Hilltop Lodge

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm. The provider was previously in breach of the legal regulation in relation to safe care and treatment and staffing. Improvement was found at this assessment, and the provider was no longer in breach of these regulations.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Records evidenced that staff knew how to report and record incidents. The service recorded actions taken to mitigate future risks, for example professional referrals, care plan reviews or by utilising assistive technology.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services . The service worked with professionals and other organisations such as hospitals, community care providers and social workers to complete assessments of people’s needs prior to admission. The service had systems in place to share important information about people should they need to move to another setting, for example hospital admission. People’s relatives told us the service provided them with information and opportunities to visit prior to the relative moving to the service. A relative told us, “We were given an information pack and a tour of the building.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. Staff understood their responsibilities to monitor for and report safeguarding concerns. A staff member told us, “I would tell my manager immediately if I saw anything of a safeguarding nature, or I would escalate further if needed, I know how to raise a safeguarding concern”. Staff had received training in safeguarding. People told us they felt safe at the service. A person told us, “I am safe and well looked after, it is a happy place.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Care plans were detailed and person centred, containing information to pre-empt and manage risks in line with people and their relatives wishes. For example, the service had recognised instances where people became upset at the end of visits from their relatives and had worked with the people and their families to implement strategies to reduce this, leading to more positive visits. Relatives told us they were involved in reviews of people’s care. A relative told us, “I am involved with the service so they can understand [my relatives] needs and history.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Maintenance records were up to date and equipment within the home was serviced as required. A recent fire safety audit had taken place, and plans were in place to meet recommendations within timescales.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. Staff were recruited safely with pre-employment checks taking place to ensure their suitability for the role, including police record checks. New staff took part in an induction which included support and ongoing monitoring of their skills. All staff undertook mandatory training, and staff told us they found this helped them in their role. A staff member told us, “I wanted to complete some additional specialised training, the manager organised this for me, the training was provided quickly.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Some areas of the home were malodorous. The service was part way through a schedule of refurbishment at the home which included new carpeting to address this. The service had sufficient stocks of personal protective equipment (PPE) throughout the home and staff knew how to use PPE appropriately.

Medicines were mainly managed safely however some improvements were required. During the inspection most medicine stock levels checked were correct, but some medicine administration record (MAR) charts had missing staff signatures. Handwritten MARs did not always have a double signature which meant they may not have been checked by two members of staff, this could lead to the wrong information being transcribed. ‘As and when required’ (PRN) medicines were not always documented on the reverse of the MAR chart when and why they were given. The care home had identified this in their audits and further training was to be put in place to improve on this. Some PRN protocols required additional person-centred detail. This was also picked up on the care home’s audits, and the provider was working to add more detail to these. Some people’s prescription creams were not applied as often as intended. Body maps were in place to show staff where to apply creams, but this was not always documented on the electronic system. The service acknowledged this, and further training was to be done to mitigate the risk of people not receiving their creams as prescribed.