All inspections: ShawCare@HighWray - Care Quality Commission

About the service

ShawCare@HighWray is a residential care home providing personal care to up to 43 people. The service provides support to older people and people with a physical disability. At the time of our inspection there were 28 people using the service.The home is a large building set over 4 floors with good sized communal areas and gardens for people to use.

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

Risks to people’s health and safety were assessed and managed, some changes were required to assessment of choking risks. People were supported to take their medicines safely. People were supported by enough staff who knew them well. People and relatives spoke highly of the staff, a relative said, “Staff are really caring and kind. They always take time to speak to me.” Another person said they received “Extremely good care.” People were kept safe, and all relatives told us they thought the home was safe. The home was clean and comfortable, and people were protected from the risk of mistakes being repeated.

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 home was managed well and a relative said, “They are strong managers. The owner is involved in the day to day running and decisions.” People were involved in making decisions and managers engaged well with people, their relatives and staff. There was a positive culture and staff said it was a good working environment.

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

Rating at last inspection

The last rating for this service was good (published 19 March 2018).

Why we inspected

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.

We received concerns in relation to recruitment of staff. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 remained good. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for ShawCare@HighWray 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.

Shawcare@HighWray is set in rural surroundings on the outskirts of Ormskirk. HighWray is a large detached property that has been extended to provide individually designed rooms with modern ensuite facilities. The home is set in extensive grounds with garden areas and a variety of outdoor seating areas. There are two communal lounges, a dining room and quiet areas to sit and view the surrounding landscapes. At the time of the inspection visit there were 27 people who lived at the home.

At the last inspection in August 2015, the service was rated ‘Good’. At this inspection we found the service remained Good. At this inspection we found evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

We observed during the inspection visit staff provided care and support for people in a patient caring manner. This was confirmed by visitors and people who lived at the home we spoke with. Comments included, “The staff are so kind and caring.” Also a relative said, “Staff are really patient and never appear rushed.”

The registered manager had procedures in place to minimise the potential risk of abuse or unsafe care. Staff spoken with were able to identify different types of abuse and had received training in safeguarding adults.

The management team had in place safe infection control procedures and staff had received infection control training. During the inspection visit staff wore protective clothing such as gloves and aprons as appropriate. This reduced the risk of cross infection.

We looked around the building and found it had been well maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced as required.

Medicines were stored in a clean and secure environment. We observed staff followed correct procedures when they administered medication during the day of our visit.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. Care records showed they were reviewed and any changes were recorded.

People had been 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.

Staff had been appropriately trained and supported. They had the skills, knowledge and experience required to support people with their care and social needs.

Staff had a good awareness of people they supported and provided a personalised service in a caring and professional manner. Care plans were organised and had identified care and support people required. We found they were informative about care people needed and what action was needed to support people and promote their independence.

People who lived at the home were very complimentary about the standard of food and cooks that prepared them. Comments about the quality of food were all positive and included, “Love the food what I like is there is always a choice.” Also, “Lovely homemade meals and cakes. We are very fortunate to have good cooks here.”

People told us staff and the management team were very caring and supportive towards them. Staff we spoke with understood the importance of high standards of care to give people meaningful lives. One staff member said, “I was really impressed by the way I was inducted and it gave me a lot of confidence to support residents.”

The service had information with regards to support from an external advocate should this be required by them.

The service had a complaints procedure which was on display in the hallway for people’s attention. People who lived at the home and relatives told us they had no complaints, they were happy with the service and found nothing to complain about.

Activities were arranged for people and they had an input into what events took place. For instance on the day of the inspection visit they had a singer and guitarist playing in one of the lounge areas. We spoke with people about the activity and one person said, “I really enjoy [singer] he is fantastic.”

The management team used a variety of methods to assess and monitor the quality of the service. These included regular audits, weekly staff meetings and resident meetings to seek their views about the service provided and what improvements should be made.

Further information is in the detailed findings below.

This inspection took place on 25 August 2015 and was unannounced. We last inspected Shawcare@Highwray on 30 January 2014 and the service was judged to be fully compliant with the previous regulatory standards.

Shawcare@HighWray is set in rural surroundings on the outskirts of Ormskirk. The home provides accommodation, personal care and support for up to 24 people. High Wray is a large detached property that has been extended to provide individually designed rooms with modern en-suite facilities. The home is set in extensive grounds with garden areas and a variety of outdoor seating areas. There are two communal lounges, a dining room and quiet areas to sit and view the surrounding landscapes. Additional accommodation was being built at the time of our inspection which would eventually mean that an additional ten bedrooms would be added to the home. Each of the new build rooms were en-suite and had access to their own small garden and patio so people could sit outside in the privacy of their own space as well as having access to the communal outside spaces.

There was a registered manager in place at the time of our inspection. 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.

People told us they felt safe at the home and with the staff who supported them. We asked one person what made them feel safe in the home and they told us, “Just how things are run”. Another person said, “There are so many staff around, it’s a beautiful place and the staff are always on hand.”

The service had procedures in place for dealing with allegations of abuse. Staff were able to describe to us what constituted abuse and the action they would take to escalate concerns. Staff members spoken with said they would not hesitate to report any concerns they had about care practices. There had been no safeguarding referrals made by the home during the twelve month period prior to our inspection. We discussed this with the home owner who told us that they had contacted the local authority safeguarding team to discuss some incidents but were informed they were not reportable under safeguarding procedures.

We looked at how medicines were ordered, stored, administered and recorded. We spoke with the deputy manager who had responsibility for administering medication on the day of the inspection and observed medication being given to people over the lunch time period. All the medicines given were done so in a discreet manner and it was evident that the deputy manager knew people well and how best to approach people when administering their medicine. We checked medication administration records (MAR) to see what medicines had been given. The MAR was clearly presented to show the treatment people had received. Medicines were stored in a locked cabinet within a locked room. Controlled drugs were stored appropriately as were medicines that needed to be refrigerated. We saw that fridge minimum and maximum temperatures were recorded daily to ensure that people’s medicines were kept in the correct manner. All the people we spoke with told us they received their medicines on time and knew why they were taking their medicine.

During our inspection we looked at the personnel records of six members of staff. We found that recruitment practices were satisfactory. However one member of staff who had not worked at the home for long did not have any references on their file. We discussed this with the registered manager and provider and were satisfied that this had been an oversight. The situation was rectified the following day and we were shown evidence of this.

Staff confirmed they had access to a structured training and development programme. They told us that a new e-learning programme had been introduced that covered a wide range of subjects. All the staff we spoke with enjoyed this way of learning as they could undertake training at their own pace. Staff told us if they had any issues during or following training they could discuss them with their line manager.

A number of the staff we spoke with had worked at the home for a number of years and we saw that staff retention rates were very good. Those members of staff we spoke with who were relatively new told us they had received a good induction which involved being supernumerary to the staff team and shadowing more experienced members of the staff team before working independently.

During our inspection we observed good interaction between the care staff and people who lived at the home. People spoke well of the staff and told us they treated them with dignity and respect.

We saw that advocacy services were available for people to access if they did not have relatives or friends to act as a voice for them. We saw that one person used advocacy services as they had no family representative. This had been a long standing arrangement and advice had been sought from the local authority to ensure the person’s best interests were met consistently.

We looked in detail at four people’s care plans and other associated documents. We saw that people’s care plans were reviewed on a monthly basis and notes were written daily that documented how each person had been throughout the day. We looked at people’s care records to see if their needs were assessed and consistently met. Care records were written well and contained good detail. Outcomes for people were recorded and actions noted to assist people to achieve their goals.

There were a number of systems in place to enable the provider and registered manager to monitor quality and safety across the service. These included regular audits and quality checks in all aspects of the service such as medication, care plans and infection control. Service contracts were in place, which meant the building and equipment was maintained and a safe place for people living at the home, staff and visitors. We saw service files in place to evidence this, which were well organised and up-to-date.

People who lived at Shawcare @ Highwray were positive about their experiences and the comments received reflected this, one person living at the home stated, "I am very happy here and content with the place." Visiting relatives we spoke to also spoke highly of the home and the care their loved ones received. One relative told us, "I couldn't fault it here, they are amazing. I have decided to move in when I am older!"

Care plans showed that people's care was delivered in a person centred way and that their likes and dislikes were noted and recognised by staff.

From speaking to staff, looking at their personnel files and staff training files it was apparent that staff felt supported and had the opportunity to develop.

The provider had an effective system in place to identify, assess and manage risks to the health and safety of people using the service and others.

The staff we spoke with told us about different ways they ensured people's privacy and dignity was upheld. One member of staff told us,'We've had training about privacy and dignity. Everyone is respectful to each other here'.

One relative we spoke to we told us, 'They (the staff) work closely with our family we feel involved'. Another relative we spoke with told us, "They are very good at letting me know of any changes. I speak with staff nearly everyday". The care plans and risk assessments reflected regular involvement of people living in the home and or relatives.

We saw the home had a comprehensive cleaning schedule and this was being followed at the time of our visit. We spoke with staff responsible for the housekeeping. One person told us,'I have been supported to do regular training in infection control and got qualifications in housekeeping'.

We saw records showing staff undertook training to give them the skills and knowledge to look after people properly. This would make sure they were confident, safe and competent. Staff we spoke with told us about their induction programme.

Relatives we spoke to told us they had no complaints about the service but would be happy to raise their concerns directly with the managers or staff. One person told us, "I speak to staff everyday and would ask to speak to the manager if something was wrong".

During our inspection we spoke with a number of residents about what life was like at

High Wray. We also spoke with some relatives, staff members and external professionals. Everyone provided us with very positive feedback about every aspect of the home.

People told us they were able to make decisions about what they wanted to do and said their privacy and dignity was maintained at all times. They felt independence was always promoted and they had confidence in the staff team, who supported them in the way they wanted to be.

Comments from people living at the home included:

"It is super here. They have done so much work to the place. It is like a five star hotel."

"The food is always delicious and everything is home made. We get plenty of choices at meal times."

"I feel so comfortable. My room is nice with my own things in it. It is nice and warm and the staff are very friendly."

Comments from relatives included:

"I cannot fault it here. High Wray is second to none. We are all like one big happy family. It is just wonderful and I wouldn't have my relative anywhere else."

"I am more than happy with the care mum receives. The staff are marvelous, so dedicated to their work. They are extremely kind and caring. They treat me with respect too when I visit."

"It is so friendly and calm. No-one is ever rushing around. The staff are able to have a chat with people. I have never heard any of the staff being sharp with the residents or talking to them in a derogatory way."

ShawCare@HighWray

All Inspections

6 July 2023

During an inspection looking at part of the service

20 February 2018

During a routine inspection

25 August 2015

During a routine inspection

30 January 2014

During a routine inspection

6 March 2013

During a routine inspection

9 February 2012

During a routine inspection