CQC report explained · a residential care home
What the CQC found at Hillyfield Rest Home Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that people's risks were assessed, monitored and reviewed. Medicines, staffing, recruitment, safeguarding and infection control were also found to be managed safely.
- Effective?
- Good
- This question was not covered by this focused inspection.
- Caring?
- Good
- This question was not covered by this focused inspection.
- Responsive?
- Good
- This question was not covered by this focused inspection.
- Well-led?
- Good
- Inspectors found effective audits, good oversight of quality and regulation, open communication and staff who felt supported in their roles.
What inspectors found, October 2022
Rated Good; inspectors found safe care and stronger management after previous concerns were addressed.
This was an unannounced, focused inspection on 12 October 2022. One inspector spoke with three people, three relatives and five staff. They also checked care and medicines records, recruitment files and management records.
The home was rated Good for Safe and Well-led. Inspectors found that risks were assessed and reviewed, medicines were managed safely, staffing and recruitment had improved, and infection control arrangements were suitable.
The home had previously been rated Requires Improvement, with breaches involving risk management, staffing, recruitment, medicines and governance. Inspectors found enough improvement had been made and said the home was no longer in breach of regulations.
This visit only covered Safe and Well-led. It was a follow-up inspection, so it did not provide new ratings for Effective, Caring or Responsive.
Risks were reviewed
People's risks, including falls, skin damage and eating and drinking, were assessed and regularly reviewed. Care records set out how staff should reduce avoidable harm.
“People had their risks assessed, monitored and regularly reviewed.” from the report
Medicines were managed safely
Trained staff managed medicines, with regular checks of their competence. Records, storage, temperature checks and arrangements for creams and controlled drugs were in place.
“People had their medicines managed safely by trained staff who had their competencies checked regularly.” from the report
Enough suitable staff
Inspectors found enough staff at the time of the visit and saw people being supported without being rushed. Recruitment checks included references and criminal record checks.
“People were supported by enough staff.” from the report
Open management
People, relatives and staff spoke positively about communication with management. Audits and an electronic care system helped the home monitor care and make improvements.
“People, their families and the staff team spoke positively about the management of the home describing an open, transparent culture.” from the report
Inspectors raised no specific concerns in this report.
- 01How are people's risks, including falls, skin damage and eating and drinking risks, reviewed now?
- 02How do you check that medicines are being given safely and that staff remain competent?
- 03How many staff are currently on duty for the number and needs of people living here?
- 04What quality audits are carried out now, and how do you show that improvements have been maintained?
- 05What is the current position on any Deprivation of Liberty Safeguards applications mentioned in the report?
This was a focused follow-up inspection of Safe and Well-led only; Effective, Caring and Responsive were not covered by this visit. This explanation was written from the published report of 26 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.
What inspectors found, September 2021
Rated Requires Improvement; inspectors found risks with safety, medicines, staffing, records and leadership.
This was an unannounced focused inspection on 28 July 2021. Inspectors looked mainly at Safe and Well-led, after concerns about medicines, staffing, infection control and management. They spoke with people, relatives, staff and professionals, and checked care, medicines, recruitment and management records.
The home was not always safe. Inspectors found problems with fire evacuation arrangements, lifting equipment checks, risk assessments, pressure care, diabetes care, medicines records, staff training and recruitment. They also found periods when there were not enough staff to supervise communal areas safely.
Leadership and record keeping were not strong enough. Care plans were not always up to date or person-centred, records about falls did not agree, and regular quality checks had not been completed since 2020. Management changes had also caused inconsistency.
The overall rating fell from Good at the previous comprehensive inspection, published in October 2019, to Requires Improvement. This inspection did not reassess Caring, Effective or Responsive. Those earlier ratings were used when calculating the overall rating.
Relatives felt people were safe
Relatives told inspectors that their family members were safe and well cared for.
“Relatives told us their family members were kept safe at the service.” from the report
Positive atmosphere
Some relatives described the home as comfortable and having a family feel.
“The atmosphere in the home is happy and comfortable.” from the report
Local professional links
The home worked with local medical practices and community health teams. Health professionals who regularly visited raised no concerns.
“The service worked in partnership with the local doctor's surgeries and community health teams.” from the report
Medicines records
seriousAllergies, eye-drop instructions, variable doses and controlled medicines were not consistently recorded or managed. Inspectors could not always tell what dose had been given or whether medicines were stored correctly.
“Allergies or the absence of known allergies were not consistently recorded for all people, therefore potentially putting people at risk of receiving a medicine that they could have an allergic reaction to.” from the report
Staffing and training
seriousSome staff had not completed relevant training or regular supervision. Inspectors also found periods when two staff were not enough to safely supervise communal areas.
“The failure to have deployed trained numbers of suitably qualified, competent, skilled and experienced staff was a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Recruitment checks
seriousTwo staff files did not contain all the required employment history and identity checks.
“Two staff files did not contain a full employment history as no application form had been obtained, or proof of identity including a recent photograph” from the report
Weak management oversight
seriousThere had been no regular quality checks or audits since 2020. Inspectors found that records, care plans, training, medicines and risk management were not being monitored well enough.
“No regular checks or audits had been completed since 2020 to assist the leadership team with measuring the quality and safety of the service.” from the report
Family communication
minorSome relatives said communication could be better. Newsletters had stopped after the end of 2020 and the last recorded family quality survey was in 2018.
“Some relatives we spoke with felt communication could be improved.” from the report
- 01Have all slings, bath lifts and other lifting equipment now had the required safety checks?
- 02How do you make sure each resident's current care plan is clear to staff while paper and electronic records are both being used?
- 03What has changed to ensure medicines, including variable-dose and controlled medicines, are recorded and stored safely?
- 04How many staff are on duty at different times, and how do you ensure communal areas are supervised safely?
- 05What action has been completed following the breaches in recruitment, training, record keeping and management oversight?
This was a focused inspection of Safe and Well-led only; Caring, Effective and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 4 September 2021 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 Hillyfield Rest Home Limited
4 rated inspections over 6 years: the service has held its Good rating throughout.
- October 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Hillyfield Rest Home Limited →
- September 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Hillyfield Rest Home Limited →
- October 2019Goodstayed GoodSafe: GoodWell-led: Good
- January 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 30 November 2010.
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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