Hillcroft Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation 11 in relation to need for consent.

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 always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

We found care plans were not consistently completed in a timely manner for new residents, although initial care plans had been completed. We found existing care plans were not always updated in line with changes in people’s needs. For example, daily notes showed a person had a catheter fitted which was not reflected in this person’s care plan.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Electronic care planning systems in use did not record people’s fluid intake targets or calculate their daily totals. The registered manager told us although fluid information was input into the electronic system, it did not transfer to the main system, so paper records were used to monitor hydration. When we reviewed these paper records we found they were not clearly printed or consistently completed, and they did not show any follow up action when a person repeatedly failed to meet their fluid target.

Meals were cooked on site, supported by a 4 week rotating menu which included puree meals, a soft option and an easy to chew option. We saw a dietary information sheet in the kitchen to advise kitchen staff of people’s dietary needs, however, this was last updated in 2024 and contained information regarding people who no longer live within the home. Not keeping this information up to date places newer residents who have dietary needs at risk of harm.

We observed people having lunch in the living room, while seated in their chairs. Staff asked each person individually what they would like to eat. For people who required assistance with eating, staff provided this to people in an unhurried way. However, the support observed was task focused, and on one occasion a member of staff engaged in conversation with another person while assisting someone with their meal. Reducing the quality of person-centred interactions.

The provider worked well across teams and services to support people. People’s assessments and needs were shared with professionals when they moved between services.

We saw evidence external professionals were involved in people’s care and support, including GPs, speech and language therapists (SALT) and other social care resources such as opticians. Staff kept records of these visits and their outcomes, and this information was added to people’s care plans. However, the recommendations provided were not always followed, even when clearly recorded in the care plan. For example, we saw SALT had recommended a person to have their medicine administered in crushed or liquid form but medicine records showed this had not been followed.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People received support to access and take part in health and lifestyle changes and were supported to access medical professionals as and when required. We saw evidence a person had a recently received an eye test.

One person told us, “Staff know about me, and staff are very good at caring for my needs.”

There were organised activities available 3 days a week, alongside special events held throughout the year to celebrate significant occasions. These opportunities supported people to maintain social connections and promote their emotional wellbeing.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive andconsistent, or that they met both clinical expectations and the expectations of people themselves.

We found care plans did not always align with the care being delivered. For example, daily notes recorded a person had a catheter in place, however, this was not reflected in their care plan, and there was no catheter risk assessment in place for this person. In another instance, a person’s care plan included recommendations from SALT for their medicine to be administered crushed or in liquid form. However, medicine records showed the person was receiving their medicines whole. These inconsistences meant people were at risk of receiving care that did not consistently reflect their assessed needs or professional guidance.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment.

Each person’s care records included a consent form, and individual risk assessments such as those relating to the use of bedrails contained a consent section. We reviewed several documents for people and found none of them had been signed by the person themselves; instead, they had been signed by a member of staff. This meant there was no evidence to show people had provided their consent to these decisions. Where people lack capacity to consent and haven’t legally appointed someone to do so on their behalf, any decisions need to be done via the best interest process. Best interest documents viewed, showed not all appropriate agencies had been involved in the decision making process. We saw several people had bedrails fitted. Documentation showed only staff members had been involved in the decision making regarding this. One person who had bedrails fitted told us they had not been explicitly asked around the use of bedrails, and they believed bedrails were a standard fitting on the bed.

We identified one person whose Deprivation of Liberty Safeguards (DoLS) authorisation had expired. The existing authorisation covered the use of bedrails and a safety belt. The registered manager informed us the renewal application had been submitted. There was no evidence of an outcome from the local authority, nor any record to show the application had been followed up. Following our assessment, we were told by the registered manager the application had not been received by the local authority, we have received evidence showing the application has been resubmitted retrospectively.