This was an unannounced inspection, which meant the staff and the provider did not know we would be visiting. One inspector carried out the inspection on the 8 August 2017.

Hillcrest provides accommodation, personal care and support for up to 4 people. There were four people living in the home at the time of the visit. People who live at the home have a learning disability. People had their own bedroom and shared the lounge and kitchen with the other occupants. The home was close to the shops and other amenities.

People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

There was a registered manager in post. The registered manager was also one of the owners of the business. 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The previous inspection was completed in July 2017. The service was rated as requires improvement. This was because staff were not taking part in a fire drill, hot water temperatures were not being checked at appropriate intervals and there had been no checks on the first aid box in line with the service’s policy. We also found that there were no individual risk assessments in relation to exposed radiators and window restrictors. The registered manager had failed to ensure appropriate applications in respect of people’s deprivation of liberty had been submitted. This was because the registered manager had submitted these to the local authority but had not ensured they had received these. The provider's quality assurance checks had not identified these shortfalls. At that time there were three breaches in regulation. The provider sent us an action plan shortly after the last inspection. These areas have now been addressed to ensure people’s safety. The service was rated as good at this inspection.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow the procedures. Systems were in place to ensure people were safe including risk management, and safe recruitment processes. People received their medicines safely. Sufficient staff supported people and this had been kept under review. The registered manager worked alongside the staff team to cover any shortfalls and agency staffing was never used.

People were involved in making decisions about their care. People had a care plan that clearly described how they wanted to be supported. People had opportunities to take part in activities in both the home and the local community. People were encouraged to be independent as they were able. Other health and social care professionals were involved in the care of the people living at Hillcrest.

People were treated in a dignified, caring manner, which demonstrated that their rights were protected. Where people lacked the capacity to make choices and decisions, staff ensured people’s rights were protected by involving relatives or other professionals in the decision making process. Information was accessible to help people make decisions and express their views about the service. Staff recognised the importance of effective communication enabling them to respond to people in a person-centred way, Appropriate applications had been made to

This was an unannounced inspection, which meant the staff and the provider did not know we would be visiting. One inspector carried out the inspection on the 8 August 2017. This was the first inspection since the provider changed to a limited company.

Hillcrest provides accommodation, personal care and support for up to 4 people. There were four people living in the home at the time of the visit. People who live at the home have a learning disability. People had their own bedroom and shared the lounge and kitchen with the other occupants. The home was close to the shops and other amenities.

There was a registered manager in post. The registered manager was also one of the owners of the business. 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People could not be confident that they were safe in the event of a fire. This was because staff had not taken part in regular fire drills. We also found that there were no individual risk assessments in relation to exposed radiators and window restrictors. Due to the complex needs of the people living at Hillcrest, this would be important to ensure their safety.

The provider had commissioned an external assessor to complete a health and safety audit of the home. They were in the process of devising an action plan to address the areas of concern, which included a faulty emergency light, the lack of checks on the hot water and first aid boxes.

The registered manager had failed to ensure appropriate applications in respect of people’s deprivation of liberty had been submitted. This was because the registered manager had submitted these to the local authority but had not ensured they had received these. The registered manager was unable to evidence the local authority had received these. We followed this up with the local authority who confirmed there was no record of these applications

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow the procedures. Systems were in place to ensure people were safe including risk management, and safe recruitment processes. People received their medicines safely. The monthly checks on the medicines required improvement so that there was a running total.

Systems were in place to ensure that complaints were responded to, with action taken to improve the service provided. People were involved in making decisions about their care. People had a care plan that clearly described how they wanted to be supported. People had opportunities to take part in activities in both the home and the local community. People were encouraged to be independent as they were able. Other health and social care professionals were involved in the care of the people living at Hillcrest.

Staff were knowledgeable about the people they were supporting. They were caring in their approach to people. Staff told us they were supported in their role and met with the registered manager regularly to discuss their performance and any training needs.

The registered manager regularly visited the service to speak with staff and people and to work alongside the team. They were knowledgeable about the people living at Hillcrest.

We found breaches of four Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of this report.