CQC report explained · a residential care home
What the CQC found at 35 Hill Top View
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People had personalised risk assessments, enough staff and safe recruitment processes. However, the possible fire safety risks linked to a stair gate had not been assessed until inspectors raised them, although the provider acted immediately.
- Effective?
- Good
- Care plans were detailed and staff received training and induction. People were supported with food, drinks, healthcare, communication and decisions made under the Mental Capacity Act.
- Caring?
- Good
- Inspectors observed people being treated with kindness, dignity and respect. Staff supported independence and tried to understand people's views through their communication and behaviour.
- Responsive?
- Good
- Care and activity plans were personalised and records were used to check whether activities suited each person. People were supported to maintain family relationships and complaints were investigated and followed up.
- Well-led?
- Good
- The rating improved from Requires Improvement at the previous inspection. The provider had audits, staff supervision and external reviews, but the home's own systems had not identified the stair-gate risk.
What inspectors found, November 2019
Rated Good; inspectors found kind, personalised care, but a stair-gate safety risk had not been identified by the home's checks.
The inspection took place on 12 September 2019. Two inspectors and an assistant inspector spoke with staff, observed the four people living there, and reviewed care files, medicines records, staff files and management records. Both properties were included.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People received personalised support, had activities and family contact, and were supported by staff who understood their needs.
Inspectors found one important gap in the home's safety and checking systems. A stair gate had been used at the top of the stairs, but the possible fire safety risks had not been assessed. The provider acted immediately and updated the relevant risk assessments before the inspection ended.
The overall rating stayed Good, the same as at the previous inspection published in April 2017. The Well-led rating improved from Requires Improvement to Good, although inspectors still said the service was not always well-led because the stair-gate risk had not been found by the home's own checks.
Personalised support
Care plans reflected people's routines, choices and health needs. Staff used activity plans and records to provide support that suited each person.
“People received care that was personalised to their needs.” from the report
Kind and respectful care
Inspectors observed staff respecting people's ways of doing things and offering help when it was wanted. People's dignity and independence were promoted.
“Throughout our inspection we observed people being cared for in a way promoted their dignity.” from the report
Staffing and medicines
There were enough staff to meet people's needs, staff were safely recruited, and medicines were given on time by trained staff.
“People received their medicine on time by staff who had been trained to administer.” from the report
Improved leadership
The Well-led rating improved from Requires Improvement to Good. Staff described management as supportive, and the service showed how it used learning to improve care.
“At this inspection this key question has improved to good.” from the report
Stair-gate risk was missed
seriousThe possible fire safety effects of a stair gate had not been considered in the person's risk assessment, emergency evacuation plan or the home's fire risk assessment. The provider corrected this immediately after inspectors identified it, but the home's governance checks had failed to find it.
“Unfortunately, the implications of there being a stair gate had not been considered under fire safety for either the person or the building.” from the report
People may need help to complain
minorA complaints process was available, but people relied on other people to speak up if something was wrong. This is particularly relevant because the report says people's communication skills were limited.
“People had access to complaints procedure however people relied on others to speak up for them if something was not right.” from the report
- 01What changes were made after the stair-gate fire safety risk was identified?
- 02How do you now check that stair gates and other equipment are included in people's fire risk assessments and emergency evacuation plans?
- 03How do you help people with limited communication to express a concern or make a complaint themselves?
- 04How are people's activity plans reviewed to make sure activities continue to suit their interests and responses?
- 05How are families kept involved in decisions about care and changes in the service?
This was a planned inspection covering all five CQC questions and both properties; inspectors observed all four people and reviewed selected care, medicines, staff and management records. This explanation was written from the published report of 7 November 2019 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, April 2017
Langston Care Limited - 35 Hill Top View was rated Good overall, but inspectors found that quality checks and incident monitoring still needed improvement.
This was an unannounced inspection on 31 January 2017. One inspector observed care, spoke with four staff and managers, and looked at two care plans and staff recruitment files. The inspector could not speak in depth with people using the service or their relatives.
The home was rated Good for safe, effective, caring and responsive care. Inspectors found that people were protected from abuse, received their medicines correctly, and had care suited to their needs. Staff were kind, supported people's dignity and helped them keep in touch with relatives.
The home was rated Requires Improvement for being well-led. Some quality audits had been introduced, but they did not give a full picture of care and safety. Accidents and incidents were recorded but not analysed for patterns. This was an improvement since the previous inspection, when the provider had breached Regulation 17, but more work was still needed.
Safe support
Staff understood people's risks and used clear plans to support them safely, including when people had seizures or became anxious.
“People were kept safe from harm because staff understood their responsibility to protect them from abuse and poor care.” from the report
Kind and respectful care
Inspectors saw friendly, polite support. Staff noticed when people were unsettled and protected their dignity, privacy and independence.
“People were provided with kind and compassionate care.” from the report
Personalised activities
Staff knew people's likes and dislikes and adapted activities when someone was unwell or did not want to take part.
“Staff recorded the level of enjoyment or disinterest people demonstrated on the trips or activities to ensure they provided them with activities they benefitted from.” from the report
Staff skills and support
New staff received an induction and shadowing. Staff had access to training, supervision and advice from healthcare professionals.
“Staff were supported to learn new skills and update their knowledge to ensure they cared for people appropriately.” from the report
Quality checks were incomplete
needs fixingThe home had introduced some audits, but they did not provide a complete overview of the quality and safety of care. This was a continuing issue from the previous inspection.
“Action was still required to ensure audits identified where improvements could be made.” from the report
Incidents were not analysed
needs fixingAccidents and incidents were recorded and passed to managers, but the home did not look for trends or patterns that might lead to better care and support.
“However there was no management analysis to identify if there were trends or patterns to the incidents.” from the report
Limited direct feedback
minorThe inspector could not speak in depth with people using the service or their relatives. The findings therefore relied mainly on observation, staff discussions and records.
“We were unable to speak in depth with anyone who used the service or their relatives.” from the report
- 01How do you now analyse accidents and incidents to identify patterns and prevent them happening again?
- 02What audits are currently used to check the quality and safety of care?
- 03What improvements have been made since the inspection to give managers a full overview of the service?
- 04How do you gather the views of people using the service and their relatives, given that the inspector could not speak with them in depth?
- 05How are activity plans reviewed when someone is unwell or does not want to take part?
This was an unannounced inspection covering all five key questions, but the inspector could not speak in depth with people using the service or their relatives and reviewed two care plans. This explanation was written from the published report of 4 April 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 35 Hill Top View
3 rated inspections over 3 years: the service has held its Good rating throughout.
- November 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 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 11 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Staffordshire
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 £1,230 a week. 85 can care for a couple. 10 years' experience on average.
“We particularly appreciate the companionship Dawn gives in the evenings when she plays cards and Scrabble with my mother.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.