The inspection visit at Hillcroft House Galgate took place on 05 January 2017 and was unannounced.

Hillcroft House is one of six homes in the Hillcroft group. It is located in the village of Galgate, south of Lancaster. The home has two floors and staff worked on both floors as part of their rota. It is registered to provide accommodation for persons who require nursing or personal care, diagnostic and screening procedures, and treatment of disease, disorder or injury.

The building is a large stone build house adapted and extended for use as a nursing home. Hillcroft House Galgate can support a maximum of 30 people. At the time of our inspection, 28 people were living at the home.

The service had 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.

At the last inspection on 08 August 2014, we found the provider was meeting the requirements of the regulations that were inspected. However, it was identified staffing levels on the first floor required improvement to keep people safe. Since our last inspection, staffing levels were reviewed and increased.

During this inspection, we found staffing levels were regularly reviewed to ensure people were safe. There was an appropriate skill mix of staff to ensure the needs of people who lived at the home were met.

Staff received training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

Staff had received abuse training and understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of vulnerable adults. Staff we spoke with told us they were aware of the safeguarding procedure.

The provider had ensured risks to individuals had been assessed and measures put in place to minimise such risks. A comprehensive plan was in place in case of emergencies which included detail about how each person should be supported in the event of an evacuation.

The provider had recruitment and selection procedures to minimise the risk of inappropriate employees working with vulnerable people. Checks had been completed prior to any staff commencing work at Hillcroft House. This was confirmed from discussions with staff.

Staff responsible for administering medicines were trained to ensure they were competent and had the required skills. There were appropriate arrangements for storing medicines safely.

People and their representatives told us they were involved in their care and had discussed and consented to their care. We found staff had an understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People who were able to speak with us told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.

We found people had access to healthcare professionals and their healthcare needs were met. We saw the management team had liaised with healthcare providers and responded promptly when people had experienced health problems.

We saw the registered manager had ensured end of life care was person centred and sensitively delivered. Relatives were welcomed and supported when they visited their loved ones.

A complaints procedure was available and people we spoke with said they knew how to complain. People and staff spoken with felt the registered manager was accessible, supportive and approachable.

Comments we received demonstrated people were satisfied with their care. The management and staff were clear about their roles and responsibilities. They

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014. 

This was an unannounced inspection carried out on the 5 August 2014.

Hillcroft House is one of six nursing homes within the Hillcroft group. It is located in the village of Galgate, south of Lancaster. The home is registered for 30 people and provided care and support for people with general nursing needs. The home has two floors and staff were flexible to work on both floors.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law, as does the provider.

The registered manager assessed staffing levels to ensure there were enough staff to meet the needs of people who lived at the home. Staff told us they were satisfied with the amount of personnel on the ground floor. However they felt not enough staff were deployed on the first floor at certain times of the day. We also received comments from relatives and people who lived at the home, telling us they felt staff were ‘always very busy’ on the first floor.

Suitable arrangements were in place to protect people from the risk of abuse. People who lived at the home told us they felt safe and secure. One person said, “Yes I feel safe here, especially at night when there are a lot of staff around checking on us.” Safeguards were in place for people who had been unable to make decisions about their care and support.

We found people were involved in decisions about their care and were supported to make choices as part of their daily life. Individual care records we looked at contained a detailed care plan which covered people’s support needs and personal wishes. We saw care plans had been reviewed and updated on a regular basis.

Staff spoken with were positive about their work and confirmed they were supported by the registered manager. Staff received regular training to make sure they had the skills and knowledge to meet people’s needs.

Staff had access to ongoing training to meet individual needs of people who required nursing care support. This ensured staff had the appropriate skills and knowledge to carry out their role effectively.

We checked that people's consent had been obtained and their wishes acted on, before they received care and treatment. We found that the provider ensured a good balance between minimising risk and respecting people’s wishes.

We checked a sample of care plans and daily notes. We found that actions noted in the care plans were followed through in daily records. We observed care in one of the lounge areas, and saw that staff were considerate and respectful. We heard people being offered choices.. We spoke with one visitor and two residents, all of whom spoke favourably about the home and the staff.

We looked at a sample of bed rooms and bathrooms, and found these to be clean. Staff demonstrated a good awareness of infection control. The home had appropriate equipment to ensure a hygienic environment. On the day we inspected, there were 23 residents and sufficient nursing and care staff to manage. However, numbers of residents were set to increase. Additional care staff had been appointed, and were due to start work as soon as they had completed mandatory induction training.

We checked that management oversight was in place to ensure quality standards were maintained. We found that the manager was hands on, and walked around the home on a regular basis. Additionally, formal audits were conducted by Hillcroft Limited. We saw that these systems were responsive to people’s needs and improvements were made as a result.

We spoke with four of the ten residents at Hillcroft House. They all told us that the care they received was excellent and that they were fully involved in discussions about how it was delivered. The staff and management at the home were praised for their helpfulness and for being easy to approach.

A few practical issues were raised with us by residents. These concerned the small size of the private ensuite facilities and a shortage of day to day activities. However the overall tone was very positive.

Care plans were comprehensive and useful. Medication was safely stored and dispensed safely.

As Hillcroft House opened less than a year ago, there was not yet a full complement of staff or residents. Good beginnings have been made to establish effective ways of working.

Hillcroft House benefitted from the range of quality assurance systems operating across the Hillcroft Nursing Homes group, complimented by the work undertaken by the manager. These provided an effective basis for ensuring that good practice will be maintained.