Archived: High Hilden

Updated 25 October 2017

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 4 and 5 of October 2017 and was unannounced. The inspection consisted of two inspectors, a medicines inspector 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.

Prior to the inspection, we gathered and reviewed information we held about the service. This included notifications from the service and information shared with us by the local authority. Before the inspection, the provider 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.

We focused the inspection on speaking with people who live at High Hilden, their relatives and staff. We spoke to 10 people living at the service, two relatives, five staff, three volunteers, the activities coordinator, chef, administrator, the nominated individual for the registered provider and the registered manager. 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 made observations of staff interactions and the general cleanliness and safety of the home. We looked at eight care plans, three staff files, staff training records, quality assurance documentation and people’s medicine records.

At our last inspection at High Hilden on 11 and 12 August 2016 High Hilden was rated as requires improvement.

Updated 25 October 2017

We inspected High Hilden on 4 and 5 October 2017. The inspection was unannounced. High Hilden provides support and accommodation for up to 40 older people. At the time of our inspection, 26 people were living at the service.

There was a registered manager in post who was registered with the CQC. 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.

At our previous inspection on 11 and 12 August 2016, the service was in breach of regulation 12 (Regulated Activities) Regulations 2014. This breach was in relation to medicine management and safely recording the amount of medicines in stock. At this inspection, improvements had been made and the service was compliant with the regulation. Medicines were stored securely and safely administered by staff who had received appropriate training to do so.

The registered provider had systems in place to protect people against abuse and harm. The registered provider had effective policies and procedures that gave staff guidance on how to report abuse. The registered managers had robust systems in place to record and investigate any concerns.

Risks to people's safety had been assessed and actions taken to protect people from the risk of harm. When appropriate, risk assessments were updated when people’s needs changed. The registered provider had effective policies and procedures in place to ensure that the environment was kept safe and well maintained for the people living there.

There was sufficient staff to provide care to people throughout the day and night. The provider used a dependency tool to identify the amount of care hours each person required. When additional staff were required due to staff sickness or leave the registered manager had an approved agency list. When staff were recruited, they were subject to checks to ensure they were safe to work in the care sector.

Staff were well trained with the right skills and knowledge to provide people with the care and assistance they needed. Staff spoke positively about the training supplied by the registered provider and the encouragement to progress their careers. Staff met together regularly and felt supported by the manager.

Mental capacity assessments were carried out and these were decision specific. Staff and the registered manager demonstrated good knowledge of the Mental Capacity Act 2005. The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people's freedom had been submitted and the least restrictive options were considered as per the Mental Capacity Act 2005.

People were supported to have a nutritious diet that met their needs. People were supported to eat by suitably trained staff. Staff completed fluid and eating charts for those that needed it. People were referred to health care professionals when needed. People's records showed that appropriate referrals were made to GP's, physiotherapists, speech and language therapists, dieticians, dentists and chiropodists.

People told us they were very satisfied with the care staff and the support they provided. Relatives told us they were happy with the service their loved ones received. Staff communicated with people in ways that was understood when giving support. Staff and the registered manager had to know people well. People and their relatives told us they were involved in the planning of their care. Care plans were reviewed on a monthly basis by staff. Staff respected people's privacy and dignity at all the times. The provider had ensured that people's personal information was stored securely and access only given to those that needed it.

People at the service had access to a wide range of activities that were designed for their individual needs. People told us they were very happy with the amount of activities on offer at the service. People had freedom of choice at the service. People could decorate their rooms to their own tastes and choose if they wished to participate in any activity. Staff respected people's decisions.

The provider had ensured that there were effective processes in place to fully investigate any complaints. Outcomes of the investigations were communicated to relevant people.

The registered manager was seen to be open, transparent and responded positively to any concerns or suggestions made about the service. The registered manager carried out audits to identify shortfalls with the service and took action as a result. People’s records were updated by staff on a regular basis and in circumstances when required such as changes in health.