Archived: Hillcrest

Updated 14 March 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by one inspector.

Service and service type

Hillcrest is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service is required to have a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. There was no registered manager at the time of this inspection. The previous registered manager had left the service in early 2019. A new manager had recently been appointed with the intention of applying to become the service’s registered manager.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection and all notifications which the service had submitted. We used this information to help plan our inspection. A provider information return was not requested prior to this inspection.

During the inspection

We met and spoke with the person who used the service and observed how staff met their support needs. We also spoke with two members of care staff and the deputy manager.

We reviewed a range of records. This included the person’s care plan and medication records. We also looked at three staff files in relation to recruitment, supervision and training. A variety of records relating to the management of the service were reviewed, including policies, procedures, staff rotas and the service’s training matrix.

After the inspection

Following the inspection, we spoke with the service’s new manager and an additional member of staff by telephone. We also reviewed a variety of documents requested from the service during the site visit.

Updated 14 March 2020

About the service

Hillcrest is a residential care home providing personal care for one person with learning disabilities.

The service is a detached two-story property with enclosed gardens. It is located within walking distance of the town centre of Redruth, Cornwall.

The service was designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. The person received personalised support in an environment that had been adapted to their individual needs.

People’s experience of using this service and what we found

The person was comfortable, relaxed and at home in the service. Staff respected the person’s wishes and responded promptly to the person’s request for support or reassurance.

The service was short staffed. Staff had completed additional shifts to ensure the person’s safety at all times. However, low staffing levels had adversely impacted on the person’s ability to access the community, engage with activities they enjoyed and achieve recognised goals and ambitions. This meant the care provided was not constantly person’s centred and represented a breach of the requirements of the regulations.

This issue had been identified by the provider prior to the inspection and a recruitment campaign was underway and additional staff were in the process of being appointed. Records showed that recruitment practices were safe and that all necessary pre-employment checks had been completed.

Staff had understood local safeguarding procedures and there were safe systems in place to support the person with medicines and finances. Risks were managed appropriately, and staff had been provided with guidance on how to support the person if they became upset of anxious.

Following our previous inspection, the service had correctly identified that the person lacked capacity and was the subject of continuous monitoring and control. They had appropriately applied to the local authority for the authorisation of the person’s potentially restrictive care plan. When additional restrictions had been introduced as a result of changes in the person’s support needs this had also been reported.

Staff had the skills necessary to meet the person’s needs and their training was regularly updated. All staff new to the care sector were supported to complete the care certificate and the provider encouraged and supported staff to achieve diploma level qualifications.

The care plan was detailed and provided staff with enough guidance to enable them to meet the person’s support needs. This included details of routines that were important to the person and information about their specific communication needs and preferences.

At the time of our inspection there was no registered manager in place. The previous register manager had left the service in early 2019 and a new manager had only recently been appointed. Staff spoke positively of the new manager were confident they could make the changes necessary to improve the service performance.

There had been a number of significant changes at provider level since our last inspection. Solar Care had been taken over by The Regard Partnership who in turn had subsequently merged with another care provider to become Achieve Together. These changes meant staff and the new manager had access to additional managerial support when required.

The provider’s quality assurance systems were not entirely effective. They had recognised prior to the inspection that the service was short staffed but timely action had not been taken to prevent staffing issues from impacting on the person’s ability to access the community.

Rating at the last inspection

The last rating for this service was good. (Published 16 August 2017.)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.