Background to this inspection
Updated
19 September 2019
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 Care Act 2014.
Inspection team
Two inspectors and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Hillcrest House 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.
The service had three managers registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. Each manager was responsible for a different aspect of the service.
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. The provider was not asked to complete a provider information return (PIR) prior to this inspection. However, the provider decided to share similar information with us before the inspection. The PIR is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We sought feedback from professionals who work with the service and from people’s friends and relatives via email. We used all of this information to plan our inspection.
During the inspection
We spoke with nine people who used the service and two relatives about their experience of the care provided. We spoke with eleven members of staff including a clinical lead, senior staff, care staff, one domestic staff and a catering manager. We also spoke with two registered managers and a manager who had applied to register. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included eight people’s care records and multiple medication records. We looked at six staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
Following the inspection the provider shared further information to support the inspection process. We also received feedback from a visitor, a relative, a district nurse and a dementia liaison nurse.
Updated
19 September 2019
About the service
Hillcrest House is a nursing and residential care home. The care home provides care and support for older people. The home can accommodate a maximum of 88 people and has a specific area of the home which supports people living with dementia. The home and garden have been adapted to meet the needs of the people living there. 74 people were living in the home at the time of the inspection.
People’s experience of using this service and what we found
People lived in a service where the provider's aim was to provide individualised care, with a focus on continuous improvement. This was embedded in the culture of the service. People, relatives and visitors to the service, without exception, described Hillcrest as a high-quality service that they would recommend. Staff told us they were proud to work at the service and showed a commitment to the provider’s aims.
People had various ways they could influence the design of the service, including via people who acted as ‘resident ambassadors’. Time was allocated for people to reflect on their care package with relatives and staff who were important to them; and time was allocated for staff to reflect on their practice. The provider and senior staff dedicated time to staying up to date with best practice; and were proactive in finding and joining local and national organisations and initiatives, to enhance people’s lives. All this information was used to improve the service and ensure people’s individual needs were met.
People lived in a service that ensured their needs were met in line with best practice. People were supported to maintain their health and staff were creative in providing ways that encouraged people to eat and drink. People were supported to have choice and control of their lives.
People, relatives and professionals praised the service and staff for their ability to understand what was important to each person and for using this to design their care and support. One person told us the staff motto was, " Anything is possible”! We found many examples of how people’s care or the design of the service had been changed to better suit the people living there.
People received individualised care from staff who had time to understand and fulfil people’s needs and wishes. For some people with more complex needs, this meant staff employing a range of skills to understand when people’s needs were not being met and what changes they needed.
People were cared for by staff who they had developed close relationships with. People described staff as like friends and family and relatives valued staff’s ability to provide emotional support to their loved one. Staff took time to seek and understand people’s views and enabled them to take the lead in their care.
People told us they felt safe living in the service. People’s risks were assessed, and staff understood how to support people when they felt anxious. People received their medicines as planned and staff followed good infection control practice. Recruitment checks did not always comply with the providers policy. We have made a recommendation about the provider’s recruitment procedures.
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. (Report published 07/12/2016).
Why we inspected: This was a planned inspection based on the previous rating.
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.