Hillcrest House

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives we spoke with said they thought the staff were kind. One relative said, “Staff are very lovely, they respect [person] privacy”. Another said, “To most part staff are kind but seems a lot of change of staff in the last three years.” Staff interacted with people with kindness, however, interaction tended to be task focussed. Where people had been assigned one to one support at times we saw staff standing observing the person with no meaningful interaction with the person. People had their own rooms and we observed staff knocking on bedroom doors before they entered the room. One relative told us they always heard staff knocking on their loved-one’s door when they have telephoned and asked to speak with them. However, there had been no assessments undertaken in relation to people’s needs and preferences around door locks for privacy and security of their property. We saw not all people had door locks and when this was raised with the registered manager their immediate response was to arrange for maintenance to fit locks without undertaking any assessments of people’s needs and preference. One person had a room on the ground floor, which was in the main thoroughfare of the house, their bedroom door was constantly left open, managers and staff did not appreciate this impacted on the person’s right to privacy and security of their property.

Families commented staff knew their relative, some better than others. One relative said, “Staff know him well, they are good at communicating with him and he likes the staff.” Staff spoke about people as individuals and could tell us about each person, their likes and preferences. However, we saw that each person had a box containing personal items kept in the office, when we asked what these were for we were told a couple of people had them to keep items such as cigarettes safe and the other’s had them because everyone else had them. There was no evidence in people’s individual care records of any rationale why these were needed and it appeared more service led than individually needs led.

Feedback from families indicated people were encouraged to be independent were possible. One relative said, “Staff encourage independence with personal care and dressing.” However, they did not feel people were accessing a full range of activities as they had previously. One relative said, “They’re not doing enough, they use to do something every day, even got on a bus to town, went to discos and yoga.” People did not have any planned activity in place and were reliant on staff to go out with them, so had limited control as to when that happened. The registered manager told us they decided to stop activity timetables to enable flexibility, as a general approach, however, this was not based on assessments of people’s individual needs. We saw new engagement plans were being implemented and staff encouraged to support people to look at what activities they wished to do. The provider had not always assessed the impact of people’s distress on everyone in the home. Due to one person’s behaviour when they became distressed people were not able to freely move around the house as staff were protective of them and wanted to ensure their safety. This meant people could not always access areas of the home when they wanted to.

Relatives said they thought staff would respond to people if they became distressed or unwell. We saw staff respond quicky to a person who became distressed. However, staff told us they did not always feel equipped to deal with some people’s distress. We saw that people’s care records did contain positive behaviour support plans but that these had not always been updated after incidents where people had become distressed. There was a lack of clarity about the role of staff and how they would support a person to prevent their distress or respond in a crisis.

The feedback we received from staff was mixed. Some staff felt well supported and able to speak up and seek the support they needed. One said, “I feel the support is good and I can ask questions.” However, others said they did not feel they were always listened to and any action taken with regards to any issues or concerns they had raised. Staff meetings were held, although we observed a staff meeting taking place with staff still expected to provide support to one of the people living at Hillcrest House throughout the meeting. The registered manager had not considered the impact this had on the staff being able to listen and speak freely nor on confidentiality. There were policies to support staff wellbeing.