Hillyfield Rest Home is a privately owned care home providing accommodation and personal care for up to 17 older people, some of who are living with dementia. People using the service are self-funding.

The inspection was unannounced and was carried out on 20 and 21 October 2016 by one inspector.

There was a registered manager in place at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

People told us they felt the home was safe. Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. They were personalised and provided sufficient information to allow staff to protect people whilst promoting their independence.

People were supported by staff who had received an induction into the home and appropriate training, professional development and supervision to enable them to meet people’s individual needs. There were enough staff to respond to and meet people’s needs.

There were suitable systems in place to ensure the safe storage and administration of medicines. Medicines were administered by staff who had received appropriate training and assessments. Healthcare professionals, such as chiropodists, opticians, GPs and dentists were involved in people’s care when necessary.

Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

Staff developed caring and positive relationships with people, were sensitive to their individual choices and treated them with dignity and respect. People were encouraged to maintain relationships that were important to them.

People were supported to have enough to eat and drink to meet their needs and were provided with choices of meals.

The service was responsive to people’s needs and staff listened to what people said. Staff were prompt to raise issues about people’s health and people were referred to health professionals when needed. People were confident they could raise concerns or complaints and that these would be dealt with.

People and, when appropriate, their families or other representatives were involved in discussions about their care planning. People were encouraged to provide feedback on the service provided both informally and through a satisfaction questionnaire.

The service was well led. Staff felt supported by the management to raise any issues or concerns. The quality of the care and treatment people experienced was monitored and action taken to promote people's safety and welfare. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.

During this visit we spoke with two of the people who used the service. We also spoke with the provider, the registered manager and three members of staff. Care and support was planned and delivered in a way that was intended to ensure people's safety and welfare. One person who used the service told us: “It’s very nice here and the people are really caring”. Another person said: “Everyone is kind and helpful”. People we spoke with told us they always had enough to eat and drink and were complimentary about the quality of the food. One person said: “I have no complaints about the food. It’s good food and I enjoy it”. The other person told us: “The food is good. There are no bad points”.

There were enough qualified, skilled and experienced staff to meet people’s needs. One person said: “I think there are enough staff here”. The other person told us: “I have never noticed a deficiency”. Staff we spoke with demonstrated that they were aware of people’s needs. Staff interacted with people using the service in an inclusive, friendly and caring manner. We saw that appropriate records were maintained and that suitable arrangements were in place for supporting people with medicines.

During this visit we spoke with three people who were using the service, two members of staff, one of the providers and the registered manager.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. People who lived in the home confirmed that staff supported them in ways that they were happy with. They told us that staff understood their needs and acted accordingly. One person said: “They know what I’m going to do before I do it”, and “If I want anything I’ve only to ask”.

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. Two people who use the service told us about the friendly atmosphere in the home and another person said: “I have never heard an angry word from the staff”.

People confirmed that they were supported by suitably skilled and experienced staff. One person described staff as: “Very patient and very caring”. Another person said: “I couldn’t see anything wrong with any of them”.

People we spoke with were not all aware of the formal written complaints procedure but confirmed that they were confident that the management would deal with any complaints appropriately. We observed that there was an open and inclusive atmosphere in the home.

People told us that members of staff always asked if they needed any help and they were never in a rush to do things for them. We spoke with five people who use the service and they told us that they found the home “nice” and “comfortable.” One person told us the home took care of his needs and treated him “kindly.” Another person told us: “I like being here. People are kind and nice to me.” One relative told us: “My mum is well settled here.”

During the visit we spent time completing a Short Observational Framework for

Inspection (SOFI). This was designed to record the experiences of people who would not be able to report them to us in a conversation or written survey. We used the SOFI because this service provided support to people with mild dementia. During the observation we saw examples of good staff interactions with people who use the service. For example, we saw one member of staff support a person from the lounge into the dining room. The member of staff consistently reassured the person and walked at their own pace. The member of staff demonstrated patience in her actions and kindness in her voice as she reassured the person using the service.