We carried out a review of the data available to us about Hillbro Nursing Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Hillbro Nursing Home, you can give feedback on this service.
Hillbro Nursing Home is a care home with nursing care. They provide care to older people, people with mental health needs and people living with dementia. Hillbro Nursing Home accommodates 43 people in one adapted building. At the time of the inspection there were 40 people using the service.
People’s experience of using this service and what we found
Everyone told us the service was safe and there were always sufficient numbers of staff on duty to meet people’s needs. Risks associated with people’s care were managed safely. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The service had systems in place for learning lessons when things go wrong. People's medicines were well managed. The service followed safe infection, prevention and control procedures. The service had effective systems in place to ensure allegations of abuse or poor care were investigated and acted on.
The service was consistently well-managed and led. Staff felt valued and were proud to work at Hillbro Nursing Home. All of the relatives we spoke with would recommend the home to others. Systems and processes for monitoring quality and safety were effective. The provider demonstrated throughout the inspection there was a strong focus on continuous improvement. The service involved people and genuinely welcomed feedback. Records showed people’s care was usually planned, although we saw examples where plans did not fully explain how to meet people’s needs. The provider had already identified they wanted a more user-friendly electronic care recording system. The service worked effectively with other professionals to support joined-up care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update: The last rating for this service was requires improvement (published 26 November 2020). At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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 has changed from requires improvement to good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hillbro Nursing Home 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.
Hillbro is a nursing home providing personal and nursing care to older people and people living with dementia. Hillbro accommodates 43 people in one adapted building. At the time of the inspection there were 42 people using the service.
People’s experience of using this service and what we found
People were not always safe. Safeguarding procedures were not consistently followed. Robust moving and handling plans were not in place and people were at risk of injury. Audits and checks were in place to monitor the quality of the service. Improvements were required to ensure they highlighted all shortfalls promptly. The registered manager was approachable and visible. The management team were open and honest throughout the inspection and responded promptly to the issues we raised.
Recruitment was managed safely. People were cared for by an experienced and consistent staff team. People who used the service and relatives provided consistent positive feedback about their experiences of the care. One relative said, “The staff are first class; I think they do a good job.” They said the staff team were kind and caring.
The home and grounds were accessible and well maintained.
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 the service was good (published 14 February 2019).
Why we inspected
We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about safeguarding concerns. A decision was made for us to inspect and examine those risks.
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 coronavirus and other infection outbreaks effectively.
We inspected and found there was a concern with safe care and treatment and reporting safeguarding incidents, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report.
The provider took immediate action to mitigate the risks.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hillbro on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to assessing and managing risks to people, governance and safeguarding people from abuse.
We have identified a breach in relation to failure to notify CQC about significant events.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Hillbro is a 42 bedded service providing nursing or personal care to older people, people living with dementia and people living with mental health issues. At the time of our visit there were 40 people using the service.
People’s experience of using this service:
Improvements to medicines management, consent to care and treatment and quality audits have been made since our last inspection in October 2017.
Staff were exceptionally caring. Everyone we spoke with was very complimentary about the service and said they would recommend the home. There was a strongly embedded culture within the service of treating people with dignity, respect, compassion and love.
Activities were on offer to keep people occupied both on a group and individual basis. Trips out were also organised in line with people’s preferences.
Medicines were being administered safely and people’s dietary and healthcare needs were met.
Staff were recruited safely and there were enough of them to keep people safe and to meet their care needs. Staff were receiving appropriate training which was good and relevant to their role. Staff were supported by the registered manager and were receiving formal supervision where they could discuss their on-going development needs.
Care plans were up to date and detailed the care and support people wanted and needed. Risk assessments were in place and showed what action had been taken to mitigate any risks which had been identified. Appropriate referrals were being made to the safeguarding team when this had been necessary.
There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received.
The registered manager provided staff with leadership and was described as being very approachable. Audits and checks were carried out and used to drive continuous improvements to the service people received.
People’s feedback was used to make changes to the service, for example, to the menu’s and activities.
More information in Detailed Findings below:
Rating at last inspection:
Requires improvement (report published 10 January 2018).
Why we inspected:
This was a planned inspection based on the rating at the last inspection. We found improvements had been made since our last inspection and the service has met the characteristics of good in four areas and outstanding in caring.
Follow up:
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.
Hillbro is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Hillbro accommodates a maximum of 42 people in one adapted building. At the time of our inspection there were 41 people living at the home.
There was a change of registration in December 2016, a new provider was registered. This was the first inspection of the new provider.
The service had a registered manager. 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 told us they felt safe and staff knew how to recognise and report any concerns about people’s safety and welfare. We found the correct safeguarding reporting procedures were not always followed and people’s money was not always managed properly.
Overall there were enough staff deployed. We recommended staffing levels should be kept under review to make sure people always received appropriate care. All the required checks were done before new staff started work and this helped to protect people. Staff were trained to meet people’s needs.
People who used the service did not have any concerns about the way their medicines were managed. However, we found some improvements were needed.
Individual risks to people’s health and welfare were identified and managed. However, improvements were needed to the emergency evacuation procedures to ensure people’s safety.
The home was clean and well maintained. Some parts of the home had recently been refurbished and we saw the provider had taken account of the needs of people who used the service.
We found people’s capacity to consent to their care and treatment was assessed. However, when people lacked capacity the correct processes were not always followed to ensure those making decisions on their behalf had the legal powers to do so.
Most people told us they liked the food. People were offered a variety of food and drink which took account of their likes and their medical, cultural and religious needs.
People were supported to meet their healthcare needs and had access to a range of healthcare professionals. People’s needs were assessed. However, their care plans were not always detailed enough and this created a risk they would not consistently receive appropriate care which met their needs.
People were treated with respect and kindness and were supported to maintain their independence. People were given the opportunity to take part in a variety of social activities.
Information about complaints was displayed in the home. People told us the registered manager was approachable and listened to them. People were supported to share their views about the service in meeting and by means of surveys.
People told us they would recommend the service and some people told us they had already done so. People had confidence in the management team.
We found the providers quality monitoring systems were not always working as well as they should be. We were assured of the provider’s commitment to making the required improvements.
We found four breaches of regulations in relation to the management of medicines, consent to care and treatment, person centred care planning and good governance. You can see what action we told the provider to take at the back of the full version of the report.