Highfield House Care Home

Updated 6 August 2022

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

This inspection was carried out by two inspectors and a medicines inspector who specifically looked at the safe management of people's medicines. Following our visit on site an Expert by Experience made telephone calls to people and their relatives to seek their feedback. 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 House Care Home is a ‘care service’. People in care services receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Highfield House Care Home is a care service without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. 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 since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return (PIR) prior to this inspection. The PIR is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who lived at Highfield House Care Home and the relatives of eight people about their experience and views of the care provided to their family members. We also had contact with 12 members of staff, including care staff, maintenance staff, the deputy manager, registered manager and the director of the provider company.

We observed people's care to help us understand the experience of people who could not talk with us. We reviewed a range of records. This included five people's care records and medication records. We looked at a variety of records relating to the management of the service.

Updated 6 August 2022

About the service

Highfield House Care Home is a residential care home providing accommodation for up to 40 people. The service is arranged over two floors and a third storey referred to as a mezzanine. At the time of this inspection there were 29 people using the service.

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

We had significant and multiple concerns at our last inspection and rated the home inadequate in two key questions and overall. We also found three breaches of the Health and Social Act 2008 (Regulated Activities) Regulations 2014.

Immediately following our last inspection, the provider took action to begin making the necessary improvements including placing a voluntary suspension on any new admissions to the care home. The provider brought in a regional manager to be based at the home full time to help address the significant concerns and to put in place a plan of action to make the necessary improvements. This involved making improvements to governance and oversight arrangements, and implementation of systems and processes to safely assess and manage risks to people. Staffing levels were reviewed and immediately increased, and staff terms and conditions were improved.

At this inspection we found improvements. Despite some remaining areas for improvement, such as the need to consistently improve record keeping, the service had enhanced leadership and there was a changed culture which was commented on by many people, staff and stakeholders we spoke with. The embedding of these new ways of working are now required to ensure consistency moving forward.

People told us they felt safe. People using the service and relatives were complimentary about the staff who they felt were caring and kind. People were protected from the risk of abuse and staff knew how to identify and report safeguarding concerns.

The provider had increased staffing levels in the service since the last inspection and staff had received an induction and training relevant to their role. Staff were safely recruited and the provider had completed the appropriate checks prior to them starting work. Despite this, the service still faced recruitment challenges and we received some mixed feedback about the staffing levels. We have made a recommendation about the provider monitoring the staffing levels closely.

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

The provider had a process in place for responding to complaints and people and relatives told us they felt comfortable raising any issues with the management team.

People, relatives and staff spoke positively about the culture of the service and told us the management team were approachable and supportive.

Rating at last inspection and update

The last rating for this service was Inadequate (published 28 January 2022). This service has been in Special Measures since that date. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Previous breaches

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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this comprehensive inspection to check the provider had followed their action plan and to confirm they now met legal requirements.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Inadequate to Good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Highfield House Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.