Background to this inspection
Updated
28 June 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
The inspection was carried out by two 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.
Service and service type
Hilltop Manor 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 a manager 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.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We looked at information about important events which the provider is required to send us by law. These include safeguarding concerns, serious injuries and deaths that occur at the service. We looked at monthly improvement updates the provider had sent to us. We also sought feedback from commissioners of the service and looked at information we had received from the local safeguarding adults’ team. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with eight people who used the service and four relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager, regional manager, a nurse, a care home advanced practitioner and care staff. We also spoke with a visiting health professional. 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 six people’s care records and multiple medication records. We looked at three 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.
Updated
28 June 2019
About the service
Hilltop Manor Care Home is a care home providing personal and nursing care to 25 people aged 65 and over at the time of the inspection.
Hilltop Manor Care Home can accommodate up to 80 people in one adapted building.
People’s experience of using this service and what we found
Improvements were needed to the way medicines were managed to ensure they were consistently safe and systems were robust. The provider needed to ensure that improvements made throughout the home were thoroughly embedded and sustained to ensure a consistently well-led service.
People were protected from abuse and avoidable harm by staff who knew people’s risks and how to reduce them. There were enough staff to meet people’s needs and they followed safe practices to ensure people were protected from the spread of infection.
People’s needs and choices were assessed and met by staff who were trained and supported to carry out their roles effectively. 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.
People were happy with the food on offer and had choices. Staff supported people to eat whilst maintaining their dignity. People’s health needs were met and they had access to healthcare professionals when required.
Staff were kind and caring towards people and encouraged them to make their own decisions. People were supported to maintain their independence whilst their privacy and dignity was respected.
Staff knew people well and encouraged them to participate in activities which were meaningful to them. Staff catered for people’s preferences and considered people’s diverse needs.
The registered manager was accessible and approachable and had oversight of the service. They had implemented new systems which needed to be fully embedded and sustained to ensure continuous improvement. Staff were supported and encouraged to learn and felt involved in the service.
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 12 December 2018) and there were three breaches of regulation. We served warning notices and the provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. However, the service remains rated requires improvement, though significant improvements had been made since the last inspection. This service has been rated requires improvement for the last four consecutive inspections.
Why we inspected
This was a planned inspection based on the previous rating and to follow up on action we told the provider to take at the last inspection. We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hilltop Manor Care Home on our website at www.cqc.org.uk.
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.