The inspection took place on 9 July 2018 and was unannounced. At the last inspection May 2016, we rated the home overall as ‘Good.’ At this inspection we found the provider continued to have an overall rating of ‘Good.’

Hillside is a care service and 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.

Hillside has a registered manager. 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.

Hillside is situated in Ilkeston. It is a purpose built bungalow, with a safe and secure garden. The property is close to shops and amenities which are utilised by the people living at the home. Each person has their own bedroom with communal bathroom facilities. There are shared spaces which include the lounge, a dining room and a kitchen. The service is registered for two people and at the time of our inspection two people were living in the service.

People were supported to achieve their aspirations in a range of ways which supported a person centred approach. Each person was supported to embrace life and encouraged to live as independently as they were able. The service had strong positive links with health care professionals who rated the service highly in the way people were supported. There was a positive relationship between people living at the service, with the local community shops and leisure opportunities.

People who used the service were at the heart of everything that the service did. Staff and management were always thinking of new ways to enable people to participate or to try new activities. All the professionals and relatives involved in people's care confirmed that the service could not be any better and how much the people had benefited from them living at Hillside.

Families and those important to people were involved in the planning of the care and had been encouraged to contribute to the way in which the person was supported. Care was person centred and tailored to each individual. People were supported to express themselves and private time was respected.

The service enabled positive outcomes for people. The provider was involved with the development of a national initiative to try and prevent the over medication of people with learning disabilities and / or autism and this ethos was firmly embedded within the service. People had benefited from this approach and the difference in their anxiety management had enabled them to participate in other activities and life choices which they had previously been unable to access.

There was a culture of positive risk taking, relatives and professionals told us people had thrived in this environment in having a fulfilling life but they were still supported to stay safe. This involved a range of ways to support people to protect them from harm and staff had received appropriate training.

Risks were managed and people were supported when they expressed themselves through behaviours which challenge. There was a dedicated team who supported people through the planned stages of support, which was monitored to enable the best approach to be taken on each occasion. There was enough staff to support people’s needs and there was flexibility to increase staffing when required.

The open approach of managers and staff enabled lessons to be learnt when things went wrong, or when reviewing a planned approach. The home was protected from the risk of infection. People had access to a hot tub and measures were in place to manage any potential infe

We inspected this service on 21 March 2016 and the inspection was unannounced. During our last inspection in April 2013 the provider was meeting the regulations we looked at.

The service provides personal care for up to two adults with a learning disability and associated conditions. There were two people living at Hillside Care Home on the day of our inspection.

There was a registered manager in post. 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 were protected from the risks of abuse because staff understood where harm may be caused and took action when people were at risk of harm. Checks were made to confirm staff were of good character and suitable to work in a care environment. There were sufficient staff available to support people.

Staff sought people’s consent before they provided care and recognised how people communicated to understand the choices they made. Where people’s liberty was restricted, this had been done lawfully to safeguard them.

Medicines were managed safely and people were supported to take their medicine as prescribed. Staff knew why people needed medicines and when these should be taken. People were helped to eat a nutritious diet which included food they enjoyed.

The delivery of care was tailored to meet people’s individual needs and preferences and they were supported to develop and maintain hobbies and interests. Staff considered different ways people could enjoy doing activities they liked. Staffing was organised flexibly to enable people to be involved with activities and do the things they enjoyed.

There were processes in place for people to raise any complaints and express their views and opinions about the service provided. People were treated with kindness, compassion and respect. People had developed good relationships with staff and were supported to maintain relationships with their families.

The provider and manager assessed and monitored the quality of care to ensure standards were met and maintained. They understood the requirements of their registration with us informed us of information that we needed to know.

We used a number of different methods to help us understand the experiences of people using the service, because the most of the people using the service had complex needs which meant they were not able to tell us their experiences. We spoke to the relative of one of the people living at the home who told us “the care is very good, they really know how to look after X”.

We found that the provider acted in accordance with legal requirements when considering people’s capacity to make decisions.

Relatives we spoke with told us “the food they eat is very good”. We found that people’s nutritional needs were met.

We saw evidence that the provider worked in partnership with healthcare providers and other organisations to ensure people health and welfare need were met.

We found people who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences.