CQC report explained · a nursing home
What the CQC found at Hill Top Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Medicines, risk assessments, staffing and infection control were generally managed safely, although one medicine chart did not record that medicine was given through a PEG tube.
- Effective?
- Good
- Care was based on assessed needs and preferences. Staff were trained, people received varied food and drinks, and the home worked with health professionals.
- Caring?
- Good
- Staff were kind and compassionate. They respected privacy, dignity, independence, cultural needs and people's involvement in decisions.
- Responsive?
- Good
- Care plans were personalised and families were involved. People had activities, support with communication and access to community links, and complaints were recorded and acted on.
- Well-led?
- Good
- The two registered managers worked well together and used audits and action plans to monitor quality. People, relatives and staff were encouraged to raise concerns and make suggestions.
What inspectors found, September 2019
Hill Top Lodge was rated Good in all five areas; inspectors found safe, kind and personalised care, with only minor issues noted.
This was an unannounced, planned inspection on 14 August 2019. Inspectors spoke with people living in the home, relatives and staff. They observed care and reviewed care plans, medicine records, staff files and quality checks.
The home was rated Good for Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff during the visit, safe medicine systems, good training and care that respected people's choices, dignity and cultural needs.
People and relatives spoke positively about the care. The home offered activities, supported links with the community and involved families in care planning. The rating was unchanged from the previous inspection, published in February 2017.
Safe care
Inspectors found that staff understood how to protect people from harm. Risks were assessed and reviewed, and incidents were investigated.
“People were cared for by staff that knew how to keep them safe and protect them from avoidable harm.” from the report
Kind and respectful staff
Staff knew people well and treated them with dignity. Inspectors saw warm and meaningful interactions in the home.
“There was a caring friendly atmosphere in the home between people, staff and family members.” from the report
Personalised support
Care plans included people's choices, communication needs, cultural needs and daily preferences. Families were involved in planning care.
“People's care plans clearly set out how staff could best meet their assessed care needs in a way that had been agreed with them.” from the report
Activities and community links
People had a range of activities and were supported to maintain relationships and take part in community activities.
“We saw that there was a range of activities throughout the day.” from the report
Open management
Managers were described as approachable and used audits, meetings and action plans to improve the service.
“During this inspection we heard from people, relatives and staff of a positive, open and person centred culture” from the report
One medicine chart needed updating
needs fixingA medicine administration chart did not state that one person's medicine was given through a PEG tube. Managers agreed to add this information to improve administration safety.
“The medication administration chart did not.” from the report
Mixed views about staffing
minorSome people were unsure whether there were enough staff. Inspectors observed that staffing levels were sufficient during the visit and call bells were answered quickly.
“We received mixed views about the numbers of staff available.” from the report
Kitchen door left wedged open
minorInspectors found the kitchen door wedged open with a chair. Managers recorded this as an issue for future checks.
“We discussed with the registered managers that we had found the kitchen door wedged open by the positioning of a chair.” from the report
- 01How do you now record medicines given through a PEG tube, and how are medicine charts checked?
- 02How many staff are on duty for each shift, and how do you adjust staffing when people's needs change?
- 03What action was taken about the kitchen door being wedged open?
- 04Have the bathroom refurbishments been completed, and are all bathrooms now available?
- 05How are families involved in reviewing care plans and raising concerns?
This was an unannounced inspection of the care provided and the premises, covering all five key questions; the previous overall rating was Good. This explanation was written from the published report of 6 September 2019 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, February 2017
Rated Good; inspectors found safe, kind and responsive care, with two minor issues corrected or noted.
Inspectors visited the home without notice on 8 December 2016. They spoke with people living there, relatives, staff, the cook and the manager. They observed care and reviewed care, recruitment, medicines and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practice, suitable staff training, kind interactions and care that reflected people's needs and preferences.
The provider had made the improvements needed since the October 2015 inspection, when some areas required improvement. Inspectors found no breaches of the regulations.
Staffing and safety
Inspectors found enough staff to meet people's needs promptly. Staff understood safeguarding, risk management and emergency procedures.
“Sufficient levels of staff were available to meet people's needs in a timely manner.” from the report
Kind care
Staff treated people with kindness and offered reassurance when they were worried or anxious. Privacy and dignity were maintained during personal care.
“People were shown kindness and compassion by the staff supporting them.” from the report
Personalised support
People and families were involved in care planning. Records included people's interests, histories, preferences and cultural or spiritual needs.
“Consultation had taken place with people's family members or representatives when the person themselves was unable to communicate this information to staff.” from the report
Management and improvement
The home had an open culture, regular staff support and systems for gathering people's views. Audits were used to identify and address problems.
“Regular checks and audits were undertaken to monitor the safety and effectiveness of all aspects of the service.” from the report
As-required medicines guidance
needs fixingTwo recently prescribed medicines did not initially have clear instructions explaining when they should be given. The omission was corrected straight away after inspectors raised it.
“However, we found two medicines recently prescribed to be given 'as required' did not have this guidance.” from the report
Choice at lunchtime
minorInspectors noted that there were no picture menus or prompts to help people choose food. They also saw that cold drinks were offered but no hot option was offered at lunchtime.
“although no pictorial menus or prompts were available to support them to make choices.” from the report
- 01How do you make sure 'as required' medicines always have clear instructions about when they should be given?
- 02How do you help a person who has difficulty choosing from a written menu?
- 03What hot and cold drinks are offered at mealtimes?
- 04How will you involve our family member in reviewing their care plan and recording their preferences?
- 05What activities are available for someone with dementia who spends much of their time in their room?
This was an unannounced inspection of the overall service covering all five key questions, and inspectors reported that improvements had been made since October 2015. This explanation was written from the published report of 14 February 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 Hill Top Lodge
5 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- September 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- June 2015Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- February 2015Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 January 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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