- Care home
Hilltop Court Nursing Home
We served a warning notice on Harbour Healthcare Ltd on 13 February 2025 for failing to meet the regulations related to the management and governance at Hilltop Court Nursing home.
Report from 6 November 2024 assessment
Contents
Ratings
Our view of the service
Hilltop Court Nursing Home is a residential care home providing personal and nursing care to up to 50 people. The service supports older people, some of whom live with dementia. This assessment was carried out 03/12/2024 to 07/01/2025.
The provider was previously in breach of regulations in relation to the management of risk and governance and oversight. At this assessment we found improvements had not been sustained with ongoing concerns about how risk was managed, and the effectiveness of systems for oversight of these concerns. New breaches of regulation regarding staffing and how people were treated with dignity and respect were found at this assessment.
People’s needs were not always met and action taken to mitigate risk was not effectively implemented. We were not assured suitable systems were in place to ensure lessons learned and best practice guidance was used to drive improvement. There was not always enough staff to meet people’s needs. Improvements were needed to make recruitment processes robust. Medicines were generally being safely managed.
There was limited oversight of people’s care and some professionals raised concerns about how advice was implemented into daily action. People were not consistently well treated by staff. Care plans contained lots of information but relevant information was not readily identifiable and was not consistently personalised. There was limited evidence of how people were supported to give feedback. There were limited opportunities to engage with local communities and a lack of stimulation for people.
Systems in place to drive the safety and quality of the service were not used effectively. Not all staff felt valued or able to raise concerns. Concerns identified at previous inspections had not been effectively addressed.
In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations have been concluded.
People's experience of this service
Feedback from people and their families was mixed. One relative commented, “I believe that Hilltop is run well and my [family member] seems happy there.” Another relative commented, “Some staff know my [family member] well and understand all their needs and wishes but I'm still having to remind staff of [other basic care needs].”
We observed that whilst some staff interacted with people with kindness and compassion, other staff did not respond to people, provide assurance or take action when needed. People were not being supported with access to good quality personal care and people appeared unkempt, had dirty hair and nails, dirty teeth and were unshaven.
People were not consistently responded to in a timely way and choice and independence was not always promoted. Feedback from families was that there were not enough staff on duty, particularly during the weekend. We observed there were limited opportunities for stimulation and interaction with people through meaningful activities. One family member commented, “I feel that if activities were encouraged the residents would not always be agitated.”
People did not always receive personalised care and there was limited evidence that people or families were involved in developing plans of care. One family member commented, “Staff have never asked about family preferences/wishes.”