The Care Quality Commission (CQC) has rated Hill House inadequate and imposed urgent conditions on its registration following an inspection in February and March.
Hill House is a residential care home providing personal care to adults, some of whom live with dementia. CQC inspected the service in response to concerns received about people’s safety and dignity.
Following this inspection, the overall rating for Hill House has dropped from good to inadequate, as have its ratings for safe, caring, responsive and well-led. Its rating for effective has dropped from requires improvement to inadequate.
CQC imposed urgent conditions on the service’s registration, restricting Hill House from accepting new residents and requiring immediate improvements to make sure people were receiving safe care and treatment. CQC has also given Hill House warning notices related to safeguarding people, people’s nutritional needs and the homes’ environment. Additionally, the service is now in special measures, which means it will be kept under review by CQC and re-inspected to check on the progress of improvements.
Gill Hodgson-Reilly, CQC deputy director of operations in the east of England, said:
“When we inspected Hill House we found leaders lacked oversight of what was happening in their service, and hadn’t ensured staff were effectively trained. This meant people were being cared for by staff who didn’t always have the skills to keep them safe.
“During the inspection, we raised multiple safeguarding incidents to the local authority which staff hadn’t previously raised, but should have. We found this was because staff didn’t understand how safeguarding works. In one of these cases, staff hadn’t raised an allegation of physical abuse and hadn’t taken any action to protect the person involved until our inspectors raised it.
“Leaders also hadn’t trained staff to manage people’s specific health needs, meaning they didn’t always understand how to care for them effectively. This created a culture that was centred around routine, instead of the people using the service.
“Leaders didn’t know about these issues so couldn’t support staff to make improvements to people’s care. When we raised these issues to Hill House, they created action plans but didn’t follow through with them effectively.
“This is unacceptable and people have the right to live in a home where staff know how to protect them and act as their advocates, which is why we’ve used our urgent enforcement powers to demand rapid improvements. We’ll continue to monitor the service closely to ensure these improvements are made and won’t hesitate to take further action if we’re not assured people are receiving safe care.”
Inspectors also found:
- Staff hadn’t always been effectively trained in managing people’s medicines and didn’t keep accurate records, putting people at risk of harm. Night staff weren’t given training to provide medicines. This meant people in need of medicines overnight had to wait until a senior staff member arrived
- Some people’s care plans were incomplete and not up to date. Some staff said they hadn’t read people’s care plans
- Staff didn’t always treat people with dignity and respect. Inspectors saw staff ignore a person who was calling out at lunch and one person cried out when a staff member placed their legs onto wheelchair footplates without speaking to them
- Risks to people’s safety weren’t always fully assessed or managed. During a COVID-19 outbreak, some staff were confused regarding whether people were still testing positive and couldn’t remember seeing a COVID-19 risk assessment
- People’s confidentiality wasn’t always respected. Staff spoke about people’s health conditions in front of others and left care records unattended in communal areas
- People weren’t always supported to be involved in their care decisions, which stopped them from having maximum control of their lives
- People were not fully supported to join in stimulating or meaningful activities
- People weren’t always provided with a safe environment to live in. Fire doors weren’t kept closed and people could easily access potentially dangerous substances such as cleaning products
- The building was in poor condition and wasn’t always clean enough to protect people from illness or infection. However, maintenance work was ongoing.
However:
- People told us they liked the staff, and we saw some staff interact with people in kind and caring ways
- People’s relatives and carers felt staff kept them up to date on their loved ones’ care.