Archived: Highfield Care Home

Updated 30 September 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

The inspection took place on the 1 August 2016 and was unannounced. The inspection was undertaken by an inspector 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. Our expert had experience of older people care.

Before the inspection we looked at information already held about the service including previous inspections and notifications which are important events the service is required to tell us about. We carried out observations of care, looked at records, we spoke with seven people using the service, 12 staff, including domestic staff, maintenance, activity staff, care staff, senior staff, and catering staff two visitors and we looked at two care plans. We looked at other records relating to the management of the business

Updated 30 September 2016

The inspection took place on the 1 August 2016.and was unannounced. It was last inspected on the 23 October 2015. It was rated as inadequate overall and inadequate in safe and well led. There were two breaches of regulation 12: Safe care and treatment and regulation 11, Need for consent. . Following this inspection the Local Authority placed an embargo on the service which meant they would not place any funded clients in the service. The service is registered for 40 people but at the time of our inspection there were 29 people using the service. Following the last inspection in October 2015 the manager provided CQC with a detailed action plan which stated what actions they were taking to comply with regulations.

There is 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.

We found there were enough staff to meet people’s needs and we observed staff providing timely, respectful care. Staff were familiar with people’s needs and provided personalised care around their individual needs.

We did not identify any hazards to people’s safety other than when people were mobilising and had the potential to fall. Staff did not stifle people’s independence but put things in place to reduce their risk of falls. We also found inadequate storage of large items of equipment which could potentially be a hazard.

We have made a recommendation about the management of risk.

Staff had a good understanding of safeguarding and what actions they should take if they suspected a person to be at risk of harm of abuse.

Staff recruitment was sufficiently robust to try and ensure only suitable staff were employed to work in care.

People received their medicines as prescribed and medicines were administered by staff who were trained to give them.

Staff induction and training could be improved upon to clearly show staff had achieved the necessary competencies.

Staff had a good understanding of legislation relating to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberties Safeguards (DoLS). The MCA ensures that, where people have been assessed as lacking capacity to make decisions for themselves, decisions are made in their best interests according to a structured process. DoLS ensure that people are not unlawfully deprived of their liberty and where restrictions are required to protect people and keep them safe, this is done in line with legislation.

People were supported to eat and drink and this was closely monitored to ensure it was adequate to people’s needs.

People’s health care needs were met by the staff and other health care professionals where appropriate. We observed care being provided which was appropriate to people’s needs, respectful and dignified. Staff supported people in a way they wanted to be supported and in consultation, gaining their consent before providing care.

Care plans were in place for people and demonstrated how they should receive their care in accordance with their needs and wishes. These were kept under regular review to ensure they accurately reflected people’s needs. Social activities were organised around people’s individual needs and helped to alleviate social isolation. However not everyone was seen to participate and it was clear that there was insufficient engagement for some people.

There was a robust complaints procedure and staff involved and consulted with people.

This was a well led service. Staff felt the manager listened and was responsive. They were adequately supported by a deputy and senior team of staff. Audits were in place to assess and monitor the standards of care and support provided to people using the service and to help identify and reduce risks. There were regular audits for record keeping, care and safety and maintenance of equipment. Action plans showed how the service resolved any service deficiencies.

It was clear there were a lot of changes occurring to improve the overall service delivery but we felt in order for these changes to be managed effectively staff needed to be adequately supported. The number of audits potentially could overwhelm the service.

The manager had good systems in place to assess people’s needs and ensure they were being met. However the organisation did not have an effective dependency tool to help demonstrate and ensure that staffing levels at the service were adequate for the needs of people using the service. We also felt that there had not been sufficient consideration of how many activity hours should be in place to ensure people received sufficient social stimulation. We have made a recommendation about this.

Quality audits were completed through head office, surveys were sent to people annually and results collated and sent to the managers. However we saw low response rates and felt this was not an effective means of engaging with the majority of people using the service many of whom had dementia. Across the whole service we saw poor evidence of active engagement with relatives and with the local community