We carried out a review of the data available to us about Hillcrest on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Hillcrest, you can give feedback on this service.
Hillcrest is a residential care home providing personal care and support for nine younger adults and older people living with learning disabilities and physical and sensory impairments. Hillcrest accommodates up to nine people living in one adapted building.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service was one of three domestic style properties owned by the provider and operating as care homes. It was registered for the support of up to nine people. Nine people were using the service on the day of this inspection. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and other domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
People were safe and protected from the potential risks of abuse and avoidable harm. People were supported and encouraged to be as independent as possible following robust risk assessments. Where risks to people’s health, well-being or safety were identified staff were knowledgeable about these and knew how to respond safely. Incidents and accidents were recorded, investigated and reviewed by the management team. There were enough safely recruited, experienced, skilled and qualified staff deployed to meet people’s needs. Staff supported people to take their medicines in accordance with prescriber's instructions. Staff had received infection control training.
Staff received training and refresher updates in basic core areas as well as training specific to meet the needs of the people they supported. Relatives said staff were skilled and competent. Staff felt listened to and supported by the management team. Staff supported people to eat a healthy, balanced diet. People had access to health and social care professionals relevant to their needs. Health professionals told us people received appropriate support from the service. Staff sought people’s consent to the care and support they received, together with that of their relatives or external advocates where appropriate.
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.
Whilst the registered manager was not familiar with the published guidance the service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People’s relatives complimented the staff team for the care and support provided. Staff had developed positive and caring relationships with people and were knowledgeable about their individual needs and personal circumstances. Relatives, where appropriate, were fully involved in the planning and reviews of people’s care and support.
People received personalised care and support that took account of their preferences and personal circumstances. Staff helped and supported people to develop the skills and confidence necessary for them to live as independently as they could. People enjoyed a varied social life according to their personal preferences with the encouragement and support of staff.
The provider had a robust quality assurance process which meant that shortfalls in performance were swiftly identified and addressed in a timely manner. The staff and management team were clear about the provider’s values and the purpose of the services provided. People’s relatives were positive about how the service was managed and the management team.
The provider routinely distributed quality survey forms to people’s relatives, the staff team and health professionals. Health and social care professionals told us that the staff and management team were responsive to any comments and suggestions and were committed to working collaboratively with people, their families, specialists and professionals.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 31 July 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
At the last inspection the service was rated Good. At this inspection we found the service remained Good.
People’s relatives told us that people were safe living in the service. Risks to people were appropriately assessed, planned for and managed. There were sufficient numbers of skilled and competent staff available to provide people with support when they needed it.
Staff received appropriate training, support and development to carry out their role effectively.
The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLs). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People received appropriate support to maintain healthy nutrition and hydration and to access health support to meet their individual needs.
People who used the service were treated with kindness by staff who respected their privacy and upheld their dignity. People’s relatives and professionals were given the opportunity to feed back on the service and their views were acted on.
People received personalised care that met their individual needs. People were given appropriate support and encouragement to access meaningful activities and follow their individual interests.
People’s relatives told us they knew how to complain and were confident they would be listened to if they wished to make a complaint.
The provider and registered manager worked hard to create an open, transparent and inclusive atmosphere within the service. There was a robust quality assurance system in place and shortfalls identified were promptly acted on to improve the service.
Further information is in the detailed findings below.
The inspection took place on 19 October 2015 and was unannounced.
Hillcrest is a care home for nine adults living with learning disabilities and autistic spectrum conditions. There were eight people accommodated at the home at the time of this inspection.
The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
CQC is required to monitor the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection we found that applications had been made to the local authority in relation to the people who lived at Hillcrest.
People felt safe at Hillcrest and were confident to approach the staff. People had health care and support plans in place to help staff know how people liked their needs to be met. Risks to people’s safety and welfare had been identified and support had been planned to enable people to live as safely as possible whilst enjoying a wide range of opportunities for engagement and stimulation. There were sufficient numbers of staff available to meet people’s care and support needs. People’s medicines were managed safely.
Staff members understood their roles and responsibilities and were supported by the manager to maintain and develop their skills and knowledge. People enjoyed a varied healthy diet and their physical and mental health needs were well catered for.
The atmosphere in the home was welcoming and there was a warm interaction between the staff and people who used the service. People were involved in all aspects of their care and support as much as they were able. People were supported to access support from external advocacy services when needed to help them make decisions about matters in their daily lives. People’s relatives were encouraged to be involved in developing people’s support plans and to visit at any time. People were actively supported to maintain family relationships. Staff promoted people’s dignity and treated them with respect.
People’s care and support was planned around their needs and they, along with family members and professionals, were involved in decisions about their care. People had access to a wide range of activities inside the home and in the wider community to provide them with engagement and stimulation. The provider had made arrangements to support people and their families to raise concerns and meetings were held for people to discuss all aspects of the care and support provided at the home.
The manager and provider promoted a positive culture within the home that was transparent and inclusive. The manager and provider had robust systems to continuously check the quality of the service provided. Staff were encouraged to develop their skills and knowledge and felt valued.