We carried out a review of the data available to us about Hillcroft House Galgate on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Hillcroft House Galgate, you can give feedback on this service.
We found the following examples of good practice.
¿ The provider had implemented an appropriate policy around visitors during the pandemic. Visits were restricted and management risk assessed each visit. Staff checked all visitors for any signs or symptoms of infection before they were allowed into the home. Visitors were required to follow best practice guidance and wear appropriate personal protective equipment (PPE). The need to restrict visits to the home had been discussed with people and their relatives.
¿ Staff supported people to maintain their relationships with their families and friends. People connected with families and friends through social media, video calls and over the telephone.
¿ The provider had implemented measures to reduce risks when people returned from hospital. This included people having to isolate in their bedrooms, following national guidance.
¿ People who lived at the home and staff were supported with regular testing for COVID-19. The provider had plans around cohorting and zoning the premises, which helped to reduce the risk when a positive result was received.
¿ Staff were provided with training around COVID-19 and the correct use of PPE. Staff used additional PPE when supporting people who had tested positive for COVID-19. We observed staff wore PPE appropriately during our inspection.
¿ We observed the home looked clean and hygienic. Staff told us high touch areas such as handles, and switches received additional cleaning several times each day. The provider had assessed risks related to infection control, COVID-19 and the general environment, in order to reduce the level of risk and keep people safe.
Further information is in the detailed findings below.
Hillcroft Galgate is a residential care home providing personal and nursing care to 36 people aged 65 and over at the time of the inspection. The service can support up to 43 people.
People’s experience of using this service and what we found
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. The provider was in the process of reviewing how their documentation reflected how they supported people effectively with decision making in line with law and guidance. Staff had received training and were knowledgeable about the principles of the Mental Capacity Act 2005.
People told us they felt safe and they received their medicines on time. Staff told us they knew how to manage risks effectively and identify signs and symptoms of abuse and who to report concerns to. The registered manager had robust recruitment procedures and staffing levels delivered responsive support to people. The home was well maintained, clean and staff had access to protective equipment to protect people from the risk of infections.
People received regular review of their care needs. Staff received training at the start and throughout their employment to ensure they had the skills to provide effective care. Staff felt very supported by the manager and management team. One staff member commented, “I love [registered manager] she genuinely cares about the residents and cares about the staff.” People told us food and drinks were of a good quality and plentiful. We saw the provider worked with community health professionals to ensure people received effective care.
People told us staff treated them with dignity and were respectful. Our observations supported these views. One person told us, “[Staff] they’re just like friends really, I love them.” We saw lots of positive interactions between people and staff, no one was rushed, and activities were person centred. One person told us, “Staff are fantastic, very caring and kind. You can’t fault the staff here they give 100%.”
Care plans contained personalised information on people’s health and communication needs plus their likes and dislikes. Activities were available for people to participate in if they wished. There was a complaints policy that supported positive engagement and timely action. The registered manager was passionate about ensuring they provided empathetic, compassionate person-centred end of life care.
The service was well led. People, staff and relatives spoke positively about the registered manager and management team. There was a positive culture throughout the service which focused on providing care that was individualised. The registered manager used a variety of methods to assess and monitor the quality of the service. They were aware of their regulatory responsibilities associated with their role.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection.
The last rating for this service was good (published 01 February 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Hillcroft House is one of six homes in the Hillcroft group. It is located in the village of Galgate, south of Lancaster. The home has two floors and staff worked on both floors as part of their rota. It is registered to provide accommodation for persons who require nursing or personal care, diagnostic and screening procedures, and treatment of disease, disorder or injury.
The building is a large stone build house adapted and extended for use as a nursing home. Hillcroft House Galgate can support a maximum of 30 people. At the time of our inspection, 28 people were living at the home.
The service had a 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.
At the last inspection on 08 August 2014, we found the provider was meeting the requirements of the regulations that were inspected. However, it was identified staffing levels on the first floor required improvement to keep people safe. Since our last inspection, staffing levels were reviewed and increased.
During this inspection, we found staffing levels were regularly reviewed to ensure people were safe. There was an appropriate skill mix of staff to ensure the needs of people who lived at the home were met.
Staff received training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.
Staff had received abuse training and understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of vulnerable adults. Staff we spoke with told us they were aware of the safeguarding procedure.
The provider had ensured risks to individuals had been assessed and measures put in place to minimise such risks. A comprehensive plan was in place in case of emergencies which included detail about how each person should be supported in the event of an evacuation.
The provider had recruitment and selection procedures to minimise the risk of inappropriate employees working with vulnerable people. Checks had been completed prior to any staff commencing work at Hillcroft House. This was confirmed from discussions with staff.
Staff responsible for administering medicines were trained to ensure they were competent and had the required skills. There were appropriate arrangements for storing medicines safely.
People and their representatives told us they were involved in their care and had discussed and consented to their care. We found staff had an understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).
People who were able to speak with us told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.
We found people had access to healthcare professionals and their healthcare needs were met. We saw the management team had liaised with healthcare providers and responded promptly when people had experienced health problems.
We saw the registered manager had ensured end of life care was person centred and sensitively delivered. Relatives were welcomed and supported when they visited their loved ones.
A complaints procedure was available and people we spoke with said they knew how to complain. People and staff spoken with felt the registered manager was accessible, supportive and approachable.
Comments we received demonstrated people were satisfied with their care. The management and staff were clear about their roles and responsibilities. They were committed to providing a good standard of care and support to people who lived at the home.
Care plans were organised and identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.
People told us they were happy with the activities organised at Hillcroft House. People told us they were happy to have the choice to participate or refuse to take part in activities. The activities were arranged for individuals and for groups.
The registered manager had sought feedback from people who lived at the home and staff. They had consulted with people and their relatives for input on how they could continually improve. The provider had regularly completed a range of audits to maintain people’s safety and welfare.
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.
This was an unannounced inspection carried out on the 5 August 2014.
Hillcroft House is one of six nursing homes within the Hillcroft group. It is located in the village of Galgate, south of Lancaster. The home is registered for 30 people and provided care and support for people with general nursing needs. The home has two floors and staff were flexible to work on both floors.
There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law, as does the provider.
The registered manager assessed staffing levels to ensure there were enough staff to meet the needs of people who lived at the home. Staff told us they were satisfied with the amount of personnel on the ground floor. However they felt not enough staff were deployed on the first floor at certain times of the day. We also received comments from relatives and people who lived at the home, telling us they felt staff were ‘always very busy’ on the first floor.
Suitable arrangements were in place to protect people from the risk of abuse. People who lived at the home told us they felt safe and secure. One person said, “Yes I feel safe here, especially at night when there are a lot of staff around checking on us.” Safeguards were in place for people who had been unable to make decisions about their care and support.
We found people were involved in decisions about their care and were supported to make choices as part of their daily life. Individual care records we looked at contained a detailed care plan which covered people’s support needs and personal wishes. We saw care plans had been reviewed and updated on a regular basis.
Staff spoken with were positive about their work and confirmed they were supported by the registered manager. Staff received regular training to make sure they had the skills and knowledge to meet people’s needs.
Staff had access to ongoing training to meet individual needs of people who required nursing care support. This ensured staff had the appropriate skills and knowledge to carry out their role effectively.
We checked a sample of care plans and daily notes. We found that actions noted in the care plans were followed through in daily records. We observed care in one of the lounge areas, and saw that staff were considerate and respectful. We heard people being offered choices.. We spoke with one visitor and two residents, all of whom spoke favourably about the home and the staff.
We looked at a sample of bed rooms and bathrooms, and found these to be clean. Staff demonstrated a good awareness of infection control. The home had appropriate equipment to ensure a hygienic environment. On the day we inspected, there were 23 residents and sufficient nursing and care staff to manage. However, numbers of residents were set to increase. Additional care staff had been appointed, and were due to start work as soon as they had completed mandatory induction training.
We checked that management oversight was in place to ensure quality standards were maintained. We found that the manager was hands on, and walked around the home on a regular basis. Additionally, formal audits were conducted by Hillcroft Limited. We saw that these systems were responsive to people's needs and improvements were made as a result.
A few practical issues were raised with us by residents. These concerned the small size of the private ensuite facilities and a shortage of day to day activities. However the overall tone was very positive.
Care plans were comprehensive and useful. Medication was safely stored and dispensed safely.
As Hillcroft House opened less than a year ago, there was not yet a full complement of staff or residents. Good beginnings have been made to establish effective ways of working.
Hillcroft House benefitted from the range of quality assurance systems operating across the Hillcroft Nursing Homes group, complimented by the work undertaken by the manager. These provided an effective basis for ensuring that good practice will be maintained.