Archived: Hillside Residential Care Home

Updated 1 August 2018

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.

The inspection took place on 13 October 2017 and was unannounced. Two additional unannounced inspection visits were undertaken on the 22 February and 13 April 2018.

The inspection team consisted of two adult social care inspectors, and an 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.

Before the inspection, we checked information that we held about the service and the service provider. We looked at any notifications received and reviewed any other information held about the service prior to our visit.

The inspection was prompted in part by the outcome of an incident investigated by the police who indicated potential concerns regarding the provision of adequate food and fluids at the home. This inspection examined those risks. The service has been told by the police they will not be preceding with a criminal prosecution but the matter remains open to and under investigation by the CQC as a result this inspection did not examine the circumstances of the incident.

During the inspection, we used a number of different methods to help us understand the experiences of people living in the home. We spoke with a total of 14 people living at the home, four visiting relatives and six staff members including the registered manager, one of the owners of the business, and four care staff.

Throughout the inspection, we observed how staff supported people with their care during the day. We looked around the building including, with the permission of the people who used the service, some bedrooms. We looked at a total of five care plans. We looked at other documents including policies and procedures; staffing rotas; risk assessments; complaints; staff records including training records; food and fluid records, maintenance records; health and safety checks; and medication records.

Updated 1 August 2018

This inspection took place on 13 October 2017 and was unannounced. Two additional unannounced inspection visits were undertaken on the 22 February and 13 April 2018.

Hillside Residential Care Home is a residential care home providing personal care and accommodation for up to19 older people. It is a privately owned family run business. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Hillside Residential Care Home does not provide nursing care and none of the staff employed at the home are registered nurses.

The home is situated in Wilmslow and is close to shops and other public amenities with easy access to main road networks. The premise is a two storey building with accommodation on both floors. Some of the bedrooms have en-suite bathroom facilities.

Seventeen people were being accommodated at Hillside Residential Care Home at the time of our inspection started.

At the time of the inspection there was a registered manager at Hillside Residential Care Home. 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 registered manager was present during our inspection and engaged positively in the inspection process. The manager was observed to be friendly and approachable and operated an open door policy to people using the service, staff and visitors. Prior to our inspection representatives of the local authority told us that Hillside Residential Care Home was known to have a warm, welcoming and relaxed atmosphere and our findings supported this. People living at the home told us that they appreciated the homely atmosphere, they felt valued and that they belonged at the home and praised the manager and the staff for the standard of care provided.

The service was previously inspected in May 2016 when it was found to be caring but requiring improvement in all other areas including safe, effective, responsive and well led care.

During this inspection visit we found that some improvements had been made but not sustained, the manager had not always capitalised on opportunities to learn and improve from past events. We identified further breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The breaches related to safe care and treatment including safe management of medicines, staffing, person centred care and good governance. You can see what action we told the provider to take at the back of the full version of this report.

The atmosphere in the home was welcoming and sociable. People told us that they were well cared for and spoke highly on the manager and staff.

People told us that they felt safe living in the home and staff were committed to providing good standards of care.

Measures designed to reduce risk were not always put into practice so some people remained at risk of harm or their needs not being met.

Safeguarding systems, processes and practices protected people form abuse, neglect, harassment and breaches of their dignity and respect.

There was an adequate number experienced staff on duty but some lacked training knowledge and skill in key areas of their work which meant they were not always sufficiently equipped to meet the needs of the people living at the home.

Care staff told us that they appreciated the support, direction and leadership provided by the manager but there were expected to complete task for which they had not been trained and this was having an adverse effect on morale.

We could see that people were involved in decisions about their care. They told us that staff listened to them and acted on what they said. However, staff needed further training on gaining consent to care and did not always understand the purpose and application of the Mental Capacity Act. .

People enjoyed a varied and nutritious diet, which catered for their individual needs and preferences. They were provided with plentiful drinks, were encouraged to take fluids where required and had access to sufficient drinks throughout the day and at night. People were fully but informally involved in assessing the quality and presentation of meals served, by direct discussion with the cook who was said to be attentive to their needs.

Social activities were organised in the home which were tailored to peoples’ individual needs. They told us that they enjoyed them and there was always something to do.

Staff were aware of the need to support people approaching the end of their life but lacked adequate training and support. Furthermore, care planning arrangements were not always person-centred to ensure the relevant person’s wishes and needs were understood, met and respected.

The home had an effective complaints procedure. People’s concerns and complaints were taken seriously but opportunities to learn from past events were missed and as a result problems were allowed to continue unaddressed.

The home had some quality assurance measures but they failed to identify the areas of concern we identified during our inspection. Additionally, the manager had decided against carrying out a survey of staff, service users, relatives and community care professionals’ views in 2017. Recording of care interventions including food, fluid, administration of medication and repositioning to prevent pressure area damage was inadequate and as a result people were exposed to unnecessary risk of harm.

People, their relatives, friends and staff praised the manager for their leadership, guidance and the way they had involved them in the day to day running of the home.