Hill House - Care Home with Nursing Physical Disabilities

Updated 13 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Hill House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Hill House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who lived at the service and 2 relatives about their experience of the care provided. We also spoke with a visiting health professional.

We spoke with 12 staff including the registered manager, duty manager, nurses, team leaders, care staff, domestic staff and the Assistive Technology team.

We reviewed a variety of records relating to the management of the service. We reviewed 7 care plan records and sampled medication records. We reviewed 6 staff files in relation to recruitment and staff supervision.

Updated 13 January 2023

About the service

Hill House - Care home with Nursing Physical Disabilities is a residential care home providing personal and nursing care to up to 24 people. Each person had their own en-suite bedroom and access to communal lounges and adapted bathrooms. Separate to the main building is a bungalow which provides activities and facilities for people to use. At the time of our inspection there were 24 people using the service.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support :

People’s support plans were developed through personal centred support planning tools. These were up to date and reflected the person’s support needs, wishes and preferences. Assistive Technology was available to support people’s independence for those who wishes to engage with this.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice. The design and layout of the property made it accessible for a person with a physical disability, with bedrooms personalised to the individual.

Right Care:

People were supported by staff who knew them well and who had a good understanding of their needs. Staff received the training they needed to support people effectively. Additional training was planned to ensure staff had the appropriate skills to support people with a learning disability. People told us they were happy with the support staff provided.

Right Culture:

The service was well-led and staff were supported by the management team and registered manager. The registered manager had systems in place to protect people from abuse, with internal and external processes in place for reporting concerns.

Staff told us they felt supported within their roles. People told us they felt safe with the support they received and could speak to the registered manager if they had a problem.

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 13 December 2019).

Why we inspected

We received concerns in relation to staffing levels, aspects of health and safety and the management of people’s nursing care needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

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 remains good.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe and Well-Led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hill House - Care home with Nursing Physical Disabilities 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 .