CQC report explained · a residential care home
What the CQC found at Hillcrest
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found effective safeguarding systems, suitable risk assessments, enough safely recruited staff and safe medicines management.
- Effective?
- Good
- Staff had relevant training and support, met people's dietary needs and worked with health and social care professionals. Inspectors noted that the building had an institutional feel and needed more homely touches.
- Caring?
- Good
- Relatives described staff as kind and caring. Staff understood people's needs, protected privacy and dignity, and supported people to make choices.
- Responsive?
- Good
- Care plans reflected people's preferences and communication needs, and people were supported with activities, independence and family relationships. End-of-life plans were basic and did not cover spiritual or emotional needs.
- Well-led?
- Good
- Inspectors found supportive management, regular audits and action plans to address shortfalls. Relatives and staff gave positive feedback about how the home was managed.
What inspectors found, February 2020
Rated Good; inspectors found safe, kind and personalised care, but noted basic end-of-life plans and an institutional feel in parts of the home.
This was an unannounced planned inspection by two inspectors on 30 January 2020. They reviewed care, medicines, recruitment and management records, observed people's care, and spoke with staff, relatives and a visiting professional. People could not share their views directly, so inspectors also used observation.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough trained staff, safe medicines management, suitable risk assessments and good links with health professionals. Staff knew people well and supported choice, independence, communication and activities.
The report also records some areas for improvement. The building had an institutional feel and lacked homely touches in some areas. End-of-life plans were basic and did not cover spiritual or emotional needs. The home was larger than current best practice guidance, although inspectors said its design and location reduced the impact.
Safe staffing
There were enough experienced and safely recruited staff. Staffing was increased when one person's night-time needs changed.
“There were enough safely recruited, experienced, skilled and qualified staff deployed to meet people's needs.” from the report
Personalised support
Care plans covered people's preferences, communication and what might upset them. Staff used this information to provide individualised support.
“People received care that was individualised because staff knew and understood people well.” from the report
Choice and independence
People were supported to make choices, build skills and take part in activities that matched their interests.
“People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.” from the report
Caring relationships
Relatives described staff as kind and caring. Staff knew people's individual needs and responded when people needed comfort.
“Staff had developed positive and caring relationships with people and were knowledgeable about their individual needs and personal circumstances.” from the report
Quality monitoring
The provider used audits and action plans to identify and follow up shortfalls. Staff and relatives were able to give feedback.
“The provider had a robust quality assurance process which meant that shortfalls in performance were swiftly identified and addressed in a timely manner.” from the report
End-of-life planning
needs fixingPeople had end-of-life plans, but these were basic and did not include spiritual or emotional needs. The manager said they would review them and staff training was scheduled.
“However, these were basic and did not cover people's spiritual and emotional needs.” from the report
Institutional feel
minorInspectors felt some parts of the home did not feel sufficiently homely. Refurbishment, painting and decorating were planned.
“We discussed that the service had an institutional feel and lacked homely touches.” from the report
Size of the home
minorThe home supported nine people, which inspectors said was larger than current best practice guidance. They considered that the design and setting reduced the negative impact.
“Nine people were using the service on the day of this inspection. This is larger than current best practice guidance.” from the report
- 01What changes have been made to the refurbishment plans to make the home feel less institutional and more homely?
- 02How are end-of-life plans now developed, including a person's spiritual and emotional needs?
- 03How does the home make sure its size does not reduce people's choice, privacy, independence or community involvement?
- 04How are changes in people's night-time support needs identified and reflected in staffing levels?
- 05How are relatives involved when care plans and best-interest decisions are reviewed?
This was an unannounced comprehensive inspection covering all five CQC questions, the care provided and the premises; people could not give their views directly, so inspectors used observation and feedback from staff, relatives and a professional. This explanation was written from the published report of 21 February 2020 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, August 2017
Rated Good; inspectors found safe, kind and personalised care, with some medicine records needing improvement.
This was an unannounced comprehensive inspection on 11 July 2017. One inspector visited the home, reviewed care and staff records, observed care, and spoke with staff, the provider, the registered manager and relatives. The inspector could not speak directly with people living at the home.
The home supported nine adults with learning disabilities and autistic spectrum conditions. Inspectors found that people were safe, staff understood their needs, and there were enough trained staff. Care was described as kind, respectful and personalised. People had access to food, drink, health professionals and activities suited to their interests.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. This was the same overall rating as at the previous inspection. Inspectors found that medicine administration was safe, but some medicine records needed improvement.
Safe staffing
Inspectors found enough safely recruited, skilled staff. The staff team was stable, helping staff understand people well.
“There were sufficient numbers of safely recruited and skilled staff available to meet people's needs.” from the report
Personalised support
Staff knew people's needs, preferences and ways of communicating. Care records included personal information to help staff provide individual support.
“People received personalised care that met their individual needs.” from the report
Kind and respectful care
Relatives said staff were kind and caring. People were supported to make decisions and their privacy and dignity were respected.
“People who used the service were treated with kindness by staff who respected their privacy and upheld their dignity.” from the report
Quality oversight
The provider used regular audits and acted on shortfalls. Inspectors found an open and inclusive culture.
“There was a robust quality assurance system in place and shortfalls identified were promptly acted on to improve the service.” from the report
Medicine records
needs fixingInspectors found that medicines had been given safely and at the right time, but some records were not complete and needed improvement.
“We checked a random sample of boxed medicines and found, whilst they had been safely administered to people at the correct time, improvements were required in relation to record keeping.” from the report
Limited activity observed
minorThe inspector did not see people being supported with activities during the visit. Four people were observed sitting or pacing in shared areas, although the home said it offered a range of activities.
“During the course of this inspection we did not observe any support provided for people to engage in activities.” from the report
Undated compliments
minorThe inspector suggested that compliments should be dated so that the feedback had clearer context.
“We made a suggestion that the registered manager ensured that such entries were dated to help give some context to the feedback received.” from the report
- 01What changes have been made to medicine record keeping since the inspection?
- 02How do you check that medicines are recorded accurately after they are given?
- 03Which activities are currently available, and how are they adapted for people with limited attention spans or anxiety?
- 04How do you find out whether people who cannot communicate verbally are happy, comfortable and involved in their care?
- 05How are relatives' feedback and complaints recorded, dated and followed up?
This was an unannounced comprehensive inspection covering all five areas; the inspector could not speak directly with people living at the home and reviewed two care records and two staff personnel files. This explanation was written from the published report of 1 August 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 Hillcrest
3 rated inspections over 4 years: the service has held its Good rating throughout.
- February 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Registered with the Care Quality Commission on 2 December 2013.
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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