Hillcroft is located in a residential area of Ormskirk. The home is on three floors, with passenger lift access. Accommodation is provided in single rooms for up to 34 adults, who need assistance with personal care. There are some amenities, such as shops, a post office, a church and a pub within a short distance and Ormskirk town centre is easily accessible by car or public transport. Some parking spaces are available at the home, but on road parking is also permitted.The last inspection of this location was conducted on 19 January 2015. Although an overall rating of ‘Good’ was awarded at that time, we did find two breaches of the previous Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. These were in relation to the management of medicines and the recruitment of staff. We asked the provider to tell us what they were going to do in order to address the shortfalls identified. The provider submitted an action plan, as requested.
This inspection was conducted on 31January 2017 and it was unannounced, which meant that people did not know we were going to visit the home.
The registered manager was on duty at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated regulations about how the service is run.
At our last inspection on19 January 2015 we found that the registered person had not implemented robust procedures for the safe keeping of medicines. Therefore, this area was in need of improvement. We made a requirement about this. The provider sent us their action plan, which showed that actions would be completed by 20 March 2015.
During the course of this inspection we assessed the management of medicines. We found that on this occasion improvements had been made in this area, which helped to protect people from any risks associated with the unsafe use of medicines. Therefore, the previous breach of the Health and Social Care Act regulations had been met.
At our last inspection on 19 January 2015, we found that recruitment practices were not always sufficiently robust, in order to ensure that people employed were fit to work with this vulnerable client group. Therefore, this area was in need of improvement. We made a requirement about this. The provider sent us their action plan, which showed that actions would be completed by 20 March 2015.
At this inspection we looked at the personnel records of four staff members, who had been recruited since our last inspection on 19 January 2015. We found that on this occasion new staff had been appropriately appointed and therefore people who lived at Hillcroft were protected by the recruitment practices adopted by the home. Therefore, the previous breach of the Health and Social Care Act regulations had been met.
We found that a varied training programme had been provided for the staff team, which helped them to keep abreast of current practices and any changes in legislation. Regular supervision sessions for staff and annual appraisals were also being conducted.
At this inspection we found the environment to be warm and well maintained throughout. However, we did note an unpleasant smell in one area of the home. We observed staff members interacting well with those who lived at Hillcroft. People looked happy and comfortable in the presence of staff and were enjoying their company.
Records showed that although a wide range of risk assessments were established at the home, in relation to people’s health, safety and welfare, these had not always been fully completed and did not always accurately reflect people’s needs. Staff we spoke with were able to discuss people's needs well and it was quite clear that they were able to provide the care and support each person required in a kind and caring manner. However, people's plans of care were not always reflective of their current needs. The recording of information could have been better in some areas and documentation could have been more accurate. We made a recommendation about this.
Fire procedures were easily available, so that people were aware of action they needed to take in the event of a fire and records we saw provided good information about how people needed to be assisted from the building, should the need arise. Records showed that equipment and systems within the home had been serviced in accordance with the manufacturer’s recommendations. This helped to protect people from harm.
People's privacy and dignity was consistently respected. Records showed that Mental Capacity Assessments had not always been conducted, in order to determine capacity levels, prior to important specific decisions being made. We made a recommendation about this.
The service had reported safeguarding concerns to the relevant authorities and suitable arrangements were in place to ensure that staff were deployed, who had the necessary skills and knowledge to meet people's needs safely. A range of health and safety training was provided for the staff team.
People we spoke with were aware of how to raise concerns, should they need to do so. A complaints procedure was in place at the home and a system had been implemented for the recording of complaints received.
The service worked well with a range of community professionals. This helped to ensure that people's health care needs were being appropriately met. Meals were being well managed.
People we spoke with were complementary about the staff team. They felt that they were treated in a kind, caring and respectful manner. People expressed their satisfaction about the home and the services provided.
Regular meetings were held for the staff team. This enabled those who worked at the home to discuss topics of interest in an open forum.