CQC report explained · a residential care home
What the CQC found at Hilltop House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough suitably checked staff, effective risk assessments, safe medicines arrangements and good cleanliness. Staff understood safeguarding and how to respond to accidents or incidents.
- Effective?
- Good
- Care plans were detailed and based on people's needs, choices and professional advice. Staff supported people's health, eating and drinking, and access to healthcare. Formal supervision took place every two months, although records had not always been completed.
- Caring?
- Good
- People were treated with kindness, dignity and respect. They were involved in decisions, could choose preferred keyworkers and were supported to maintain relationships and independence.
- Responsive?
- Good
- Care was personalised and adapted to people's changing needs, communication styles and interests. People were supported to take part in activities at home and in the community, and complaints systems were in place.
- Well-led?
- Good
- Inspectors found an open, inclusive culture and effective quality checks. The manager and staff worked with health and social care professionals and used incidents, feedback and improvement plans to develop the service.
What inspectors found, February 2020
Hilltop House was rated Good; inspectors found safe, kind and personalised care, with some supervision records not always completed.
This was an unannounced inspection carried out on 11 and 18 December 2019. The inspector spoke with people living in the home, relatives, staff and community professionals. They also reviewed care, medicines, recruitment and management records, and observed care and medicines being given.
The home supported seven people and could provide care for up to eight people with mental health needs. Inspectors found enough staff, safe medicines practices, good risk management and a clean, well-maintained environment. People told inspectors they felt safe and were treated with kindness and respect.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This was the same overall rating as the previous inspection, published in June 2017. The report says no formal complaints had been made since that inspection and that the home had effective systems for learning and improvement.
Staffing and continuity
There were enough staff with suitable skills, and people benefited from regular staff who knew them well.
“There were enough staff, with the right mix of skills, to support people safely, in accordance with their support plans.” from the report
Personalised support
Care plans reflected people's needs, preferences and goals. Staff supported people to live as independently as possible and to follow their interests.
“People received personalised care which met their needs and enabled them to live as full and independent a life as possible.” from the report
Safe medicines and risk management
Staff were trained and checked as competent to give medicines. Risks such as choking, malnutrition and risks linked to mental health needs were assessed and managed.
“People received their medicines from staff who had completed the provider's mandatory training.” from the report
Open management
The home had quality checks, regular meetings and links with outside professionals. The manager reviewed incidents and used them to reduce future risks.
“The registered manager effectively operated quality assurance and governance systems to drive continuous improvement in the service.” from the report
Supervision records
minorStaff said they received formal supervision every two months, but these meetings had not always been recorded. The manager was updating the records during the inspection.
“Staff confirmed that they had received formal bi-monthly supervisions, although these had not always been recorded.” from the report
- 01How will you make sure supervision meetings are recorded consistently for every staff member?
- 02How would you assess and manage my relative's specific mental health, choking, nutrition or other safety risks?
- 03How do you check that staff remain competent to administer medicines, including any as-required medicines?
- 04How would you support my relative's preferred activities, relationships and independence in the community?
- 05How will you adapt information and communication if my relative finds it difficult to express their choices?
This was an unannounced planned inspection that looked at the premises and care and reviewed all five CQC questions; the previous overall rating was also Good. This explanation was written from the published report of 26 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, June 2017
Rated Good; inspectors found safe, kind and personalised care, with some improvements needed in risk assessments, activity records and audits.
The inspection was unannounced and took place on 15 May 2017. It was the first inspection since the change of ownership. One inspector observed care, spoke with six people, staff, managers and health and social care professionals, and reviewed three care plans and other records.
The inspectors found enough trained staff to meet people's needs safely. Medicines were managed safely, people were treated with respect, and staff understood their preferences. People were supported with food, health appointments, activities and their legal rights.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors did identify improvements needed, including making risk assessments more personal, recording activities more clearly and keeping complete records of quality audits.
Safe staffing
The rota showed enough staff during the day and night to meet people's assessed needs. Staff had relevant training and experience.
“Staff had relevant skills and experience and were sufficient in numbers to keep people safe.” from the report
Kind, respectful care
Inspectors observed positive interactions. Staff understood people's needs, communication and preferences and respected their privacy.
“Throughout the visit staff were communicating and interacting with people in a respectful and positive way” from the report
Health and wellbeing
People had health needs recorded and were supported to attend appointments and make healthy choices about food and drink.
“People received regular health and well-being check-ups and any necessary actions were taken to ensure people were kept as healthy as possible.” from the report
Supportive management
Staff described the management as approachable and supportive. The home had ways to gather views and respond to concerns.
“There was an open and supportive culture in the service.” from the report
Blanket risk controls
needs fixingSome restrictions, such as controls on the tea urn and window restrictors, applied to everyone rather than being based on each person's individual risk. The risk scoring system also did not explain what scores meant or what action was needed.
“some risks such as using the tea urn or the use of window restrictors were applied to everyone regardless of whether a specific individual risk had been identified.” from the report
Activity records
minorPeople had activities in the home and community, but the home could not clearly show how often people took part in outside activities. The manager said a recording system would be reintroduced.
“It was not entirely clear how often people were able to undertake activities” from the report
Incomplete audit records
needs fixingThe home carried out some quality audits, but written records were not kept for all of them. This made it difficult for inspectors to confirm that audits were completed systematically.
“we could not ascertain whether these were systematically undertaken because written records were not maintained for all audits.” from the report
- 01How have you changed risk assessments so that restrictions are based on each person's individual needs?
- 02What do the risk scores mean now, and what action is taken when a score is high?
- 03How often can residents take part in accompanied activities outside the home?
- 04How do you record activities and the choices people make each day?
- 05How do you record all audits and check that agreed improvements have been completed?
This was an unannounced comprehensive inspection covering all five key questions and the overall rating; it was the first inspection under the new ownership. This explanation was written from the published report of 21 June 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 Hilltop House
2 rated inspections over 3 years: the service has held its Good rating throughout.
- February 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015
Registered with the Care Quality Commission on 14 May 2015.
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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