Background to this inspection
Updated
20 March 2018
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 is 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 30 and 31 January 2018 and it was unannounced. The inspection was carried out by one inspector and two experts-by-experience on day one of the inspection. The inspector completed the inspection alone on day two. 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-by-experience who assisted with this inspection had knowledge and experience relating to older people.
We looked at information we held about the service, which included notifications sent to us since the last inspection. Notifications are when providers send us information about certain changes, events or incidents that occur within the service. We also contacted North Yorkshire County Council (NYCC) safeguarding and commissioning teams. We used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at last once annually to give some key information about the service, what the service does well and improvements they plan to make. The information we gathered was used to plan this inspection.
During the inspection we met and spoke with a senior general manager, the registered manager, a registered nurse, one senior care staff, two care staff, the chef, the activities co-ordinator and a member of housekeeping staff. We also spoke with 16 people who used the service and four relatives. On both floors we observed care interactions between staff and people who used the service, and observed the lunch time period in the dining rooms. Most people could communicate with us, although some people had communication problems or dementia.
We looked at three people’s care records, including their initial assessments, care plans, reviews, risk assessments and Medication Administration Records (MARs).
We also looked at a selection of documentation created as part of the management and running of the service. This included quality assurance information, audits, stakeholder surveys, recruitment information for three members of staff, staff training and supervision records, risk assessments and accident/incident documentation, policies and procedures and records of maintenance carried out on equipment.
Updated
20 March 2018
This inspection took place on 30 and 31 January 2018 and was unannounced.
Highfield [the service] is a care home with nursing for 55 people over the age of 18 with a physical disability. Some people who use the service are living with dementia. There are two floors and people with nursing or residential needs lived on the ground floor and people living with dementia were on the upper floor. We found there were 25 people with nursing or residential needs and 14 people living with dementia in residence, at the time of this inspection.
People in care homes receive accommodation and personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
At the last inspection, the service was rated Good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
At this inspection we found the service remained Good.
People told us they felt safe and were well cared for. The provider followed robust recruitment checks, to employ suitable people. There were sufficient staff employed to assist people in a timely way. Medicine management practices were being reviewed by the registered manager and action was taken to ensure medicines were given safely and as prescribed by people’s GPs.
Staff had completed relevant training. We found that the nurses and care staff received regular supervision and yearly appraisals, to fulfil their roles effectively.
People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.
People were able to talk to health care professionals about their care and treatment. People could see a GP when they needed to and they received care and treatment when necessary from external health care professionals such as the district nursing team and speech and language therapists (SALT).
People had access to adequate food and drinks and we found that people were assessed for nutritional risk and were seen by the SALT team or a dietician when appropriate. People who spoke with us were satisfied with the quality of the meals.
People were treated with respect and dignity by the staff. People and relatives said staff were caring and they were happy with the care they received and had been included in planning and agreeing the care provided.
People had access to community facilities and the range of activities provided in the service ensured people could engage in stimulating and interesting social activities.
People and relatives knew how to make a complaint and those who spoke with us were happy with the way any issues they had raised had been dealt with.
People told us that the service was well managed and organised. People and staff were asked for their views and their suggestions were used to continuously improve the service.