During our inspection we looked at the way people were cared for and supported, nutrition, staff recruitment, the safety and suitability of equipment and quality monitoring systems. We spoke individually with a number of people living at the home, six relatives, and members of the staff team. Care practices were also observed throughout the inspection.
This helped to answer our five questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?
Below is a summary of what we found.
Is the service safe?
We saw that people were treated with respect and dignity by the staff team. People told us they felt the home was safe and secure. People were cared for in an environment that was safe, clean and hygienic. Equipment in the home had been well maintained and serviced.
The senior management team were reviewing policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DOLS). This was in response to recent national events and was being reviewed in conjunction with supervisory bodies in Lancashire and Cumbria, who were the home's major commissioners. Reviewing this policy would strengthen the processes in place to protect people living at the home and ensure that practices were up to date.
Recruitment practices were safe and thorough. Policies and procedures were in place to make sure that unsafe practices were identified and that people were protected.
A monthly medication audit was in place. This helped to ensure medication practices remained safe, by ensuring any shortfall was quickly identified and addressed.
Is the service effective?
People told us they were pleased with the level of care being provided to them and to their relatives. We saw there was a good understanding of each person's assessed needs and personal preferences were accommodated. One person told us, 'My mother's been much better since she moved here. She used to sleep all day'. Another said 'We have seen a massive difference, she is much more alert'.
People's health and care needs had been assessed with professional help and in consultation with relatives. Most people were unable to participate in writing their plans of care because of their conditions. Specialist assessments of nutrition, behaviour, dietary, mobility and equipment needs had been identified in care plans as required.
The relatives we spoke with also said they had good communication with the staff team and were always informed of any changes or concerns. One said 'If I went and asked them for a boiled egg for my Mum right now, I know they would get one. They are always helpful and kind'.
Is the service caring?
We saw people were supported by kind and sensitive staff. Staff were attentive to people's needs and showed patience and encouragement when supporting them. We saw that staff were engaged in a number of activities with residents in addition to offering personal care. These included reading a memory book, looking at a newspaper and taking someone for a short walk outside. A pamper session with hand massage was planned on the challenging behaviour unit on the day we inspected. We knew this because the day's activities and menus were prominently displayed on a large white board.
People's preferences, interests and individual needs had been recorded along with the actions required to ensure these were met. This helped to make sure people were provided with an individualised service that met their specific requirements.
Is the service responsive?
Visitors we met told us they felt listened to and staff were attentive to the needs and wishes of residents. We saw that breakfasts were available at times residents wanted to eat, and they included a wide choice from full English fry ups to toast or porridge. We saw staff were encouraging people to eat, and giving them time to do so.
We saw residents were engaged in a range of activities. Individual preferences were recorded and used by the activities co-ordinator to tailor their likes and dislikes into daily activities.
The home had a complaints procedure in place. Visitors we spoke with knew how to make a complaint if they were unhappy. However they all said that the management was approachable and someone was always there if there were any concerns or questions.
Is the service well-led?
Hillcroft North Road is one of six homes managed by Hillcroft Limited. The provider conducts regular audits of all its homes on a planned basis. These quality assurance systems helped to ensure the quality of the service was continually monitored.
Staff at Hillcroft North Road were clear about their roles and responsibility and said they were well supported by colleagues and the management team.
We saw internal audits had picked up a slippage in supervisions earlier in the year, and that this had been rectified as a result. Staff confirmed good supervision arrangements were in place.
A range of routine audits were in place including medication, accidents, health and safety, risk assessments and fire safety. We saw that any issues identified during these audits were addressed. This helped to ensure a consistent service was maintained that helped to protect people and keep them safe.