Archived: Hillgreen Care Ltd - 13 Ruskin Road

The service had been rated Good following our inspection in December 2014 but there was a breach of the regulations with regard to medicines administration. A focussed inspection was carried out in June 2015 where we found there was a continuing breach with regard to medicines administration. We conducted a further follow up focussed inspection in September 2015 and found that the service had taken steps to address the medicines administration concerns.

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 service did not consistently provide hand wash and paper towels in bathrooms, toilets and the kitchen. There were some poor food hygiene practices by staff such as leaving out of date food in the fridge posing a risk that people might eat the food and become ill.

The staff supported people to attend health appointments and were knowledgeable about people’s health support needs. However, they were not always keeping accurate and robust health records.

Some people using the service accessed a variety of activities in the local area with staff support. However activities provision within the service were limited as equipment and facilities for the activities such as the sensory room and the garden both required attention to make them inviting for people to use and enjoy. We made a recommendation that the service look at best practice in activities within the service setting.

Audits and monitoring by the management team took place however due to the above concerns we found that these were not effective and robust. The provider did not have enough oversight of the provision of the service to ensure that people always received safe and quality care.

The registered manager assessed people’s support needs to ensure there was enough staff on duty. Staff received an induction and training to equip them to undertake their role and staff told us they felt well supported by the management team. There were good lines of communication between the management team, staff and people.

People told us they liked staff and other people at the service. We saw caring and respectful interactions by staff that maintained people’s dignity and supported people to make choices in their daily living activities.

People told us that they felt safe at the service and staff had received training to understand their responsibilities to report safeguarding adult concerns appropriately. People had risk assessments and behavioural support plans that identified risks and measures were taken to minimise the risk of harm to people and others.

Medicines were stored and administered in a safe manner.

The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and had applied for authorisations under the Deprivation of Liberty Safeguards (DoLS) appropriately for people living in the service to ensure their liberty were not unduly deprived.

Staff supported people to eat healthily and remain well hydrated.

People had person centred plans that detailed how they wished to be supported by staff. People were asked their views about their care and relatives views were included in the care planning.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014 in regards to safe care and treatment and good governance. You can see what action we told the provider to take at the back of the full version of the report.

We made a further visit on 20 December 2013 to check on the action the provider had taken to meet the requirements of the regulation. We found that the provider had ensured that staff were supported to deliver care and treatment safely and to an appropriate standard. Staff had received appropriate training, were supervised regularly and had been appraised by the manager.

This meant that the provider had taken sufficient action to meet the requirements of the regulation.

At the time of the inspection there were six people living at the home. We spoke with five of them, and they told us that they liked living there. People told us “I like it here,” “I get on with everyone,” and “I like [three named staff]."

They told us that staff provided them with the support that they needed, and helped them to develop independence skills. They said that staff listened to them and supported them to take part in activities of their choice inside and outside of the home.

We also spoke with the manager, four staff members and the social workers for three people living at the home. Quality assurance systems were in place for the home, and staffing numbers appeared to be sufficient to meet people’s needs. However there was insufficient training and staff appraisal in place to ensure that staff delivered care and treatment safely and to an appropriate standard.