Hillside House

Updated 5 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 5 and 8 October 2018, the first day was unannounced. The inspection team on the first day consisted of one adult social care inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The second day was announced and carried out by the adult social care inspector.

Before the inspection we reviewed the information, we held about the service. This included the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally required to let us know about. We also contacted the local authority safeguarding team and quality assurance team to ask if they had any concerns.

We used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we met most of the people using the service. We spoke with ten people who used the service and eight visitors/relatives to ask their views about the service. We spoke with nine members of the staff team including the registered manager, the HR and utilities manager, five care staff and a member of the housekeeping team and the cook. We also spoke with a visiting GP, hospice nurse and therapist.

We reviewed two people's care records and three staff files which included recruitment, supervision and training information. We reviewed all the medicine administration records as well as records relating to the management of the service. We contacted health and social care professionals who have worked with the provider, to ask them their views about the service. This included staff at the two local GP surgeries and social care team staff. We received two responses.

Updated 5 December 2018

This comprehensive inspection took place on 5 and 8 October 2018. The first day of the inspection was unannounced. This meant that the provider and staff did not know we were coming. This was the first inspection of this service since it registered with The Care Quality Commission (CQC) in October 2017.

Hillside House is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Hillside House can accommodate up to 14 people in a newly refurbished building in East Devon, on the edge of the village of Newton Poppleford near the seaside town of Sidmouth. The home consists of two floors with a five-person passenger lift providing level access to each floor. There is a main communal lounge, dining area and small clusters of seating throughout the home where people could spend their time as they chose. To the rear of the house was a large decked veranda which people could easily access with views of the country side and provider’s smallholding.

At the time of this inspection there were 14 people using the service. Three of these people were staying at the service for a period of respite.

There was a registered manager who was also one of the directors of the service. A registered manager is a person who has registered with 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.

The registered manager provided excellent strong leadership, was a brilliant role model for all staff and drove up excellent practice to provide people with opportunities. They were at the home most days and was very passionate about the service being people’s home. They had been the lead in designing the service and employing a high quality of dedicated staff to ensure they had the same ethos as they did. The registered manager said they had worked hard to get the right staff. Staff said there was a good team spirit at the service. The registered manager was supported by the other directors and family members and an HR facilities manager.

People, relatives and staff described the service in outstanding terms. Everybody without exception was full of praise of the registered manager and their staff team. They said they were marvellous, caring, approachable and always available if they wanted to talk with them.

People and visitors said they felt the care at the home was brilliant. Comments included, “This is a wonderful place to live, they are all so lovely and kind, I was lucky to find this home.” Health professionals were very happy with the care provided to their patients. One commented, “The standard of care is excellent.”

Staff worked as a team to create a better quality of life for people and ensured they were at the heart of everything at the service. They spoke with glowing pride about the people they cared for and as friends and family. They were very attentive and reassured people and ensured people were comfortable and had all they needed. They were intuitive to people’s specific needs and responded proactively to them.

People were supported to have a peaceful, comfortable and dignified end of life care. The registered manager and staff were committed to ensuring people experienced end of life care in an individualised way. There were numerous thank you messages from relatives regarding the good quality care people had received at the end of their lives at the service. In the garden there was a remembrance garden for people who had lived and passed away at the service.

People were cared for without discrimination and in a way, that respected their differences. This was a new service with a small team. Staff were familiar with people’s history and backgrounds and supported them as equals. Staff said it was important that people were at the heart of planning their care and support needs. They treated people with utmost respect and ensured their privacy and dignity when helping them with daily living tasks and personal care. Staff promoted people’s independence which was very important to them. The registered manager and staff on a daily basis went above and beyond to support people. We were told “we do what they want to do.”

People and staff were actively involved in developing the service and were aware of events at the service. Resident and staff meetings took place, both formally and informally. Feedback was always sought from people using the service and relatives in a variety of ways. The provider worked to make the home an integral part of the local community.

People’s medicines were safely managed. Staff who administered medicines had received medicine training. Staff supported people to administer their own medicines if able. They had completed self-administration risk assessments and medicine care plans.

Safe recruitment procedures were in place and appropriate pre-employment checks were undertaken. There were sufficient staff on duty to meet people’s needs and keep them safe. Staff worked in an unhurried way and had time to sit and talk with people and meet their individual needs. Staff were up to date with training and additional training courses linked to the needs of the people using the service had been completed by staff.

Care records contained detailed risk assessments. People had individual personal emergency evacuation plans in place and staff discussed regularly with them the procedure to follow in the event of a fire. Accidents and incidents were recorded and analysed to look for patterns or trends. Regular maintenance checks and repairs were carried out and all areas of the service were clean and tidy.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The registered manager had a good understanding of the Mental Capacity Act (MCA) and staff had received training.

Staff were supported to reach their true potential. They felt able to discuss any issues with the registered manager. Staff were motivated and proud of their service. They said they were well supported and had regular supervision sessions. Staff said they felt involved with the development of the service.

There was excellent partnership working with other health and social care professionals.

People were supported to maintain their health and wellbeing and had access to health professionals when needed. Health professional comments included, “Great really good. Great communication, they call us, keep us updated.”

People were very happy with the food they received. There was a two week varied menu containing well balanced nutritious options and vegetables grown by a person using the service. Snacks and drinks were available if people required them. People's weights were monitored regularly and advice sought from health professionals if there were any concerns.

The atmosphere at the home was calm and welcoming with people living there appearing ‘at home’. People’s relatives and friends were able to visit without being unnecessarily restricted.

Relatives were made to feel welcome and were involved in the care planning process. Staff provided care in a way that protected people's privacy and dignity and promoted independence.

People were receiving care that was tailored to their individual needs. Care plans contained detailed information, including their life history, to help staff support people in a personalised way.

The provider recognised the importance of social activities. People were encouraged to engage in meaningful activity to aid both their physical and emotional well-being. A staff member was responsible for co-ordinating activities and there was a varied timetable of events.

There was a complaints procedure in place and people knew how to make a complaint if necessary. The registered manager had not received any complaints since the service had opened. They were very active at the service and had dealt with small niggles as they had occurred to prevent them from escalating.

The provider had a quality monitoring system at the service. The premises and equipment were managed to keep people safe. Records contained accurate and up to date information relating to people's care needs.

A national care homes review website scored 9.9 out of a possible ten, with everyone saying they would be extremely likely to recommend Hillside House. Comments from people included, “This home really feels like home where staff and residents are all kind and friendly. There is a sense of freedom and encouragement.”