CQC report explained · a residential care home
What the CQC found at Hillside
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2023
Hillside remains rated Inadequate and in special measures, although inspectors found important improvements in safe care and management.
This was an unannounced targeted inspection on 8 February 2023, with inspection activity continuing until 16 February. One inspector visited the home and reviewed risk assessments, care plans, fire safety checks and medicine records for five people. The inspector also spoke with people living at the home, staff and managers.
The inspection focused on medicines, risk management, infection control, person-centred care and how the home was managed. Inspectors found that care plans and risk assessments had been improved, the home was clean, and staff generally supported people safely and kindly.
There were still shortfalls. Some medicine records were not signed, some medicines did not have the required guidance, and some risk assessments and care plans lacked enough detail. The manager dealt with these particular issues during the inspection.
The overall rating remains Inadequate because this targeted inspection did not reassess the whole service. The home remains in special measures and will be kept under review.
Improved care planning
Care plans and risk assessments had been updated for people's support needs. This gave staff better guidance about how to support people safely.
“People's care plans had been updated to help ensure staff knew how to support them safely.” from the report
Kind and positive support
Staff were described as confident, kind and compassionate. People appeared happy and relaxed with the staff team.
“Staff were confident when supporting people and spoke with them with kindness and compassion.” from the report
Clean home
The home was clean and free from clutter. New checks had been introduced to help keep it clean and tidy.
“The service looked clean and was free from clutter.” from the report
Action after the previous inspection
Managers had taken the previous findings seriously and introduced audits covering medicines, care plans, risks, fire safety and infection control.
“The manager and nominated individual had taken the findings from our last inspection seriously.” from the report
Support for people's independence
Staff had started helping people work towards personal goals, such as accessing the community independently or making their own drink.
“People had started working on accessing the community independently or making their own drink.” from the report
Medicine records and guidance
seriousStaff sometimes did not sign records when giving as-required medicines. Some people also did not have protocols explaining when those medicines should be used. The manager acted on these issues immediately.
“Staff sometimes did not sign to say when 'as and when required' (PRN) medicines had been given.” from the report
Risk assessments lacked detail
needs fixingSome risk assessments, including those about fire safety, did not contain enough detail. The manager said these would continue to be reviewed.
“Some of these risk assessments would still have benefitted from more detail.” from the report
Goals and feedback not fully developed
needs fixingWork had begun to help people set meaningful goals and to collect feedback in ways that suited them. The report says this work was not yet fully embedded.
“The nominated individual recognised this was a good start, but more work was needed to fully embed a culture of supporting people to set and achieve meaningful goals.” from the report
- 01How are you checking that staff sign every record when as-required medicines are given?
- 02Which people still need more detailed risk assessments or care plans, and when will these be completed?
- 03How are you making sure each person has meaningful goals and is supported to achieve them?
- 04How do you collect feedback from people who do not communicate verbally?
- 05What improvements are still required before the home can leave special measures?
This was a targeted inspection of selected parts of Safe and Well-led, so it did not reassess the full five key questions and did not change the previous overall Inadequate rating. This explanation was written from the published report of 9 March 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 2022
Inadequate and in special measures; inspectors found serious risks with medicines, safeguarding, care planning and leadership.
The inspection was unannounced. One inspector visited on 13 and 21 September 2022, spoke with people, relatives, staff and managers, and checked care records, medicines, risk assessments, fire safety and other documents.
The home was not consistently safe. Staff sometimes missed medicines, did not always record them, and gave one person's as-required medicine without proper advice. Care plans and risk assessments were missing or unclear, fire safety arrangements were poor, and safeguarding concerns were not always reported.
The home was also not well-led. Leaders had not created effective checks on care quality or people's experiences. Inspectors found that people's goals, interests and independence were not consistently supported, and parts of the home were tired and poorly maintained.
The overall rating was Inadequate, down from Good at the previous inspection published on 7 August 2019. The home was placed in special measures, with warning notices issued for safe care and treatment, person-centred care and good governance.
Staffing levels
Inspectors found there were enough staff to meet people's needs. Staffing was increased when a new person moved into the home.
“There was sufficient staff to meet people's needs.” from the report
Visits from relatives
Relatives were confident that people were safe with staff. Relatives were supported to visit without restrictions.
“People's relatives were confident people were safe at the home and with the staff.” from the report
Mental Capacity Act
The inspection found that the home was working within the principles of the Mental Capacity Act and that appropriate legal authorisations were in place when needed.
“We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.” from the report
Medicines
seriousMedicines were sometimes missed or not recorded. One person was at risk of being over-medicated because an as-required medicine was given without proper medical advice and sometimes for the wrong reasons.
“Staff sometimes forgot to give some people their medicines and did not always sign to say they had given people their medicines.” from the report
Risk and fire safety
seriousCare plans and risk assessments did not always cover people's changing needs. Fire drills and suitable evacuation plans were missing, and a fire exit alarm was not working.
“There were concerns with fire safety. Fire drills did not take place and evacuation plans were not made to accommodate people's needs and when there are different staffing levels at the home.” from the report
Safeguarding
seriousPotential neglect or harm was not always reported to the local authority. Some staff did not know how to recognise or report abuse.
“When potential neglect took place as a result of staff practices managers did not raise safeguarding alerts to the local authority.” from the report
Leadership and oversight
seriousManagers and the provider did not have effective systems to check care quality, manage risks or learn from incidents. Staff also said they lacked enough training and management support for some complex needs.
“There was inadequate day to day management and provider oversight at the home.” from the report
Person-centred support
needs fixingThe home had not properly explored people's goals, interests or experiences. Inspectors found missed opportunities to support independence and reduce social isolation.
“The managers, providers and staff had not completed any work to look at people's goals and ambitions in life and if they were getting enough out of life.” from the report
Condition of the home
needs fixingParts of the home were dusty, tired and uncared for. Some bedrooms needed decorating or replacement items, and broken furniture and unwanted items were visible.
“The environment of the home was tired and uncared for.” from the report
- 01What has changed to make sure every medicine is given correctly, recorded and reviewed by a health professional when needed?
- 02What current care plans and risk assessments are in place for people's changing health needs, falls and distress?
- 03Have fire drills, evacuation plans, alarms and other fire safety issues now been checked and fixed?
- 04How are safeguarding concerns reported, and how do you check that all staff know the reporting process?
- 05How are you now checking people's goals, interests, independence and experience of living at the home?
This inspection focused on Safe and Well-led; the report gives no ratings for Effective, Caring or Responsive. This explanation was written from the published report of 18 November 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 Hillside
4 rated inspections over 7 years: the service has slipped, from Good to Inadequate.
- March 2023Inspected but not ratedcurrent ratingSafe: Inspected but not ratedWell-led: Inspected but not rated
- November 2022Inadequatedown from GoodSafe: InadequateEffective: GoodCaring: GoodResponsive: GoodWell-led: Inadequate
- August 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- May 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 27 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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