Hilldales Residential Care Home

Updated 28 September 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can 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

Hilldales Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Hilldales Residential Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced on the first day and announced on the second day.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

During the inspection

We spoke with nine people using the service. We also spoke with eight members of staff, which included the registered manager.

We reviewed a range of records. We looked at a variety of records relating to the care and support provided; three staff files in relation to recruitment; staff training; various policies and procedures and specific audits/reports relating to the quality and safety of the service to ensure people received safe care and support specific to their individual needs.

After the inspection

After our visit we sought feedback from health and social care professionals to obtain their views of the service provided to people. We received feedback from three health and social care professionals. We continued to seek clarification from the provider to validate evidence found.

Updated 28 September 2022

About the service

Hilldales Residential Care Home is a residential care home providing accommodation and personal care up to 56 people. The service provides support to adults who have needs arising from alcohol problems or mental health issues. At the time of our inspection there were 39 people using the service.

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

We were not assured that the provider was using PPE effectively and safely. On the first day of our inspection, staff were either not wearing masks or were not wearing them in line with best practice. This meant, potentially, people were not protected from the risk of infections.

We were not assured that the provider was preventing visitors from catching and spreading infections. On both days of inspection, we were not asked for evidence of a negative lateral flow test (LFT) or asked to complete any screening documentation before entering the home. This did not assure us that people living at the service and visitors were prevented from catching or spreading infections.

The provider's policy regards to visiting was in line with government guidance. However, we could not be assured that staff were ensuring visitors were following the government's protocols to minimise the risk of infection and or spread of COVID-19.

The provider's staff training matrix did not reflect the level of training that staff had received. The provider was in the process of transitioning from three yearly to yearly training to comply with the provider’s actions to update and complete all training annually. The training matrix was in the process of being developed and had not been finalised at the time of our inspection.

Staff were able to demonstrate knowledge and competency in their roles when supporting people living at the home. For example, encouraging and supporting people to reduce their alcohol consumption with input from relevant professionals and providing appropriate support to help people manage their mental health well-being.

People told us staff were well trained and competent in their jobs; and did not raise any concerns. Comments included, “I have lived here for 31 years, excellent staff” and “The staff appear to know their jobs.”

The registered manager recognised that improvements were needed to staff supervision. An action plan was in place to address this to ensure staff received supervision on a three-monthly basis. Staff had, however, received an annual appraisal in April 2022. Staff did feel well supported in their roles. Comments included, “The support is really good, we pull together.”

Despite systems being in place to monitor the quality and safety of the service, these had not identified the concerns we found regards to infection control. Specifically, the safe and effective use of Personal Protective Equipment (PPE) and effective screening of visitors before entering the home.

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 said they felt safe with staff; staff practice showed they knew them well. People were at ease and looked comfortable in the company of staff. Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.

Care files were personalised to reflect people’s personal preferences. People were supported to maintain a balanced diet.

Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them. A professional praised the service regards to how proactive they were at contacting them for advice and guidance. They commented, “They (staff) are on the ball. They do an amazing job. The paperwork is thorough, no problems with medicines and staff ensure they take people to appointments.”

People received kind and compassionate care from staff who used positive, respectful language people understood and responded well to.

There were sufficient staff to meet people’s needs. People were supported by a core team of staff. Staff confirmed that people’s needs were met promptly, and they felt there were sufficient staffing numbers. There were effective staff recruitment and selection processes in place.

Staff spoke positively about communication and how the registered manager worked well with them and encouraged their professional development.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 8 March 2021 and this is their first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.