Archived: Hillcrest

Updated 27 August 2021

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we could understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Hillcrest is a ‘care home’. 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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the healthcare professionals who worked with the service.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection-

We met and spent some time with the person currently living at the service. We spoke with four members of staff including the regional manager, deputy manager and care workers.

We reviewed a range of records. This included one person’s care records and medication records. A variety of records relating to the management of the service, including finance and health records were reviewed.

After the inspection

We continued to seek clarification from the regional manager and deputy manager to validate evidence found. We received feedback from one relative and two professionals who had worked with the service.

Updated 27 August 2021

About the service

Hillcrest is a residential care home registered to provide personal care for two people with a learning disability. At the time of the inspection one person was using the service.

People’s experience of using this service and what we found

Due to the persons needs they were unable to provide us with feedback about their care.

We last inspected the service in March 2021 and the service was rated requires improvement. At that time, we had concerns regarding the safety of the environment, including unlocked cupboards containing potentially dangerous products and the dining area was a possible infection control risk. We also found medicines prescribed ‘as required’ did not have a record to show why they had been administered and some records had not been completed, including records to show checks to monitor the quality of the service. At that inspection the registered manager had been absent and there had been little or no structured management oversight.

At this inspection we found things had improved and they had met the breaches of regulations from the last report.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Based on our review of safe, responsive and well-led the service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support:

Staff worked to support the person in line with their preferences providing choice and control.

Right care:

Staff demonstrated a person-centred approach to care and support. People were treated as individuals and staff promoted people’s dignity, privacy and human rights.

Right culture:

Many of the staff working at Hillcrest had done so for some time therefore knew the person well. They were supporting people to have as good a quality of life as possible.

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.

The registered manager was unavailable at the time of this inspection. However, the deputy manager and regional manager supported us during the inspection.

The person living at the service was relaxed and comfortable with staff and observations showed they knew this person well. Staff were caring and spent time chatting with them and though this person spent a lot of time confined to bed, staff interacted with them as much as they wanted.

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 9 April 2021) and we issued a warning notice for a repeated breach of regulation. There were also further breaches of regulation. The provider completed an action plan after the last inspection to show what action they would take and when they would have improved. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced inspection of this service on 4 March 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when they would have complied with Regulation 9, Person-centred care, Regulation 12 Safe care and treatment and Regulation 17, Good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires improvement to Good. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hillcrest on our website at www.cqc.org.uk.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.