Archived: Highfield Care Home

Updated 19 February 2020

The inspection

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

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Highfield Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with 12 people who used the service and eight relatives about their experience of the care provided and a visiting health professional. We spoke with seven members of staff. In addition, we spoke with the Chef, the maintenance operative, the registered manager and the regional support manager. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at a variety of records relating to the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with the regional manager and the provider’s director of care.

Updated 19 February 2020

About the service

Highfield Care Home is a care home set across two floors and is registered to provide accommodation and personal care for up 54 older people some of whom are living with dementia. At the time of our inspection 36 people were living at Highfield Care Home.

People’s experience of using this service and what we found

People were not always protected from the risk of harm. When people sustained unexplained bruises or skin tears these were not investigated or reported to external safeguarding authorities.

Lessons following incidents, accidents or complaints were not learnt. Information was not shared with staff, so the service had not improved the care that staff provided to people.

There were not always enough staff effectively deployed to meet people’s needs in a timely way. Staff had not received training to understand the needs of the people they supported, and their competency and skills were not assessed.

Staff did not always follow guidance from health and social care professionals when supporting people at risk of choking or at risk of developing pressure ulcers. People’s dignity was not always promoted.

People who developed pressure ulcers or who’s health needs changed were not always referred to health care professionals in a timely way. Staff were not always responsive to people’s changing needs to ensure that the care and support they provided to people was personalised.

The registered manager had not investigated or responded to complaints raised. The governance systems in place were not used effectively to identify and improve the service.

The provider failed to ensure that people received a good quality service in a personalised and safe way. People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People’s medicines were managed safely. People had been provided with activities and opportunities to pursue their hobbies and interests.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update: The last rating for this service was requires improvement (published 23 November 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found that the provider was still in breach of regulations. This service has been rated requires improvement for the last four consecutive inspections.

Enforcement

We have identified breaches in relation to safe care and treatment, staffing, complaints, dignity and governance systems at this inspection.

For requirement actions of enforcement which we are able to publish at the time of the report being published:

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Special Measures:

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.