CQC report explained · a residential care home
What the CQC found at Hill Ash House Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm. Inspectors found safer recruitment checks, enough staff, care risk assessments, safe medicines practice and infection control systems.
- Effective?
- Good
- This key question was not inspected during this visit. Its rating was carried forward from the previous inspection.
- Caring?
- Good
- This key question was not inspected during this visit. Its rating was carried forward from the previous inspection.
- Responsive?
- Good
- This key question was not inspected during this visit. Its rating was carried forward from the previous inspection.
- Well-led?
- Good
- The home had systems to monitor care quality, and inspectors found improvements in infection control and recruitment audits. People, relatives and staff spoke positively about the management and culture.
What inspectors found, April 2022
Rated Good after improvements; inspectors found safe care and stronger oversight, but recruitment records still needed a clearer audit trail.
This was an unannounced focused inspection on 9 March 2022. Two inspectors observed care, spoke with people, relatives and staff, and checked care, medicine, recruitment and quality records.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safer recruitment checks, safe medicines practice, infection control measures and systems for managing risks and incidents.
The overall rating improved from Requires Improvement. The home had completed an action plan following the previous inspection and was no longer breaching regulations.
This inspection only checked Safe and Well-led. The other key question ratings were carried forward from the previous inspection.
Safer recruitment
The home had improved its pre-employment checks, including checks with the Disclosure and Barring Service and previous employers.
“Checks on staff were completed before they started work.” from the report
Staffing
Inspectors found enough staff who knew people well and supported them promptly.
“People were supported by enough staff who knew them well.” from the report
Medicines
Medicines were stored securely, records were signed correctly and staff had training and competency checks.
“Medicines administration records were appropriately signed by staff when administering people's medicines.” from the report
Stable team
The home had many long-standing staff members. Relatives described the staffing team as caring, helpful and familiar with families.
“The service has a stable staffing team with many long-standing members.” from the report
Quality monitoring
Inspectors found that audits had improved and were better at identifying and addressing some quality and safety concerns.
“Improvements had also been made to ensure that audits were fully effective in identifying and addressing quality and safety concerns in areas of infection control and staff recruitment.” from the report
Recruitment records
minorThe registered manager was still working to ensure there was always a clear record showing the reasons behind recruitment decisions.
“The registered manager was working on ensuring a clear audit trail related to recruitment decisions would always be available.” from the report
- 01How do you now make sure there is a complete audit trail for every recruitment decision?
- 02How do your current audits identify and address infection control concerns?
- 03How do you maintain continuity of staff who know each person well?
- 04How do you check that medicines records remain complete and accurate?
- 05What were the current ratings for Effective, Caring and Responsive at the previous inspection?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous inspection. This explanation was written from the published report of 15 April 2022 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, October 2021
Hill Ash House Care Centre was rated Requires Improvement; inspectors found kind, person-centred care but unsafe recruitment checks and weak quality audits.
This was an unannounced comprehensive inspection on 24 August and 2 September 2021. Inspectors observed care, spoke with people, relatives and staff, and checked care plans, medicines, recruitment records, audits and infection control arrangements.
People were generally positive about the care. Staff knew people well, treated them kindly and supported their health, medicines, choices, activities and relationships. The home had enough consistent staff and people were supported to receive care safely.
The main problem was that required checks were missing for some new staff. Quality checks had also failed to identify problems with recruitment and infection control. The home took action during and after the inspection, but the overall rating was Requires Improvement. Safe and Well-led were Requires Improvement, while Effective, Caring and Responsive were Good.
Kind and respectful care
Inspectors saw staff speaking gently, checking people's agreement and making sure people understood. People and relatives also spoke positively about staff.
“We observed staff interacting with people and saw they spoke softly to people, maintained good eye contact, and made sure people understood what they were saying.” from the report
Consistent staffing
The home had low staff turnover and enough staff to support people without rushing. Staff knew people well and had time to spend with them.
“People were supported by enough staff that knew them well.” from the report
Safe medicines support
Medicines were stored securely, records were signed correctly and staff had training and competency checks.
“Medicines were safely administered. Medicines administration records were appropriately signed by staff when administering a person’s medicines.” from the report
Personalised activities and independence
The home offered activities suited to people's interests and had created spaces to support independence, including cooking and sensory activities.
“People living with dementia were offered sensory and reminiscence activities such as a train memory activity and there was a sensory room with interactive equipment.” from the report
Quality audits missed problems
needs fixingThe home's governance system and audits did not always identify or address concerns about recruitment and infection control. The provider said it would review its governance arrangements.
“However, we found some audits were not fully effective in identifying and addressing quality and safety concerns.” from the report
Infection control records needed updating
needs fixingInspectors were only somewhat assured that personal protective equipment was being used effectively and that the infection control policy was up to date. The provider reviewed the policy after the inspection.
“We were somewhat assured that the provider's infection prevention and control policy was up to date.” from the report
- 01Have all current staff files now been checked for references, employment histories, health information and proof of identity?
- 02What happens if a reference or employment-history check cannot be obtained, and how is the risk recorded?
- 03What changes have been made to infection control audits and the infection prevention and control policy?
- 04How do managers now check that audits identify and fix recruitment, infection control and other safety concerns?
- 05How will the home record and communicate each person's communication needs in their care plan?
This was an unannounced comprehensive inspection covering all five key questions, including infection prevention and control under Safe. This explanation was written from the published report of 28 October 2021 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 Hill Ash House Care Centre
5 rated inspections over 7 years: the service has held its Good rating throughout.
- April 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not rated
- February 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2019
Registered with the Care Quality Commission on 12 July 2019.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
38 live-in carers within about an hour of Gloucestershire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,030 to £1,360 a week. 31 can care for a couple. 12 years' experience on average.
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.