Background to this inspection
Updated
25 July 2019
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 team included two inspectors and an Expert by Experience on the first day. One inspector visited on the second day. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Hillcroft Caton Green 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 had 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.
Notice of inspection
This inspection was unannounced on the first day.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
We spoke with two people who lived at Hillcroft Caton Green Nursing Home. Not everyone was able to speak with us. We used observations during our visit to assess people’s experience of the care provided. We spoke with four relatives and two visiting health professionals about their experience of the care provided. We spoke with the registered manager, deputy matron, the director, and three members of the Hillcroft Limited heads of department. We spoke with four carers, four nurses and the chef on duty.
We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at a variety of records relating to the management of the service and walked around the building to make sure it was a clean and safe environment for people to live in.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
25 July 2019
About the service
Hillcroft Caton Green is a residential care home providing personal and nursing care to 30 people aged 65 and over at the time of the inspection. The service can support up to 31 people.
People’s experience of using this service and what we found
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, documentation did not always show the provider was working within the principles of the Mental Capacity Act. We have made a recommendation about following good practice guidance related to the Mental Capacity Act.
Staff were caring, patient and took time to ensure people felt valued. They worked in partnership with people, offered choices and promoted people’s independence. However, sometimes the language used did not promote person-centred care. We have made a recommendation about the use of positive language within a care setting.
Medicines were managed safely, however, guidelines did not show how to administer variable dose, as and when medicines. All other risks people faced were assessed and safely managed. People and relatives felt the care and support kept people safe. Staff showed good knowledge of safeguarding procedures. Infection prevention was ongoing, and the home was clean and well maintained.
The provider had strong links with health professionals. This promoted timely support and positive outcomes for people. People had access to food and drinks, 24 hours a day if requested. Staff told us the training ensured they had the skills to carry out their roles effectively and the management team were supportive.
People took part in valued activities within the home and in the local community. People became more sociable and less reliant on medicines as they participated the activities on offer. The registered manager delivered end of life care to ensure people stayed in a familiar environment with people they knew. People’s communication needs were identified, and appropriate support offered. There was a complaints procedure which was made available to people and their families.
The management team had good oversight of relevant procedures through monitoring and auditing to ensure people received effective support and the service was well-led. The registered manager used a variety of methods to assess and monitor the quality of the service. They were aware of their regulatory responsibilities associated with their role.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 20 January 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.