Archived: Highfield House Nursing Home

At the last inspection, the service was rated good. At this inspection, we found the service remained overall good.

People were not always protected from the risks of harm associated with the use of mobility equipment. Risk assessments and modification to equipment was not personal to the individual neither did they take account of people’s individual needs.

People were safe from the potential harm of abuse or ill-treatment as staff knew how to recognise and respond to such concerns. People were supported by enough staff to meet their needs. People were assisted with their medicines safely.

The provider followed safe recruitment procedures when employing new staff members. Staff were well supported and undertook training relevant to those they assisted.

People were assisted by a staff team that knew them well. People had care and support plans that were personal to them and reflected their individual needs and preferences.

People had choice and control over their lives. Staff were aware of current guidance which directed their practice and people’s human rights were protected by the staff who supported them.

People received support from a staff team that continued to be caring and compassionate. People had their privacy and dignity respected by those supporting them. People were supported by staff members when they needed comfort and support.

People and their relatives were encouraged to raise any concerns or complaints. The provider had systems in place to address any issues raised with them.

The management team were approachable and supportive. People receiving services from Highfield House Nursing Home felt involved and their suggestions were valued by the provider.

Staff members felt respected as employees and their opinions and ideas were listened to by the provider. The provider had systems in place to monitor the quality of service and where necessary made changes to drive improvements.

Further information is in the detailed findings below.

We carried out this inspection to follow up on action taken by the provider to ensure people were receiving safe and appropriate care. As part of this inspection we spoke with a number of representatives of the local authority, the provider/manager and three staff. We also spoke with five of the people who lived at the home, and one of their visitors.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with the people who used the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that the people who lived at the home were at risk of receiving unsafe or inappropriate care and support. We could see that improvements had been made in certain aspects of the delivery of care since our last inspection and we saw some examples of good care practice. However we also found that management had not responded appropriately to allegations of abuse so vulnerable people had remained at risk of abuse or poor care.

The Mental Capacity Act 2005 sets down legal requirements that need to be followed to ensure decisions made about people who do not have capacity are made in their best interests. We found that the manager and staff routinely involved people in decision making and where appropriate mental capacity assessments were in place with best interest decisions recorded where people needed support with their decision making.

Is the service effective?

The home provided nursing care for 13 older people many of who presented with complex needs. All of the people spoken with during the inspection made positive comments about the staff, the standard of care and facilities and services. We saw that people were comfortable, relaxed and at ease, clean and well-presented.

Records showed that specialist dietary, mobility and equipment needs had been identified in care plans where required. People told us that they had been involved in writing their care plans, they were happy with them and considered them satisfactory to meet their needs.

Is the service caring?

The atmosphere in the home felt relaxed and sociable. We observed staff carrying out their duties and responsibilities with confidence and skill, in good humour and in a relaxed and positive manner. Those who were able to discuss arrangements made for their care told us that they were happy and content. One person said 'I love it here it's lovely, really nice. I feel safe here. Staff are very kind and I can talk to them. I did not want to go into a home because I had bad feelings about care homes but I really do like it here. Visitors are made very welcome. Food is lovely ' in fact it's exceptional with lots of choices on offer'.

Is the service responsive?

Since our last inspection the provider/manager had responded to concerns we raised and had taken action to improve the standard of care provided. Policies and procedures on responding to an emergency had been revised and the provider had identified staff training and development needs and staff training and a supervision programme was in place.

Quality assurance systems had been improved and the home sought the views of people who used the service, their relatives and friends and their health and social care professionals. The provider/ manager responded to concerns raised during our inspection regarding the inaccessibility of vital records and took action to ensure that these were made available on the second day of our inspection.

Is the service well led?

The home was not well led at the time of our inspection. We found that the provider/manager and deputy manager had not responded appropriately to allegations of abuse. The deputy manager told us that they were conversant with the local authority's safeguarding procedures but did not like to report safeguarding concerns because they perceived people would think wrongly of the home. This showed a marked lack of understanding regarding adult safeguarding procedures. This meant that vulnerable people were at risk of not being adequately safeguarded from abuse.

We carried out this inspection to follow up on action taken by the provider to ensure people were receiving safe and appropriate care. The inspection helped answer one of the five questions we ask:

Is the service safe?

During this inspection we spoke with the provider/manager and two staff members. We also spoke with four of the people who lived at the home to check if they felt safe and well cared for. People told us that they were very well looked after and if they did have any concerns they would speak with staff who "would sort anything out".

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

We found that the home had a relaxed welcoming and sociable atmosphere. Some of the people spoken with were able to discuss the arrangements made for their care and support. They made positive comments about the standard of care, facilities and services provided at the home. One of the people we spoke with said 'the home could not be better and I would like you to put that in your report'. Another person who was conversant with all aspects of their care said 'the home is excellent'.

We saw that the people who lived at the home enjoyed good relationships with the manager and staff. We observed staff providing responsive, sensitive and compassionate care.

We found that improvements were needed to protect people from inappropriate or unsafe care, in all four of the outcome areas we inspected including care and welfare, safeguarding people who use services from abuse, assessing and monitoring the quality of service provision, and record keeping.

We spoke with three people who lived in the home and they all told us they thought that the home was very good and were complimentary of the staff.

We saw that the building and gardens were well maintained and that appropriate security arrangements were in place.

We spoke to four members of staff who told us they liked working at the home and that the manager was supportive of them.

We saw that there were some gaps in the recording of training and an environmental check.