We inspected Hill House Care Home on 24 and 25 September 2015. The inspection was unannounced.
Hill House Care Home is a service which provides nursing and personal care to elderly adults. At the time of our visit there were 51 people using the service.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The registered manager was not at work on either day of our inspection.
People felt safe. There were procedures and risk assessments in place which staff implemented to reduce the risk of harm to people. Staff had been trained in safeguarding adults. They knew how to recognise the signs of abuse and how to report any concerns.
There were procedures in place to ensure that people received their medicines safely which staff consistently followed. People were protected against the risk and spread of infection.
Appropriate checks were carried out on staff and they received an induction before they began to work with people living in the home. Staff understood their roles and responsibilities. However they were not adequately supported by the management through regular supervision and performance reviews.
There was not a sufficient number of staff on duty to meet people’s needs. Some people told us staff did not have time to speak to them.
People’s care records were not person centred and did not focus on people’s individual needs, personal preferences and dislikes.
Staff asked for people’s consent before delivering care. Staff understood the main provisions of the Mental Capacity Act 2005 and how it applied to people in their care.
Regular checks were carried out to maintain people’s health and well-being. People also had access to healthcare professionals and staff liaised well with external healthcare providers. People were supported to plan their end of life care.
People were treated with kindness and respect. Staff ensured people received a nutritious, balanced diet. People were happy with the quality of their meals and said they were given enough to eat and drink. There were a variety of group activities for people to participate in inside the home but few if any opportunities for people to leave the home unless they had the support of their relatives.
Comprehensive internal audits were conducted to check the quality of care people received. However, where areas for improvement were identified and an action plan put in place, management did not always implement the action plan.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to there being an insufficient number of staff to meet people’s needs, the lack of consistency with staff supervision and appraisal, the lack of person centred care and the lack of effective systems to assess the quality of care people received. You can see what action we told the provider to take at the back of the full version of the report.