CQC report explained · a nursing home
What the CQC found at Hillcrest House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- There were gaps in medicines administration records and weaknesses in medicines checks. Staffing had sometimes fallen below planned levels, and regular fire alarm testing had not been possible since March 2022.
- Effective?
- Requires improvement
- Food quality, portions, choices and evening snacks had been inconsistent after changes by the new provider. People were supported with nutrition and healthcare, but supervision for less than half of staff was up to date.
- Caring?
- Good
- People and relatives described staff as kind, friendly and respectful. Inspectors saw caring interactions and found that people's privacy, dignity, independence and choices were respected.
- Responsive?
- Requires improvement
- Care plans contained personalised information, but some important health risks were not fully assessed or recorded. Concerns about food, staffing and showers had not always received an effective response.
- Well-led?
- Requires improvement
- Managers' roles were unclear and audits had not been completed since June 2022. Communication with staff and residents was poor, and management information did not always match what people and staff reported.
What inspectors found, October 2022
Rated Requires Improvement; inspectors found kind care, but concerns about medicines, staffing, food and management oversight.
This was an unannounced first inspection of the newly registered home. Inspectors reviewed six care plans, three staff recruitment files and other records. They spoke with people, relatives, staff and managers.
The home was caring, with kind and respectful interactions. Staff knew people well, supported their choices and helped people stay in touch with family and take part in activities.
However, some safety checks and records were not reliable. There were gaps in medicines records, concerns about staffing and delayed responses to call bells, and fire alarm testing had not taken place regularly. Food quality and choices had also worsened after changes by the new provider.
The overall rating was Requires Improvement. Safe, Effective, Responsive and Well-led were rated Requires Improvement. Caring was rated Good. CQC requested an action plan and said it would monitor progress with the provider and local authority.
Kind and respectful care
People and relatives spoke positively about the staff. Inspectors saw people being treated with kindness, dignity and respect.
“People were treated with kindness and compassion and their privacy and dignity were promoted.” from the report
Personalised care plans
Care plans recorded people's routines, preferences and communication needs. Staff knew people well and used this information to provide individual support.
“Care plans provided person-centred information about each person and guided staff on how to meet their needs in a way that the person preferred.” from the report
Qualified and trained staff
Inspectors found that staff had the relevant skills and qualifications to meet people's needs. Recruitment checks were thorough.
“People received effective care and treatment from competent, knowledgeable and skilled staff who had the relevant qualifications and skills to meet their needs.” from the report
Support with health and activities
People were supported to access healthcare, maintain relationships and take part in activities if they wished. The home also provided end of life care and support for relatives.
“People had opportunities to take part in activities. Activity co-ordinators were employed to support people to enjoy games, quizzes and craft.” from the report
Medicines records and checks
seriousThere were gaps in medicines administration records and handwritten records did not always contain the information staff needed. Checks did not identify all risks, including the incorrect rotation of a medicines patch.
“There were not enough checks in place to make sure that people always received their medicines as prescribed and in a safe and effective manner.” from the report
Staffing and response times
seriousStaffing had sometimes fallen below planned levels. Some people said they waited for help at night or did not receive showers when requested.
“One staff for both sides of this floor is not enough at night. I often have to wait when I need the toilet” from the report
Fire safety testing
seriousWeekly fire alarm tests had not been possible since March because of a fault in the fire panel. The Fire Service was contacted about the risk.
“This meant we could not be assured that the fire alarm system was operating effectively.” from the report
Food and snacks
needs fixingPeople and staff reported cold or burnt food, small portions, unsuitable descriptions of meals and the loss of evening snacks. These changes had not been properly explained or resolved.
“People told us they did not understand the descriptions of some of the new meal options offered, when staff asked them for their choices.” from the report
Weak management oversight
seriousManagers' responsibilities were unclear, audits were out of date and records about DoLS authorisations were not accurate. This meant the home did not have consistent oversight of quality and safety.
“This meant the oversight of the quality of the service provided was not consistent or robust.” from the report
- 01What changes have been made to prevent gaps in medicines administration records, and how are medicines checks now audited?
- 02What staffing levels are planned for each unit during the day and at night, and how are missed call bells or delayed personal care recorded and followed up?
- 03Has the fire panel been replaced and are regular fire alarm tests now taking place?
- 04What food choices and evening snacks are currently available, and how are residents involved before menus or catering arrangements change?
- 05Who is now responsible for management oversight, DoLS records, audits and responding to residents' concerns?
This was an unannounced first comprehensive inspection of the newly registered home, covering all five key questions; the previous provider's Good rating was published on 4 July 2019. This explanation was written from the published report of 15 October 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.
Every inspection of Hillcrest House
4 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- October 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Outstanding
- January 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- January 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2021
Registered with the Care Quality Commission on 9 November 2021.
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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10 live-in carers within about two hours of Cornwall
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 £980 to £1,200 a week. 8 can care for a couple. 12 years' experience on average.
“He had been a little anxious before she arrived, but has since stated that he would be very happy for her to care for him again”
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