reduce risks, helping to keep people safe.
Staff championed people’s rights to freedom and choice in their day to day service provision. People received care and support in line with the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.
Most people either managed their own medicines or their family members helped them. Some people required the health care assistants to assist with their medicines. The management team checked that staff were safe to administer people's medicines by carrying out regular competency assessments. The management team ensured that staff had a full understanding of people's care needs and had the skills and knowledge to meet people's needs
The service had robust recruitment practices in place to ensure staff were safe and suitable to work with people. An extensive range of training was provided and training was refreshed at regular intervals. All staff received a two week induction training and they worked alongside experienced staff when they first started employment. Staff had their competency assessed before they were allowed to work on their own. Support and the opportunity to develop was given through regular one to one supervision, observational assessments and annual appraisals. Staff were very highly motivated and proud of the service. They said that they were fully supported by the registered manager and management team and a programme of training and supervision that enabled them to provide a high quality service to people.
Staff presented a caring approach as did the staff working in the office who supported the delivery of care. People were happy with the staff and made many positive comments about the staff, even naming specific staff who had supported them. For example, “To X and X, We would like to say a big thank you for all your help and being so nice, helpful and happy”.
The provider made sure people had information about the service people could expect within a Hilton Nursing Partners Ltd folder at the commencement of care and support. People who used the service confirmed they were given information about service.
There were enough staff available to meet people's needs. People were supported with meal planning, preparation and eating and drinking as needed. Staff also supported people, by contacting the office to alert management, to any identified health needs so that their doctor or nurse could be informed. Staff felt they were well supported and their requests were responded to quickly. They found the management approachable and would be happy to raise any concerns with them, confident they would be acted on.
Management had processes in place to monitor the delivery of the service. People were given information about how to make a complaint and the people we spoke to knew how to go about making a complaint if they needed to. People's views were obtained through meetings with the person and meetings with families of people who used the service. The provider checked how well people felt the service was meeting their needs, by carrying out sur