CQC report explained · a residential care home
What the CQC found at 1 Hill Close
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found poor cleanliness, unsafe storage of some medicines, no fire extinguishers, uncovered hot radiators and unclear staffing records. Medicines administration records and recruitment checks were otherwise completed appropriately.
- Effective?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Caring?
- Good
- People were treated with kindness and respect. Staff supported people's choices, privacy, dignity, independence and involvement in daily activities.
- Responsive?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Well-led?
- Requires improvement
- The home's checks and audits did not identify important problems with cleanliness, risk management or staff deployment. Inspectors also found that managers did not always use respectful terminology.
What inspectors found, December 2023
1 Hill Close was rated Requires Improvement; inspectors found caring support but important safety and management weaknesses.
This was an unannounced focused inspection. Inspectors visited on 24 October 2023 and gathered further information until 17 November 2023. They spoke with people, staff and managers, observed care, and checked care plans, risk records, staff files, audits and other records.
People were treated kindly and supported to make choices about their daily lives. Inspectors saw positive relationships, community activities and support that respected people's privacy, dignity and independence.
However, the home was not always clean, some risks were not properly assessed or managed, and staffing records did not clearly show how staff were deployed across the linked homes. Quality checks had not found these problems. The provider acted quickly after the inspection findings were raised.
The overall rating changed from Good at the previous inspection to Requires Improvement. Safe and Well-led were rated Requires Improvement, while Caring remained Good. Effective and Responsive were not inspected in this focused inspection, so their previous ratings were used when calculating the overall rating.
Kind relationships
People appeared relaxed with staff and said they were happy living at the home. Staff knew people well and supported them in a caring way.
“People's positive, relaxed body language and affectionate response to staff showed they enjoyed staff's company and were relaxed in their home.” from the report
Choice and independence
People chose activities, went out into the community and had control over where they spent their time. They were supported to take part in household tasks and personal interests.
“People were encouraged to exercise choice and control in their daily lives.” from the report
Safe medicines administration
Inspectors found that staff administered medicines appropriately and that records and audits were completed correctly. The main medicine concern was storage, which is included under safety risks.
“Medicine administration records were completed correctly and outcomes of audits and spot checks were recorded.” from the report
Safe recruitment
The provider carried out the required pre-employment checks described in the report, including checks of criminal records and references.
“The provider operated safe recruitment processes and undertook appropriate pre-employment checks on staff including Disclosure and Barring Service (DBS) checks and reviewing references.” from the report
Cleanliness and infection control
seriousInspectors found dried excrement on surfaces and dirty kitchen equipment. Food temperature checks and opening-date records were not consistently completed, and there were no hand-drying facilities in some areas.
“We saw dried excrement on various surfaces upstairs. The kitchen cupboards, fridge, freezer and oven were dirty.” from the report
Unmanaged safety risks
seriousA skin cream and other medicines were stored in a cabinet next to a scorched oven housing. The home had no fire extinguishers, and hot radiators were not covered or risk-assessed for people's needs.
“The cabinet was positioned, pushed up against the oven housing. The veneer on both the cabinet and the oven housing were visibly scorched.” from the report
Unclear staffing deployment
needs fixingWhen inspectors arrived, no staff were present at the home. Records did not clearly show how two night staff were shared across the three homes, so inspectors recommended that staffing records be reviewed.
“Rotas and dependency tools showed that no night staff were provided at 1 Hill Close.” from the report
Weak management checks
seriousThe home's audits had not identified the problems with cleanliness, risk management and staffing records. This led to a breach of the governance regulation.
“The provider's systems did not always effectively monitor the quality of care provided to drive improvements.” from the report
Respectful language
needs fixingInspectors found that management did not always use respectful or empowering terminology when referring to people. They recommended reviewing best practice and changing this.
“The registered manager did not always use respectful terminology when referring to people who used the service and did not set a good example for staff.” from the report
- 01What has been done to remove the cleanliness and infection control problems found during the inspection?
- 02Where are medicines and skin creams now stored, and how is their storage temperature checked?
- 03Have fire extinguishers been provided and have the risks from hot, uncovered radiators been assessed?
- 04How are staffing levels and night cover recorded across the three linked homes now?
- 05What checks now make sure these problems are identified promptly by management?
This was a focused inspection of Safe, Caring and Well-led; Effective and Responsive were not inspected, and their previous ratings were used to calculate the overall rating. This explanation was written from the published report of 15 December 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, November 2017
1 Hill Close was rated Good; inspectors found safe, caring and well-managed support, with a few areas needing clearer information and involvement.
This was an unannounced comprehensive inspection on 29 August 2017. Inspectors spoke with the two people living at the home, staff and the manager. They looked around the building and checked care plans, recruitment records and other records.
The home supported up to three adults with learning disabilities, and two people lived there at the time. Inspectors found people felt safe, medicines were managed properly, staffing levels were sufficient and staff were safely recruited and trained.
Care was person-centred and respectful. People were supported to choose meals and activities, access health professionals and make plans in accessible formats. Inspectors also found regular checks of quality and good feedback about the management.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The home had also been rated Good at the February 2015 inspection, with no breaches of regulation identified then.
Safe staffing and medicines
Inspectors found enough staff to provide care and support activities. Medicines were securely stored, and administration records were complete.
“We saw records which showed staff were deployed in sufficient numbers to provide care and support, and also assist people to participate in activities at the home and in the community.” from the report
Person-centred care
Care plans included people's preferred routines and how they wanted support to be given. Staff understood how to protect privacy and dignity.
“Care plans were written in a person-centred way, including information about preferred routines and ways in which support could be given when needed.” from the report
Activities and choice
People were offered activities linked to their interests and were consulted about what they wanted to do. Inspectors saw records showing activities took place.
“We saw records of consultations with people about the activities they wanted to take part in, and evidence these activities took place.” from the report
Diabetes information
needs fixingInspectors found some gaps in information about diabetes management and raised this with the manager.
“We noted some gaps in information relating to diabetes management however, and brought this to the attention of the registered manager.” from the report
Consent information
needs fixingAlthough people had signed consent records and pictorial information was used, some explanations were lengthy and technical. The manager said this would be reviewed.
“We fed this back to the registered manager who told us they would look at changing this.” from the report
Involvement in care reviews
needs fixingCare plans were reviewed, but inspectors said it was not clear enough that people were involved in the process. The manager said they would look at making it more inclusive.
“We highlighted to the registered manager that people's involvement in this process needed to be more evident.” from the report
Radiator safety
needs fixingRadiators did not have low-temperature surfaces or guards to reduce the risk of burns. The manager told inspectors after the visit that this had been dealt with.
“We noted that radiators were not low surface temperature models, and did not have any guards in place to reduce the risk of burns.” from the report
- 01What changes have you made to the information and guidance for managing diabetes?
- 02How do you now explain consent and care choices in a way that is easy for each person to understand?
- 03How are people involved in reviewing and changing their care plans?
- 04Have all the radiators been made safe, and how do you check for similar environmental risks?
- 05How do you use people's views about activities, care and daily life to improve the home?
This was an unannounced comprehensive inspection of the home, carried out alongside inspections of two linked services because staffing and management were shared. This explanation was written from the published report of 10 November 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of 1 Hill Close
3 rated inspections over 9 years: the service has slipped, from Good to Requires improvement.
- December 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017Goodstayed GoodSafe: GoodCaring: GoodWell-led: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- July 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 11 April 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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