Archived: Hillbrow Residential Home

Updated 30 June 2016

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 9 May 2016 and was unannounced.

Due to the small size of this home the inspection team consisted of two inspectors who were experienced in care and support for people with Learning Difficulties.

Before the inspection we reviewed records held by CQC which included notifications, complaints and any safeguarding concerns. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern at the inspection.

The provider had completed a 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. This information was reviewed to see if we would need to focus on any particular areas at the home.

We spoke with six people who lived at the home and four staff which included the registered manager and the provider. We also reviewed care and other records within the home. These included three care plans and associated records, three medicine administration records, two staff recruitment files, and the records of quality assurance checks carried out by the staff.

During the inspection we spoke with a commissioner of the service. The local authority safeguarding team and quality assurance team had no concerns about the home. We also received positive feedback from a relative and a GP.

At our previous inspection in September 2013 we had not identified any concerns at the home.

Updated 30 June 2016

Hillbrow Residential Home provides accommodation to a maximum of fourteen people. They provide support to people over the age of sixty five who may be living with the experience of dementia, or mental health conditions. At the time of our inspection 10 people were living at the home, with another two being cared for in hospital.

The premise is presented across two floors with access to the first floor via stairs and stair lift. People’s bedrooms are single occupancy. Communal space consists of a lounge area and dining room. There is a private garden with a patio at the rear of the property.

There was a registered manager in post. 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.

The home was well decorated and adapted to meet people’s needs. Flooring was smooth and uncluttered to aid people’s mobility needs. The home had a homely feel and reflected the interests and lives of the people who lived there.

The inspection took place on 9 May 2016 and was unannounced.

There was positive feedback about the home and caring nature of staff from people who live there. One person said, “Staff are looking after me alright.” Feedback form a healthcare professional said, “This is a professionally run home with caring staff who are sensitive to and respond to resident’s needs.”

People were safe at Hillbrow Residential Home. There were sufficient staff deployed to meet the needs and preferences of the people that lived there.

Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. People were involved in these decisions because staff took the time to explain to them in a way they could understand. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police.

The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff received a comprehensive induction and ongoing training, tailored to the needs of the people they supported.

People received their medicines when they needed them. People were supported to manage their own medicines where possible. Staff managed the medicines in a safe way and were trained in the safe administration of medicines.

In the event of an emergency people would be protected because there were clear procedures in place to evacuate the building. These procedures were regularly discussed with people to ensure they knew how to respond in an emergency. An alternative location for people to stay was also identified in case the home could not be used for a time.

People had the capacity to understand and make decisions about their care and support. The registered manager and staff had a good knowledge of what would need to be done if people did not have the capacity to understand or consent to a decision. They would then follow the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Staff were heard to ask people for their permission before they provided care. People’s human rights were protected because where a person’s capacity around a specific decision had been queried; the registered manager immediately contacted the local authority to discuss an assessment of capacity, and the possible need for a DoLS application.

As people had capacity to make decisions for themselves their liberty had not been restricted to keep them safe. The Staff and management had a good understanding of the requirements of the Deprivation of Liberty Safeguards (DoLS), so if a person’s capacity changed they would know what to do to ensure the person’s rights were protected.

People had enough to eat and drink, and received support from staff where a need had been identified. People were complimentary about the food, after lunch one person said, “That was lovely; I enjoyed that.” Staff had a good understanding of specialist diets that people were on to ensure people could eat and drink safely, and still enjoy their meals.

People were supported to maintain good health as they had access to relevant healthcare professionals when they needed them. When people’s health deteriorated staff responded quickly to help people and made sure they received appropriate treatment. People’s health was seen to improve due to the care and support staff gave.

The staff were kind and caring and treated people with dignity and respect. One person said, “Staff are very good. They’re first class.” Another person said, “I like the staff. I get on very well with them.” Good interactions were seen throughout the day of our inspection, such as staff talking with them and showing interest in what people were doing. People looked relaxed and happy with the staff. People could have visitors from family and friends whenever they wanted.

Care plans were based around the individual preferences of people as well as their medical needs. They gave a good level of detail for staff to reference if they needed to know what support was required. People received the care and support as detailed in their care plans. Details such as favourite foods in the care plans matched with what we saw on the day of our inspection, and with what people told us.

People had access to activities that met their needs. Although some people told us they wanted more to do, minutes of residents meetings recorded that the issue had been addressed multiple times to try to get people more involved in activities that interested them. The staff knew the people they cared for as individuals, and had supported them for many years.

People knew how to make a complaint. Feedback form a relative said, “If I ever have any needs or suggestions I know I can always ring and visit to discuss with the manager.” The policy was in an easy to read format to help people and relatives know how to make a complaint if they wished. No complaints had been received since our last inspection. Staff knew how to respond to a complaint should one be received.

Quality assurance records were kept up to date to show that the provider had checked on important aspects of the management of the home. Records of checks on health and safety, infection control, and internal medicines audits were all up to date. This was a small family owned business so the provider was at the home on a daily basis to give people and staff an opportunity to talk to them, and to ensure a good standard of care was being provided to people.

People had the opportunity to be involved in how the home was managed. Surveys were completed and the feedback was reviewed, and used to improve the service. One person said, “Staff are very good. They’re first class.” A staff member said, “You’ve got to take pride in your work. If the residents look nice and are happy you know you are doing your job right.”