Archived: Highgrove

Updated 22 July 2015

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

This inspection took place on 8 June 2015 and was unannounced. This meant the provider did not know we were going to carry out an inspection on the day. The inspection was carried out by two adult social care inspectors and two expert-by-experience’s (ExE’s). An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The experts had experience of older people and dementia care.

Prior to our inspection, we spoke with four stakeholders including the local authority, a district nurse, a pharmacist and a member of the Community Mental Health Team (CMHT). All stakeholders we spoke with who told us they had no current concerns about Highgrove. We also checked any previous notifications or concerns we had received about the service so that we could look into these during our inspection.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The provider returned their PIR.

During our inspection, we spoke with the regional manager, the home manager, 4 staff members, 9 people who lived at the home, fourteen relatives or visitors of people and 1 visiting professional, who was a Macmillan Nurse.

We looked at documents kept by the home including the care records of four people who lived at the home and the personnel records of five staff members. We also looked at records relating to the management and monitoring of the home.

Updated 22 July 2015

We carried out this inspection on 8 June 2015 and it was an unannounced inspection. This means the provider did not know we were going to carry out the inspection. The last full inspection at Highgrove was in May 2013. We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2008. A follow up inspection was carried out in August 2013 and we found the home was fully compliant with the regulations inspected at that time.

Highgrove is a care home registered to provide accommodation and nursing care for up to 67 people, who may have dementia care needs. The home was built in 2009, is purpose built and provides all single bedrooms with en-suite facilities. On the day of our inspection, there were 47 people living at the home.

It is a condition of registration with the Care Quality Commission that the home has a registered manager in place. 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. The home had a new manager in post on the day of our inspection, who had sent their application to CQC to become the ‘registered manager’.

People and their relatives told us they felt the service was safe, effective, caring, responsive and well led. Comments included; “I feel very safe here, thank you”, “[The service] always asks what I want to do and how I want to do it”, “The staff are brilliant, so patient and caring. They go the extra mile for you” and “I give feedback about [the home]. If I don’t like something, then I say. It’s no bother to [staff], they just sort it if they can.”

People were protected from abuse and the service followed adequate and effective safeguarding procedures. Care records were personalised and contained relevant information for staff to provide person-centred care and support.

There were issues with staff support, where some staff had not received supervisions for a number of years. We also found some staff were out of date with training in several areas, including safeguarding and infection control. The home manager and regional manager told us they had training and supervision plans in place to ensure all staff were up to date with supervisions, appraisals and training. We saw evidence that training had already been planned in some areas and the home manager told us what they were doing to source other, required training programmes.

We found good practice in relation to decision making processes at the service, in line with the Mental Capacity code of practice, the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

There were good, regular quality-monitoring systems carried out at the service. We saw that, where issues had been identified, the manager and regional manager had taken (or were taking) steps to address and resolve them.

During our inspection, we found one breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.