We carried out a review of the data available to us about Hill Ash House Care Centre 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 Hill Ash House Care Centre, you can give feedback on this service.
Hill Ash House Care Centre 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. Hill Ash House Care Centre does not provide nursing.
Hill Ash House Care Centre accommodates 36 people in one adapted building in the village of Dymock. At the time of our inspection there were 28 people living at the home.
People’s experience of using this service and what we found
The service had made improvements in implementing safeguards to ensure safe recruitment practices were followed.
People and their relative spoke positively about the staffing team and the leadership in the home.
People were supported by a consistent staffing team who understood their needs and how to protect them for avoidable harm. Care documentation and risk assessments were in place, which provided staff with guidance on how to meet people's needs and manage identified risks.
People were supported to receive their medicines safely and as prescribed.
People were supported by staff who had been trained and supported to meet their needs.
The service had infection control processes and systems in place to reduce the risk of people contracting COVID-19.
Managers promoted a culture which enabled people, their representatives and staff to feel comfortable in giving feedback, raising a concern or where needed, to make a complaint.
There were quality monitoring systems and processes in place to ensure outcomes for people remained positive and that the service remained compliant with necessary regulations. Since our last inspection we found improvements were made to ensure that audits were fully effective in identifying and addressing quality and safety concerns in areas of infection control and staff recruitment.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 29 October 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 24 August and 2 September 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link on our website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Hill Ash House Care Centre 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. Hill Ash House Care Centre does not provide nursing.
Hill Ash House Care Centre accommodates 36 people in one adapted building in the village of Dymock. At the time of our inspection there were 27 people living at the home and one person was being admitted on the first day of the inspection.
People’s experience of using this service and what we found
People, their relatives and staff consistently praised the leadership in the home and the quality of care people received.
We found some improvements were needed to ensure safe recruitment practices were followed and that audits were fully effective in identifying and addressing quality and safety concerns in areas of infection control and staff recruitment.
We did not find that these shortfalls had impacted on people’s care and the registered manager had started taking action during our inspection to ensure improvements were being made.
People received care and support from a consistent staffing team. Staff spoke positively about the support they received and how this promoted person centred care.
Staff understood people's needs and how to assist them to protect them from avoidable harm. Care plans and risk assessments were in place, which provided staff with guidance on how to meet people's needs and manage identified risks.
People were supported to receive their medicines safely and as prescribed.
People were supported by staff who had been trained and supported to meet their needs. People and their relatives spoke positively about the caring nature of staff.
The service had infection control processes and systems in place to reduce the risk of people contracting COVID-19.
Rating at last inspection
This is the second time we have inspected this service since it was registered in July 2019. The first time we inspected (02 March 2021) we undertook a targeted inspection and therefore did not rate the service.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 24th August 2021 and 2nd September 2021.
This was a planned inspection based on the service being newly registered.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last inspection, by selecting the ‘all reports’ link for Hill Ash House Care Centre on our website at www.cqc.org.uk.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Hill Ash House Care Centre accommodates 36 people in one adapted building in the village of Dymock. At the time of our inspection there were 19 people living at the home. Hill Ash House Care Centre does not provide nursing care.
Hill Ash House Care experienced an outbreak of COVID-19 in December 2020 to January 2021.
We found the following examples of good practice.
Visitors to the home had their temperature taken, were asked relevant COVID-19 questions and were supported to sanitise their hands and put on personal protective equipment (PPE). People had received visitors by appointment only, in the garden in good weather and in a designated visiting room. This was accessed from the outside by the relative and designed to prevent the introduction of infection. Relatives were supported to visit inside the home, in exceptional circumstances, in line with government guidance, such as end of life support. During the home’s COVID-19 outbreak all visiting stopped except for exceptional circumstances. The registered manager was aware of changes in visiting guidance and was organising this in line with government guidance.
People had been supported to self-isolate during the home’s COVID-19 outbreak. The layout of the premises supported the cohorting of COVID-19 positive and negative tested people, although it had been assessed as too distressing for people to do this. People who lived with dementia and who could not successfully self-isolate in their bedroom, had been supported to remain segregated from others. Before and after the outbreak social distancing guidelines were followed.
Admission to the home was completed in line with COVID-19 guidance. People were only admitted following a negative COVID-19 test result and were supported to self-isolate for up to 14 days following admission to reduce the risk of introducing infection. In instances where this had not possible, the registered manager had put measures in place to mitigate the risk.
Action had been taken to reduce the risk of infection spreading. The provider had ensured adequate supplies of personal protective equipment (PPE). All staff, including laundry and kitchen staff, had received training and support in relation to the use of PPE. Staff had been provided with infection, prevention and control (IPC) training as well as other COVID-19 related training. The registered manager observed staff practice ensuring they followed correct PPE and IPC guidance.
People and staff were tested in line with national guidance for care homes. Testing had helped the registered manager identify when full infection control measures needed to be implemented and when staff needed to self-isolate.
All areas of the home were well ventilated, looked clean and were uncluttered supporting easy and effective cleaning. Cleaning had been enhanced including cleaning of frequently touched surfaces to reduce the risk of infection spreading. Footfall through the home had been reduced by the different use of the buildings entrances and exits. Decontamination of the premises had been completed post outbreak. Arrangements were in place for the safe handling of laundry and waste.
The provider’s policy for managing COVID-19 and related infection prevention and control procedures had been reviewed and kept up to date. COVID-19 guidance was also kept up to date for staff reference. The registered manager and staff had reflected on the COVID-19 outbreak to help inform any adjustments needed to their COVID-19 management and outbreak plan.
People’s care and health needs had continued to be monitored and supported throughout the home’s outbreak. Healthcare professionals continued to provide support to maintain people’s health including the provision of the COVID-19 first vaccination.
People were supported with activities and engagements which met their health and wellbeing needs, in a safe manner and which reduced the risk of infection spreading.