1 Hill Close

Updated 15 December 2023

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.

Inspection team

This inspection was carried out by an inspector and a regulatory coordinator.

Service and service type

1 Hill Close is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under 1 contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

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

Notice of inspection

This inspection was unannounced. Inspection activity started on 24 October 2023 and ended on 17 November 2023. The inspection visit took place on 24 October 2023.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with 2 people using the service. We also spent time observing interaction between people using the service and staff to help us understand the experience of people who did not use speech as their primary means of communication. We spoke with the registered manager and 3 support staff. A registered manager from another of the provider’s home attended to support the inspection. We reviewed a range of records kept by the provider. This included 3 people’s care plans and risk records. We looked at 3 staff files in relation to recruitment, training, and staff supervision.

After the inspection visit we continued to seek clarification from the provider to validate evidence found. We received additional information, which was used as part of our inspection. This included service audit records regarding maintenance, fire safety and risk management, records regarding staffing and staff training and policies and procedures. We spoke by phone with 2 staff members and sought feedback from the local authority who commission the service.

Updated 15 December 2023

1 Hill Close is a ‘care home’ that provides care and support for up to 3 people with a learning disability or autistic spectrum disorder. There were 3 people living at the home at the time of the inspection.

There are also Hillcrest and 2 Hill Close care homes which are registered separately but form part of 1 complex with elements such as staffing and policies shared across all 3 buildings. We inspected these services in a 2-week period as much of the evidence we needed to gather was common to all 3 services.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: Systems were not robust enough to demonstrate people’s safety was always effectively managed. There were shortfalls in cleanliness and in the assessment and management of risk. There was a lack of clarity in relation to staff deployment. These shortfalls had not been picked up through the provider's governance arrangements although prompt action was taken once we brought this to the attention of the management team.

It was clear the service had been established on the principal of promoting people’s self-direction and self-reliance. The location of the service in a residential area provided good access to local amenities and services which helped support people’s independence and autonomy. 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.

Right Care: People told us they were happy living at 1 Hill Close and we saw people were relaxed in the company of staff and others they lived with. Support was available when needed and people were able to participate in activities within their local community.

Right Culture: Overall, there was a positive culture in the service and people were happy with the support they received. However, the terminology and definitions used by the provider were not always respectful or empowering.

Staff knew their responsibilities and were confident to report concerns that might arise. People were encouraged to make their own decisions in their daily lives and had opportunities to share their views. Staff felt well supported by the management team. The management team was responsive to the inspection findings and keen to deliver a high-quality service.

Rating at last inspection

The last rating for this service was Good (published 10 November 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service, specifically, the time elapsed since the last full inspection. We undertook a focused inspection to review the key questions of safe, caring and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. 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 read the report from our last comprehensive inspection, by selecting the 'all reports' link for 1 Hill Close on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

We made recommendations about staffing, radiators, and the use of respectful terminology and definitions.

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 and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.