CQC report explained · a residential care home
What the CQC found at 2 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 inconsistent cleaning, missing fridge checks, no hand-drying facilities, no fire extinguishers and hot radiators without a risk assessment. Medicine support, safeguarding systems and recruitment checks were found to be safe.
- Effective?
- Good
- This question was not inspected during this focused inspection. The report does not give a current rating for it.
- Caring?
- Good
- People told inspectors they were happy. Staff were kind and knew the people they supported. People were involved in choices about their care, activities and personal space.
- Responsive?
- Good
- This question was not inspected during this focused inspection. The report does not give a current rating for it.
- Well-led?
- Requires improvement
- The home's monitoring and audit systems had not identified or dealt with safety and staffing problems in good time. Inspectors also raised concerns about terminology and whether people were being fully empowered to develop their independence.
What inspectors found, December 2023
2 Hill Close was rated Requires Improvement; inspectors found kind, person-centred care but serious shortfalls in safety and management.
This was an unannounced focused inspection. Inspectors visited on 24 October 2023 and also gathered information afterwards. They spoke with people and staff, observed care, and checked care, medicine, staffing, recruitment and management records.
People told inspectors they were happy and appeared relaxed with staff. Care was caring and person-centred. People made choices about their activities, rooms and daily lives, and were supported to take part in community activities.
However, inspectors found problems with infection control, fire safety, hot radiators and staffing information. The home's checks and audits had not identified or dealt with these problems quickly enough. 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.
Kind and person-centred support
People appeared relaxed with staff and received care that reflected their needs and choices.
“People told us they were happy living at 2 Hill Close and we observed that people were relaxed in the company of staff and others they lived with.” from the report
Choice and community life
People chose their own activities and took part in trips and activities in the local community.
“People choose their own activities and if they want to stay in and do their own thing that's up to them.” from the report
Medicines support
Medicine records were completed correctly, checks were recorded and staff had suitable training.
“Medicine administration records were completed correctly and outcomes of audits and spot checks were recorded.” from the report
Safeguarding and recruitment
The home had safeguarding systems, staff training on protecting people from harm, and appropriate recruitment checks.
“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
Infection control and cleanliness
seriousCleaning was not consistent. Fridge temperatures and food opening dates were not recorded, and there were no hand-drying facilities in the toilet or kitchen.
“Some areas of the home were not clean and there was limited evidence of consistent management oversight to ensure compliance with service policies.” from the report
Fire and radiator risks
seriousThere were no fire extinguishers, and some radiators were very hot without radiator covers or a risk assessment. Inspectors found this increased the risk that people could be harmed.
“There were no fire extinguishers in 2 Hill Close.” from the report
Unclear staffing arrangements
seriousNo staff were present when inspectors arrived. Rotas and dependency tools did not clearly show the shared night staffing arrangement across the three buildings.
“When we entered the location, there were no staff present on-site.” from the report
Weak management checks
seriousThe home's audits and monitoring did not identify or resolve infection control, risk assessment and staffing problems promptly.
“The provider's systems did not always effectively monitor the quality of care provided to drive improvements.” from the report
Respectful language and independence
minorInspectors said some terminology was not respectful or empowering. They also found limited evidence that the home helped people develop skills such as cooking, cleaning and shopping.
“The registered manager referred to people as "Our rezzies" which meant residents.” from the report
- 01What has been done to provide fire extinguishers and manage the risk from hot radiators?
- 02How are cleaning, fridge temperatures, food opening dates and hand-drying facilities now checked?
- 03How are staff rotas and dependency tools being corrected so that staffing is clear across the three buildings, including at night?
- 04What evidence can you show that management audits now identify and fix safety problems promptly?
- 05How will you help people build independence skills such as cooking, cleaning and shopping, and ensure staff use respectful language?
This was a focused inspection of Safe, Caring and Well-led only; Effective and Responsive were not inspected, and their ratings were not given in this report. This explanation was written from the published report of 5 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
2 Hill Close was rated Good; inspectors found safe, caring support, with some improvements needed to the environment and care planning.
The CQC carried out an unannounced comprehensive inspection on 29 August 2017. Two inspectors and an expert by experience looked around the home, spoke with staff and the manager, and reviewed care, medicine and recruitment records. They also used information from other organisations.
The home supported three adults with learning disabilities. Inspectors could not speak with the people living there because they were on holiday. They found suitable risk assessments, enough staff, safe recruitment and medicines management. Staff had training, supervision and support.
Care plans were personalised and activities reflected people's interests. Inspectors found kind and respectful care, regular quality checks and good management. The home remained Good in all five areas, the same overall rating as at the previous inspection in February 2015.
Safe medicines
Inspectors found medicines were stored securely and administration records were complete. There were also clear instructions for medicines given when needed.
“We saw storage was secure and MARs were correctly completed with no gaps.” from the report
Staff training
Staff had a thorough induction, regular refresher training, supervision and appraisals. The provider checked whether training had been understood.
“We saw they completed written tests in key areas such as mental capacity, safeguarding and care for people with epilepsy.” from the report
Personalised care
Care plans included people's routines, preferences and ways of receiving support. Accessible information helped people create detailed plans, including for end of life care.
“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 consulted about menus and activities. Records showed they took part in activities such as swimming, outings, baking and gardening.
“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
Quality monitoring
The manager used audits and people's feedback to monitor the service. Records showed that the audits were changed and followed up when needed.
“Records showed action was taken as required, and the scope of audits changed over time to ensure they remained effective.” from the report
Radiator safety
seriousRadiators were not low-surface-temperature models and had no guards to reduce the risk of burns. The manager told inspectors after the visit that action had been taken.
“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
Consent information
needs fixingAlthough pictorial information was used, some explanations of what people were consenting to were lengthy and technical. The manager said this would be reviewed.
“We saw the description of what people were consenting to was written in a way which was lengthy and technical in nature.” from the report
Involvement in care reviews
needs fixingCare plans were reviewed regularly, but inspectors said the involvement of the people using the service was not clear enough. The manager said they would look at making this process more inclusive.
“We highlighted to the registered manager that people's involvement in this process needed to be more evident.” from the report
- 01What action was taken to guard or replace the radiators after the inspection?
- 02How do you now explain consent information in a way that people can understand?
- 03How are people involved in reviewing and updating their care plans?
- 04How do you make sure activities continue to reflect each person's interests and past experiences?
- 05How do audits identify and follow up any new safety or care concerns?
This was an unannounced comprehensive inspection covering all five key questions; people living at the home could not be interviewed because they were on holiday, and some evidence was gathered through the wider inspection of the linked services. This explanation was written from the published report of 8 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 2 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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