Archived: The Highgrove

Updated 17 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 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.

This inspection took place on 24 and 25 January 2018 and was unannounced. The inspection team consisted of one adult social care 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. The expert by experience for the inspection at The Highgrove had experience of caring for people who lived in a care home setting.

Before our unannounced inspection, we checked the information we held about the Highgrove. This included notifications the provider sent us about incidents that affect the health, safety and welfare of people who lived at the home. We also contacted other health and social care organisations such as the commissioning department at the local authority and Healthwatch Blackpool. Healthwatch Blackpool is an independent consumer champion for health and social care. This helped us to gain a balanced overview of what people experienced living at The Highgrove.

Furthermore, we looked at the Provider Information Return (PIR) the provider had sent us. 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.

Additionally, we spoke with a range of individuals about this home. They included nine people who lived at The Highgrove, a relative, four staff members, the manager and the provider. We observed care and support in communal areas and looked around the building to check environmental safety and cleanliness. This enabled us to determine if people received the care and support they needed in an appropriate environment.

We also spent time reviewing records. We examined care records of four people who lived at the home. This process is called pathway tracking and enables us to judge how well The Highgrove understands and plans to meet people's care needs and manage any risks to people's health and wellbeing. We checked the recruitment, training and support documents in relation to four staff members. We also looked at records related to the management and safety of The Highgrove.

Updated 17 March 2018

The Highgrove provides care and support for a maximum of 30 people who live with dementia and mental health conditions. At the time of our inspection there were 29 people living at the home. The Highgrove is situated in a residential area of South Shore, Blackpool, and is close to local amenities. A lounge, dining room and an external smoking area are available so people can choose where to relax. Bedrooms are situated over two floors, with lift access, and there are sufficient washing facilities to meet people’s needs.

There was no registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. However, we saw evidence the manager at the Highgrove was in the process of registering.

At the last inspection on 24 and 25 January 2018, the service was rated ‘Good’. At this inspection, we found the service remained ‘Good’.

The Highgrove is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, both of which we looked at during this inspection.

During this inspection, people told us they received their medication on time and staff managed this safely. Staff completed with each person, or their representative, a medication care plan and risk assessment. Staff responsible for administering medicines completed regular audits to assess the safety of related procedures.

We observed staff supported people with a safe approach. For example, we saw they attended very quickly to one person who was choking. Staff were calm and soothing in their tone, which helped to reassure the individual and resolve the incident. Care records included risk assessments to assist staff to understand how best to support those who lived at the home. Staff we talked with demonstrated a good understanding of safeguarding people from unsafe or poor care.

Staff files included required recruitment documents. The manager was implementing a new system to review each candidate’s employment history to confirm their suitability to work with vulnerable adults. We noted there were sufficient staffing numbers and staff skills mixes to support those who lived at The Highgrove. A staff member stated, “I feel there’s enough staff on.” Staff accessed a range of courses to support them in their designated roles.

Care planning focused upon people’s nutritional support, including the management of potential risks, such as malnutrition and dehydration. We observed a ‘hydration station’ was provided in the lounge so that those who lived at the home could access drinks whenever they wished. People commented positively about the meals they received.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

The manager had considered people’s rights and implemented innovative practices to improve the lives of those who lived at the home. For example, the manager trained staff to better support Lesbian, Gay, Bisexual and Transgender (LGBT) older couples. We observed staff had a friendly, caring approach and used humour appropriately. One person who lived at The Highgrove told us, “I have been here [a long time]. The staff are brilliant.”

Care records we looked at had the person at the heart of their support planning. For example, the manager documented people’s backgrounds, life histories and preferences. There was clear evidence those who lived at the home or their representatives were involved in their care planning.

People, staff and visitors had a variety of opportunities to feedback their experiences of living and working at the home. The manager had a detailed system to retain clear oversight of everyone’s safety and the quality of the service provided. They produced for people and visitors a regular newsletter about the service and any recent events. This included a poem written by someone who lived at The Highgrove, the Christmas party and a note thanking staff for their hard work.