Hillcrest Residential Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question good. At this assessment the rating has changed to Requires Improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities. We received mixed feedback from people relatives and staff members. One relative told us, “As soon as [my relative] moved in I knew it was the best place for [them]; the staff did everything they could for [them], [deputy manager] is fab, the staff were all so friendly I felt so happy that [my relative] was at Hillcrest. I went whenever I could, and we all visited because we all live close.” We received mixed feedback from staff, with some staff stating that they felt supported to do their role and some stating that they did not this meant that a positive culture was not embraced and embedded into practice. Staff said this caused anxiety for the staff team and staff morale was affected.

The provider did not always embody the culture and values of their workforce. They did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty.At the time of the inspection no registered manager was in place and a deputy manager was overseeing the service We received mixed feedback from staff with some Staff feeling that the culture of the home was not a positive one and others feeling that although there were difficulties the deputy manager was doing a good job.’ Staff were mostly supportive of the deputy manager and recognised the challenges that the deputy manager is facing following the registered manager leaving the service.

People did not always feel they could speak up and that their voice would be heard. People, relatives and staff feedback that they did not always feel listened to by provider. Staff told us that they felt restricted in what they could do and although they did speak up action was not always taken. One staff member told us they have spoken up regarding a hole in the bathroom floor, this was reported to the provider as the staff member felt it required urgent action, staff member stated that no action had been taken, and a bin had been placed over it. Another staff member told us “I raise things when I see them and think they need to change, sometimes the change happens, then it goes back to how it was, nothing changes for good.”

The provider did not always value diversity in their workforce. They did not always work towards an inclusive and fair culture by improving equality and equity for people who worked for them. Many staff members told us that they did not feel empowered in their role, although staff meetings took place, things didn’t change. One staff member told us that they felt ’unappreciated and demotivated’, due to saying the same things repeatedly. Although the staff team felt that they worked together and supported each other well they did not always feel supported by the provider.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance, and outcomes, or share this securely with others when appropriate. We reviewed audit records for the service. Some aspects of governance were positive, showing detailed audit trails of care records, health and safety, and IPC for example. However, there was a lack of detailed analysis following audits, for example, of any lessons learnt following safeguarding concerns, and updates of care plans and risk assessments where gaps had been found.

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement. We received positive feedback from partners regarding communication with them. One health professional said “We do find [deputy manager] to be responsive to enquiries and follows up as required. Communication is easy and we can liaise smoothly about [people].” However, we found action was not always taken as required for people. For example, one person who had moved to service was distressed about their situation, this had been escalated by management, but not resolved and further escalation had not taken place. This had left the person feeling vulnerable and angry due to the uncertainty of their situation.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcomes and quality of life for people. They did not always actively contribute to safe, effective practice and research. The deputy manager was aware of the challenges that Hillcrest faced regarding the improvement required and had started to take action to improve and address some of the issues regarding the environment, staff morale, and support and activities for people that used the service. However, this required support from the provider to ensure that the issues identified could be rectified and embedded into practice.