High View

Updated 9 September 2023

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 Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors.

Service and service type

High View is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection, there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service’s performance since its registration. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We met and spoke with all 4 of the people living at High View. We also spoke with 8 members of staff, the registered manager and the provider’s Improvement and quality lead. We reviewed 3 people’s care plans, as well as medicine records, daily care records, incident reports, staffing rotas and staff recruitment and training records. The provider was asked share various documents relating to the management of the service and this information was reviewed following the site visit. In addition, we spoke 3 people’s relatives and requested feedback from 2 health and social care professionals.

Updated 9 September 2023

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

About the service

High View is a residential care home providing personal care for up to 5 people with a learning disability or autistic people. The service is located on the outskirts of Truro, and people were able to walk into town from the service. The service was supporting 4 people at the time of the inspection.

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

Right Support:

Staff had not received the necessary training in positive behaviour management and did not have the skills to ensure people’s safety when they were upset or distressed. This had exposed people to the risk of harm.

The service employed less than 50% of the staff necessary to meet people’s needs and agency staff often covered shifts to ensure people’s safety. The Provider booked agency staff well in advance in an attempt to ensure consistency. However, we found one agency staff member was working excessive hours and the high level of agency staffing had impacted on the quality of support people received. The provider recognised the adverse impact of the service current dependency on agency staff and was actively recruiting.

Managers and staff understood their roles in protecting people from abuse and all forms of discrimination. Staff had been safely recruited.

Medicines were managed safely, and staff understood and followed current infection control guidance.

People were supported to access medical appointments and regular heath checks. Advice from health professionals was acted upon.

Staff involved people in planning and decision making and respected people’s choices. People were supported to gain new skills, to do things for themselves and to be as independent as possible.

Right Care:

People’s capacity to make specific decisions had been appropriately assessed and staff had supported people to make meaningful decisions. Where people lack capacity to make a specific decision the service had consistently acted in the persons’ best interests. Necessary applications had been made to the local authority where people lacked capacity and their freedom was restricted.

People and staff were able to communicate effectively together, and tools were used appropriately to aid communication and enable people to make choices.

Staff were caring and enjoyed spending time with people. The atmosphere in the service was relaxed, and people interacted with staff well. Staff had received most necessary training from the provider and felt well supported.

Relatives recognised, and records showed, that people were supported to engage in a wide variety of activities and to access the community regularly.

People were supported to maintain links with friends and family and visiting was encouraged.

Right Culture:

Relatives and professionals recognised that moving to High View had impacted positively on people’s well being. There was a positive empowering and supportive culture in the service.

However, quality assurance systems were not entirely effective, and had failed to ensure staff had the training and skills necessary t to meet people’s needs.

The provider’s audits had identified performance issues prior to the inspection, and action plans had been developed to improve performance. Additional support had been provided to address these issues, and progress was being monitored by senior managers.

The registered manager and staff team were complimentary of the support they had received from the new provider.

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

In September 2022 the new provider was asked by the Local Authority to take over the operation of this location from another provider. This service was registered with us on 21 November 2022 and this is the first inspection.

The last rating for the service under the previous provider was inadequate, published on 18 June 2021.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We needed to check on the actions taken by the new provider since they took on responsibility for the service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We have identified a breach of the regulations in relation to safe care and treatment.

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

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.