Hillbeck Residential Care Home

Hillbeck is a residential care home that was providing personal care to 49 older people, some who were living with dementia, at the time of the inspection.

People’s experience of using this service:

• People told us they felt safe at Hillbeck. They knew who to report any concerns to and were happy with the support they received from staff. One person told us, “If I need to complain there wouldn’t be any problem with that.”

• People's care records contained guidance for staff about how to support people safely and minimise risks to people. Staff were trained in their responsibilities for safeguarding adults and knew what action to take if they witnessed or suspected any abuse.

• People felt safe and received support to take their medicines safely. One person told us, “"My medicine is all brought to me at the same time each day."

• There were sufficient staff to meet people's needs and recruitment processes and procedures were robust.

• Risks to people's well-being and safety were assessed, recorded and kept up to date. Staff supported people to manage these risks effectively. One person told us, “I have a frame to help my mobility, and I am managing it with the help of the careers.”

• Staff were competent, knowledgeable and skilled. They received regular training, supervisions and appraisals which supported them to conduct their roles effectively. One person told us, “The staff get on well and they are good at what they do.”

• Staff and people said the manager was approachable and listened. One person told us, “The manager is very nice and approachable, you can tell her anything.”

• The provider's quality assurance processes were effective and resulted in improvements to the service.

Rating at last inspection:

At the last comprehensive inspection the service was rated Good (27 September 2017).

Why we inspected:

This was a focused inspection. We had received a high number of notifications from the provider and concerns in relation to the way people were supported. We undertook a focused inspection to check whether people were receiving consistently safe care We looked at our domains 'safe' and 'well led'. This report only covers our findings in relation to these topics.

Follow up:

We will continue to monitor intelligence we receive about the service.

For more details, please read the full report which is on the CQC website at www.cqc.org.uk.

Hillbeck Residential Care Home provides care and support for up to 60 older people some of who may be living with dementia. The property has two floors, with a lift. There is 53 single room and three double rooms. Most bedrooms have en suite facilities and bathrooms with assisted baths are available. A garden is available for people who use the service. The provider organisation is a company that has other services across the South and East of England. At the time of our inspection, 47 people were living or staying at the service.

At the last Care Quality Commission (CQC) inspection on 29 September 2015, the service was rated Good in all domains and overall.

At this inspection we found the service remained Good.

The service had a registered manager in place who had worked at the service for six months prior to our inspection. 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 felt safe with the staff that supported them. The safety of people using the service continued to be taken seriously by the management team and staff who understood their responsibility to protect people’s health and well-being. Staff and the management team had received training about protecting people from abuse, and they knew what action to take if they suspected abuse.

Risks to people’s safety had been assessed and measures put into place to manage any hazards identified. Staff followed appropriate guidance to minimise identified risks to people’s health, safety and welfare. The premises were maintained and checked to help ensure people’s safety. Medicines were managed safely and people received them as prescribed.

There were enough staff on duty with the right skills to meet people’s needs. Staff had been trained to meet people’s needs including their specialist needs. Recruitment practices were safe and checks were carried out to make sure staff were suitable to work with people who needed care and support.

People’s needs had been assessed to identify the care and support they required. Care and support was planned with people and their relatives and regularly reviewed to ensure people continued to have the support they needed. People were treated with dignity and respect by staff who also maintained people’s privacy. People participated in a wide range of activities of their choice within the service and the local community. People were actively encouraged to maintain and increase their independence.

People and their relative’s spoke highly of the staff and management team. Staff had a full understanding of people’s care and support needs and had the skills and knowledge to meet them. People received consistent support from the same members of staff who knew them well. People were supported to be fully involved in the care and support they received and, decisions relating to their lives.

People spoke positively about the food they received. People had access to the food that they enjoyed and were able to access drinks and snacks throughout the day. People’s nutrition and hydration needs had been assessed and recorded. Staff met people’s specific dietary needs. Staff ensured people remained as healthy as possible with support from health care professionals, if required.

The management team were committed to providing a high quality service to people and its continuous development. People and/or their relatives were involved in the running of the service and were continually asked for their views, ideas and suggestions. Processes were in place to monitor the quality of the service being provided to people.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The management team and staff understood their responsibilities under the Mental Capacity Act 2005.

The provider ensured the complaints procedure was made available in an accessible format if people wished to make a complaint. Systems were in place to monitor the quality of the service being provided to people.

Further information is in the detailed findings below.

People who used the service were protected from the risk of abuse, because reasonable steps had been taken to identify the possibility of abuse and prevent abuse from happening.

There were appropriate arrangements in place to manage medicines safely and effectively.

We saw that the premises were designed to provide care in an environment that is suitable for its purpose and adequately maintained.

There was an effective system to regularly assess and monitor the quality of service that people received.

We saw that people received care and support in line with their needs. People told us that they were happy at the home.

People received the medicine they needed at the time they needed it. However medicine was not stored safely when delivered in to the home.

We looked around the home and found that maintenance was not always completed and that there were some odours around the home.

We looked at how the service monitored the quality of the care they provided. We saw that although there were some systems in place, action was not always taken where shortfalls were found.

We looked at care records for people who used the service. We saw that records reflected people's needs and were updated when necessary.

We spoke with staff about their working practices and how the service ran on a day to day basis. Staff told us that although they were busy, they felt that there were enough staff available to meet people’s needs. We saw that the service employed a person who arranged activities for people who used the service. We observed that people enjoyed the activities available to them.

Wespoke to the homes GP and looked at care records for people. We saw that some care records were not accurate and did not reflect all of people’s needs. A relative of a person told us “Sometimes the staff do not follow what is in people’s care plans”.

We viewed most areas of the home. We saw that not all areas of the home were in good repair and needed maintenance. We found that the some people’s bedrooms contained hazards which could cause them to trip.

We looked at other records held by the home which included maintenance, staffing and medication records. We saw that some records were not completed accurately and did not contain all the information they needed to.