Hilton Park - Oaklands provides nursing and personal care for up to 54 people, some of whom are living with dementia. There are three units called Maple, Elm and Willow. Maple and Elm provide nursing care for people living with dementia. Willow provides nursing care for adults living with a range of conditions. All bedrooms have en-suite bathrooms and there are external and internal communal areas for people and their visitors to use.

At the last inspection, on 3 December 2014, the service was rated good. At this inspection we found the service remained good.

This unannounced inspection took place on 5 June 2017. There were 52 people living at the service at that time.

People were cared for by staff who provided care and treatment that ensured people's safety and welfare and took into account each person’s individual preferences. People were supported to manage their medicines safely. People were cared for by staff who had been recruited and employed only after appropriate checks had been completed.

Staff were sufficiently skilled, experienced and supported to enable them to meet people's needs effectively.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported to maintain a balanced diet and received suitable food and fluid. People were supported to access healthcare when they required it.

People received care and support from staff who were thoughtful and caring. Staff treated people with respect and dignity. Staff knew the people they supported well, and understood, and met, their individual preferences and care needs. People were involved in planning their care. Care plans provided staff with sufficient guidance to provide consistent care to each person.

People were encouraged to develop individual interests and hobbies. Staff supported people to maintain existing, relationships that were important to them.

The provider continued to have a robust complaints procedure in place. The service was well managed. There were effective systems in place to monitor the quality of the service people received. Staff looked for ways to improve their knowledge and the service offered to people.

Hilton Park - Oaklands is a home providing nursing and personal care for up to 54 people, some of whom are living with dementia. There are three units called Maple, Elm and Willow. All bedrooms have en-suite bathrooms and there are external and internal communal areas for people and their visitors to use.

The service had a registered manager in place. 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.

Our last inspection took place on 12 November 2013 we found the provider was meeting all the regulations we looked at.

This unannounced inspection took place on 3 December 2014.

Staff were only employed after the provider carried out satisfactory pre-employment checks. Staff were trained and well supported by their managers. There were sufficient staff to meet people’s assessed needs. Systems were in place to ensure people’s safety was effectively managed. Staff were aware of the procedures for reporting concerns and of how to protect people from harm.

People’s health, care and nutritional needs were effectively met. People were provided with a balanced diet and staff were aware of people’s dietary needs. People received their prescribed medicines appropriately and medicines were stored in a safe way.

The CQC monitors the operations of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) which applies to care services. We found people’s rights to make decisions about their care were respected. Where people did not have the mental capacity to make decisions, they had been supported in the decision making process. DoLS applications were in progress and had been submitted to the authorising body.

People received care and support from staff who were kind, friendly, caring and respectful. Staff respected people’s privacy and dignity. People and their relatives were encouraged express their views on the service provided.

People and relatives were encouraged to provide feedback on the service in various ways both formally and informally. People, and their relatives, were involved in their care assessments and reviews. Care records were detailed and provided staff with sufficient guidance to provide consistent care to each person that met their needs. Changes to people’s care was kept under review to ensure the change was effective. People were offered ‘event’ type activities, (such as entertainers) and group activities (such as bingo), but individualised activities that focused on people’s interests or hobbies were limited.

The registered manager managed one other service in addition to this one, Hilton Park Care Centre, which was a care home next door to this service. The registered manager was supported by senior staff, including qualified nurses, care workers and ancillary staff. People, relatives and staff told us the home was well run. People and their relatives told us that staff of all levels, including the registered manager, were approachable. People’s views were listened to and acted on.

Oaklands Care Centre has three units, two downstairs and one upstairs. The entrance was light and airy and had a drinks machine and biscuits available for people living in the home and their visitors and friends. We saw that some people sat with their relatives to chat (or sing in the case of one person). There were different areas for people to sit quietly in each of the units and all units were clean and free from bad odours.

All the relatives we spoke with said the staff did an excellent job and the care people received was very good. Two relatives commented that they felt there were not enough staff. One relative said: “I feel the staff have to complete a lot of paperwork at the expense of providing one to one care for people, and they often seem short of staff”. Another relative said: “The care is very good, but the staff are often under pressure and there is little one to one time”.

Two relatives commented that there were issues with the laundry and things went missing or other people’s clothing was put in their relative’s room and sometimes clothing had been damaged.

One person told us they felt there was no-one to speak on their behalf, although they did feel able to talk with one specific member of staff. We spoke with the manager who said an independent advocate would be requested as soon as possible.

During our inspection on 16 July 2012 we found that people living at Hilton Park – Oaklands had varied experiences in the way they were treated. In one unit, Maple Lane, we found that people were treated well. However, in Elm Avenue, another unit, we observed a number of occasions when people were not treated with dignity and respect. We also noted that people were not protected against the risks of malnutrition or dehydration. The provider sent us an action plan, informing us what they were doing so that they would be compliant with the regulations.

During this inspection on 7 February 2013, we used our Short Observation for Inspection (SOFI) tool to observe the way people on Elm Avenue were treated by staff during lunch time. We did not speak with people directly about the care and support they received.

We saw that a number of improvements had been made. People could choose where they ate their meal and with whom they shared a table. Each person was given greater choice about what they ate and drank. Staff treated people with respect, assisted people who needed their help and supported people wherever possible to be as independent as they could be. Records gave staff detailed guidance on each person’s needs related to meals and mealtimes, and enabled more accurate monitoring of how much food and fluid each person had taken.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a Care Quality Commission (CQC) inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service, and a practicing professional.

During our inspection of Hilton Park – Oaklands on 16 July 2012 we used a number of different methods to help us understand the experience of people living in the home. This was because some people were living with dementia, which meant that they were not able to tell us their experiences. For part of the inspection we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Hilton Park – Oaklands was divided into three distinct units, which met people’s different needs. The inspection team looked at the service offered to people in two of the units, Elm and Maple. We found that people had very different experiences depending on which unit they lived in. In Maple, people’s privacy and dignity were respected and their independence promoted. However, in Elm, there were a number of occasions when people were not treated with respect.

People in Maple were more able to talk with us. They said they were happy at this home. One person said, “I don’t worry too much and I feel quite safe here”. Another person told us, “I know all the people and I like them and I think they like me. I feel very safe here”.

Accommodation was provided throughout the home in single rooms with ensuite facilities and people could lock their bedroom door if they wanted to. People were able to express a preference about whether they wanted their personal care provided by male or female staff.

People we spoke with said the food was good. One person told us, “I like the food and if I don’t want my choice they will always change it for me”.

There were sufficient numbers of staff to ensure that people’s care was delivered as planned, however in Elm, staff were less well organised at lunchtime, which resulted in very slow service of the meal to people and the mealtime became chaotic. Most staff showed that they had the skills, knowledge and experience to provide appropriate care, however, one staff member in particular was less skilled at treating people with dignity and respect.

We did not speak to any people who use the service about the arrangements made for the handling of their medicines.