About the service

Hilton Community Services Ltd provides personal care and support to adults with learning and physical disabilities in their own supported living schemes across a variety of locations. Each home is purpose built, and leased by the people who use the service. However, Hilton Community Services Ltd provides 24-hour care to people based within each of these homes. For this report when we refer to people living in their own homes; these are shared schemes that accommodate a small number of people across the Essex, Suffolk and Norfolk areas. At the time of our inspection, the service was providing care and support to 72 people.

People’s experience of using this service

People told us that they were very happy living at the schemes because they felt safe and all their needs were met by kind and caring staff. Relatives were pleased with the service provided to their family members and staff enjoyed working at the service.

Relatives praised the managers of the service and agreed that they were approachable, knowledgeable, fair and did their job well. The staff team worked well together and supported the registered manager. The provider employed enough staff to make sure people’s need were met in a timely way.

The staff team was committed to providing a high-quality service and keeping people safe. They had undertaken training so that they were skilled and knowledgeable to effectively meet people’s needs. Staff understood their responsibilities to report any concerns.

Staff encouraged people to be as independent as possible and respected people’s privacy and dignity. Staff knew people well. Staff managed the risks to people’s health and welfare.

People were given choices about the way in which they were cared for. Staff listened to them and knew their needs well. Care plans contained detailed information about each person’s individual support needs and preferences in relation to their care and we found evidence of good outcomes for people. When people did not have the capacity to make their own decisions, staff maximised their involvement and made decisions in their best interests, in accordance with legislation.

Staffing levels were sufficient to meet people’s needs. Recruitment practices were safe and relevant checks had been completed before staff worked at the home. People’s medicines were managed appropriately so they received them safely.

People continued to receive a service that was responsive to their individual needs and preferences. Most people had complex needs and staff involved other professionals, to ensure they gained a full understanding of the factors influencing each person and further developed an individualised approach to their care. They had access to a range of activities and were encouraged to participate in events in the local community.

The managers of the service actively sought the views of people and their relatives about the running of the schemes and they dealt promptly with any concerns that people raised.

The provider had a number of systems in place to monitor and improve the quality and safety of the service provided.

More information is in the full report.

Rating at last inspection

At the last inspection we rated this service Good. The report was published on13 September 2016.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor this service.

We carried out this inspection on 23 and 31 March and 05 and 12 April 2016. We also spoke to professionals on 15 and 20 April 2016 for their feedback about the service. We gave the provider 48 hour notice before we inspected to ensure that people were home when we visited and that staff would be available to talk to us. When we last inspected the service 13 February 2014 we found them to be meeting the standards. At this inspection we found that they had continued to meet the required standards.

Hilton Community Services Ltd provides personal care and support to adults with learning and physical disabilities in their own supported living schemes across a variety of locations. Each home is purpose built, and leased by the people who use the service. However, Hilton Community Services Ltd provides 24 hour care to people based within each of these homes. For the purpose of this report when we refer to people living in their own homes; these are shared schemes that accommodate a small number of people across Essex, Suffolk and Norfolk area.

At the time of the inspection there was a registered manager in post. A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.

People told us they felt safe using the services provided by Hilton Community Services Limited. Staff were aware of how to keep people safe and risks to people's safety and well-being were identified and effectively managed. Where people's needs changed staff ensured these were responded to and met in a safe manner. There were sufficient numbers of staff deployed to support people, and the home was calm and relaxed throughout our inspection. There were suitable arrangements for the safe storage and administration of people's medicines, and these were regularly reviewed.

People were asked for their permission before staff assisted them with care or support. Staff had the skills and knowledge necessary to provide people with safe and effective care and demonstrated this throughout the inspection. Staff received regular support from management which helped them feel supported and valued.

People received appropriate support and encouragement to eat and drink sufficient quantities and people's nutritional needs were assessed and monitored effectively. People had access to a range of healthcare professionals when they needed them and feedback from health care professionals was positive and supportive of the care provided.

People's privacy and dignity was promoted. People told us they were treated with kindness and compassion by staff that listened to them and who knew them very well.

People and staff told us the positive culture within the service was set by the provider and shared by all staff when providing care. Regular audits and checks of the quality of care provided were carried out, and managers met regularly to review any outstanding areas identified as in need of improvement. Arrangements were in place to obtain feedback from people who used the service, their relatives, and staff members about the quality of care services provided. People's care records were maintained accurately and depicted each person’s unique needs comprehensively.

Hilton Community Services Limited provided care and support to adults with learning disabilities, or physical disability and complex care needs, who lived in their own homes. People often shared accommodation with three or four other people who were also supported by the organisation. The accommodation was owned by housing associations and local authorities.

Relatives told us that they were invited to regular care plan reviews to ensure that any changes to people’s care regimes continued to meet their individual wishes and preferences. One relative said "I cannot fault them in any way with the care, they are always up front with us about anything that is going on. They constantly keep me in touch with [my relative’s] health needs and I honestly do not know what we would do without the care they receive.” Another person told us, “They are extremely well looked after, I take my hat off to them, they do a marvellous job, long may it continue.”

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People who used the service received support from a staff team that were suitably skilled and qualified. A relative we spoke with said, “The staff training seems to be constant. There are always at least two staff available to provide [relative’s name] care and support .”

People received a service from an organisation that sought to improve the quality of the service they provided.

On our visit on 13 February 2013, we looked at records maintained by the company, and following this visit we spoke with care staff and relatives by telephone to seek their views on the service.

We found that relatives were very happy with the service their family member received. One told us "I was worried about the move into the community but it has been really good." Another, referring to their relative said "They are so busy I almost have to make an appointment. They have very full lives."

We were told that people were encouraged to take part in planning their care and support with the use of pictures to aid their understanding. Care plans were developed to meet people's individual needs and life goals. Relatives told us they were involved in decisions about people's care where they were unable to make these themselves.

We found that staff received support and training to carry out their role and were able to demonstrate to us their understanding of safeguarding people form any potential abuse. The process used by the company to recruit staff was robust and people were protected.

The provider had put in place systems to assess the quality of the care it provided, such as questionnaires and internal audits to address care and health and safety. They had a system in place for people to make complaints and one relative told us "I would soon tell them if things weren't right. I have no complaints; if I had I would go straight to the managers."