Archived: Hillcroft Nursing Home

Updated 9 September 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 6 July 2015 and was unannounced. The inspection team comprised of three inspectors.

We looked at the information we already had about this provider. The provider sent us their Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

Providers are required to notify the Care Quality Commission about specific events and incidents that occur including serious injuries to people receiving care and any safeguarding matters. These are called notifications and help us to plan our inspection. We contacted other organisations such as the Clinical Commissioning Group [CCG] for information.

We spoke with 12 people who lived at the home, two relatives, the manager, operational manager, the nurse and deputy manager, five care staff, a domestic and the cook. We looked at the care records of six people, the medicine records for six people, staffing rotas, staff training records, complaint records, the providers audits of the quality of the service, accident/ incident records and staff recruitment processes. We also carried out observations of people’s care.

Updated 9 September 2015

This inspection took place on 6 July 2015 and was unannounced. At the last inspection in April 2014 we found that the provider was meeting the regulations that we assessed. The home provides accommodation and nursing care for up to 28 people, some of who were living with dementia. On the day of our inspection there 24 people living at the home.

A registered manager is required to manage this service. At the time of our inspection there were interim management arrangements in place. The provider has had interim management arrangements in place since November 2013. The current manager had been appointed in June 2014 but had not been registered with the Care Quality Commission to manage the service. A registered manager is a person who has registered with the Care Quality Commission 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.

People and their relatives told us that they felt safe. Staff had been trained and knew what to do to keep people safe from the risk of harm.

People who lived in the home and their relatives told us that they were happy with the care provided. Risks to people’s health and care had been identified and staff knew how to help reduce risks to people from falling or pressure sores.

We saw that appropriate pre-employment checks had been carried out for new members of staff so that as far as possible staff with the appropriate skills and experience were employed. People said there were enough staff to meet their needs. Our observations showed that a number of people were cared for in bed which impacted on the capacity of staff to spend meaningful time with them.

The staff told us how they had been or were being supported to achieve their vocational qualifications and they valued this opportunity. The staff told us the new manager was very approachable and responsive to requests for training.

Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Staff understood the need to ask people for their consent before carrying out care tasks. We saw the provider had followed the correct procedures where people’s liberty needed to be restricted for their safety.

People were complimentary about the choice of foods available to them. People’s nutritional and dietary needs were assessed and people were supported to eat and drink sufficient amounts to maintain their health. People had access to healthcare professionals when this was required. The arrangements in place for people’s medicines meant people received their medicines when they needed them.

We saw staff talking and listening to people in a caring and respectful manner. We observed that staff were courteous and spoke warmly to and about the people they cared for. They all seemed to know the people well. There was an emphasis on protecting people’s dignity.

People had been involved in identifying their care needs and staff knew how to support people’s needs. Care plans provided guidance to staff as to how to do this appropriately. Staff demonstrated an understanding of people’s individual needs and preferences and knew how people communicated their needs. People told us they enjoyed the opportunities provided in the home such as arts and crafts. They also enjoyed trips out for lunch and shopping.

People and relatives told us that they were able to raise their concerns or complaints and were confident that they were listened to.

People who used the service, relatives and staff told us the manager was approachable, listened and was supportive to them. There were systems in place to monitor and improve the quality of the service provided. However these were not always effective. The monitoring of risks to people’s health was not consistent and the nurses did not have a full clinical overview of these risks.