Archived: Highfield House

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

This is a summary of what we found-

Is the service safe?

The service was undergoing some minor refurbishment at the time of our visit. We saw that risk assessments had been carried out to ensure the safety of people who lived at the home during this work. Equipment in use in the home was being routinely serviced and one item had recently been replaced with a new and better model.

Staff had been trained in the policies and procedures to do with keeping people safe from harm and these were being actively discussed in their one to one meetings. They demonstrated a good understanding of what to look for and how to respond to signs of abuse.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Following a recent court ruling regarding depriving people of their liberty in care settings the manager had started to review the living arrangements of individual people, to identify where their circumstances may amount to a deprivation of liberty, according to the revised definition.

Is the service effective?

People and relatives told us they were happy with the care that had been delivered and needs had been met. It was clear from our observations and from speaking with staff that they had a good understanding of people's care and support needs and that they knew them well. Staff had received training to meet the needs of the people living at the the home.

Is the service caring?

People told us they were happy with the care provided at the home. One person said, "It's marvellous here, really so friendly. The staff are wonderful, it's such a nice atmosphere. I have come on a long way since coming here." A relative told us, "I am very involved and they are really on the ball here. If a GP is needed for example, they are straight on to it and they ring me up to keep me up to date as soon as anything happens." We saw people were supported by kind and attentive staff. A visitor told us, "I am reassured every time I come here, they are so caring."

Is the service responsive?

People's needs had been assessed before they moved into the home. Where people's needs required a change in care delivery this was arranged. Records confirmed people's preferences and care and support had been provided in accordance with people's wishes. The home encouraged and supported people to maintain contact with friends and relatives.

Is the service well led?

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still registered as manager on our register at the time. The new manager had applied to us for registration and was awaiting confirmation of the outcome of her application. Staff told us they were clear about their roles and responsibilities and felt supported in these. People's relatives told us they were informed and consulted about the care being delivered. Quality assurance processes were in place and new ones were being developed.

We spoke with eight people and three relatives to find out their opinion of the home. People and relatives with whom we spoke were complimentary. Comments from people included, 'You could not wish for anything better, it's marvellous,' 'I'm very happy. Everything is just 100%' and 'I wouldn't be anywhere else, it's perfect. They look after me well.' Comments from relatives included, 'She's a lot better since she's come in here' and 'I've no concerns; on the contrary, there's been a big improvement with her.'

People's privacy and dignity was respected and people were offered choices in relation to their meals.

People who used the service were not protected from the risk of abuse, because the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We found during our inspection, that a new manager had started a supervision process. However, we saw that supervision sessions had been carried out irregularly and some staff had not received an appraisal. Staff training needs were not always being met.

We saw that although one area of the building had no heating the provider had put in place appropriate contingencies which were risk assessed to ensure that people were not affected by this. We also noted that the provider had made all efforts to try and resolve the issue as quickly as possible.

We concluded people who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.

We identified people were provided with a choice of suitable and nutritious food and drink and were supported to be able to eat and drink sufficient amounts to meet their needs.

People were being cared for in a clean, hygienic environment and systems were in place to reduce the risk and spread of infection.

There were enough qualified, skilled and experienced staff to meet people's needs. One person said, "He stays in his room all time but the staff make sure they check on him hourly, they never leave him out, they always have time for everyone."

Care records contained accurate and appropriate information.

During the inspection we identified people's privacy and dignity were not always respected and people were not always offered choices in relation to their meals.

We spoke with people and their relatives about their experiences of the care and support they received from this service. One relative said, "She is always happy and content when I come in. She gets easily confused but I've got no concerns."

People were not provided with a choice of suitable and nutritious food and drink and were not supported to be able to eat and drink sufficient amounts to meet their needs.

People were not being cared for in a clean, hygienic environment and systems were not in place to reduce the risk and spread of infection.

There were not enough qualified, skilled and experienced staff to meet people's needs. One staff member said, "I'm contracted for 35 hours a week, but next week I'm doing 47. We do have people off sick and we're trying to cover as best we can."

Care records did not always contain accurate or appropriate information.