This inspection site visit took place on 30 January 2018 and was unannounced.

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

Hillside accommodates a maximum of 20 older people in one adapted building. There were 15 people living at Hillside at the time of our inspection. Care and support is provided to people with dementia, learning disabilities and personal care needs. Bedrooms, bathrooms and toilets are situated over two floors. People have use of communal areas including a lounge, dining room and garden areas.

.

At the last inspection, in October 2015 the service was rated Good.

At this inspection we found the service remained Good.

People were supported to stay as safe as possible by staff who understood what actions to take to reduce risks to their well-being. This included risks to people’s physical health and mental well-being. People, their relatives and staff were confident if they had any concerns for people’s safety the registered manager would react to support them. There was enough staff employed to meet people’s care needs.

People were supported by staff that had been trained to administer their medicines safely. Staff knew how to use safe infection control practices to help people avoid infections. Checks on the environment were undertaken and systems for identifying if there was any learning after safety incidents were in place

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People and where appropriate relatives had been consulted regarding people’s care and support needs. Staff had received training so they had the skills to be able to deliver individuals care requirements.

People were supported to choose what they wanted to eat and to obtain care from other health and social care professionals, so they would maintain their physical and mental wellbeing.

People had formed caring relationships with the staff that supported them. Staff recognised the importance of helping people maintain their independence, privacy and dignity.

People’s care had been planned by taking their individual wishes, histories and needs into account. People’s care plans incorporated advice provided by other health and social care professionals to help people stay as independent as possible.

People told us they liked living at the home and found the home was well managed. The registered manager listened to the views of people, their relatives and staff when developing people’s care and the home further. The registered manager and provider conducted regular quality audits to identify any shortfalls and rectify them promptly.

The inspection took place on 13 October 2015 and was unannounced.

Hillside is a residential home for people with complex health needs and is registered to provide accommodation for up to 20 older people who need personal care. There were 18 people living at Hillside at the time of our inspection. Care and support is provided to people with dementia, learning disabilities and personal care needs. Bedrooms, bathrooms and toilets are situated over two floors. All but one of the bedrooms has their own en-suites. People have use of communal areas including a lounge, conservatory, dining room and garden areas.

A registered manager was in post 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff were caring and respectful towards people and considered people’s individual communication needs when they chatted to them. Staff were knowledgeable about people’s health and well-being needs and how to meet those needs. This included caring for people so they did not become anxious.

People and their relatives told us staff treated people well and they felt safe. Staff knew how to identify harm and abuse and how to act to protect people from the risk of harm which included unsafe staff practices. People’s medicines were stored securely and available at times when they needed these. Staff had the knowledge to support people with taking their medicines and checks were in place so people could be assured of receiving their medicines as prescribed.

Relatives and staff told us there were sufficient staff on duty who knew how to meet their needs and keep people as safe as possible. We saw on the day of our inspection there were enough staff to deliver care in a safe way and allow time for staff to chat to people. Staff had received the training they needed to fulfil their roles and felt supported by the registered manager.

Staff respected people’s rights to make their own decisions and choices about their care and treatment. People’s permission was sought by staff before they helped them with anything. When people did not have the capacity to make their own specific decisions these were made in their best interests by people who knew them well.

People’s care and support needs were met by staff in the least restrictive way. The registered manager had recognised there may be times when people’s liberty may need to be restricted in order to keep them safe and well. The registered manager had made applications to the supervisory body where this was needed. These actions made sure people’s liberty was not being unlawfully restricted.

Relatives told us people were supported to access health care, mental health teams and social care services to maintain and promote their health and well-being. This included when people needed support to meet their mental health, hydration and dietary needs so people remained healthy and well.

Staff offered people the opportunity to have fun and interesting things to do. People’s right to private space and time to be alone with their relatives and friends was accepted and respected.

Relatives knew how to make a complaint or raise any concerns. Relatives told us they felt able to speak with the staff or the registered manager about any issues they wanted to raise. People and their relatives were encouraged to give their views and experiences of the home through regular surveys and discussions with staff.

There was evidence the leadership had begun to enhance the quality of life of people who lived at the home. This included improvements to the décor of the home to make it more stimulating and interesting for people. We saw people and their relatives had been involved in decisions about how their rooms were decorated.

Relatives felt the management team were approachable and the environment was friendly and welcoming. Staff understood their roles and responsibilities and told us they were supported by the management team.

People benefited from living in a home where quality checks were completed to monitor and further develop the quality of the service. The checks were completed by the registered manager and the provider. The leadership team were open and responsive to making further improvements so that people consistently received good standards of care and treatment.

We talked with three people who used the service. We also spoke with the registered manager, deputy manager, a cook and three members of staff who provided care to people.

The people who used the service told us that they were happy with the home and the staff. One person told us: “I like my room, it’s really nice”. Another person we spoke with said: “I love it here and the staff are really nice”.

We found consent had been obtained from people before care and treatment had been provided. We spoke with one person who told us: “I can do what I want. I have a choice”. Staff we spoke with told us they respected people’s individual choices and decisions.

We found staff knew about the needs of the people they were caring for. We looked at care plans for two people and found that these contained guidance for staff on how to meet their needs. We saw that people’s needs were reviewed regularly.

People told us that they felt safe living at the home and knew who to speak to if they had any concerns. Staff had been trained how to recognise signs of abuse and knew how to report concerns.

We saw that sufficient numbers of appropriately skilled and qualified staff were employed to meet people’s needs.

During this inspection we spoke with one person who used the service, one relative and with three staff. We also spoke with the registered manager. We were unable to speak with all of the people who used the service due to their level of complex health needs. Therefore we looked at some people’s care plans which provided information on the needs of each person, written from their perspective. We also looked at how staff cared for the people who used the service.

We saw that people appeared relaxed and comfortable. They were being cared for in a way that they preferred. One relative said that, "The quality of care is very good”.

We found that medicines were being appropriately stored and administered. This meant people who used the service received their medicines as prescribed to meet their health needs.

Staff employed at the service had access to further training and told us that they felt supported by their peers and the registered manager. This enabled them to offer effective care and support to the people who used the service

The provider was able to monitor the quality of the service provided as regular audits and regular contact with families was maintained.