Archived: Highfield Farm

Updated 11 May 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.

Inspection team

The inspection was carried out by 2 inspectors 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.

Service and service type

High field Farm is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Highfield Farm is a care home without nursing care. 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 not a registered manager in post. An acting manager was overseeing the service and the provider was actively recruiting for a registered manager.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 6 March 2023 to help plan the inspection and inform our judgements.

During the inspection

We spoke with 3 people and 2 relatives about their experience of the care provided. We spoke with 9 members of staff including the operations manager, acting manager, team leaders and support workers. We carried out observations of care to help us understand the experience of people who could not talk with us.

We reviewed a range of records, including 2 care records and a range of medicines records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 11 May 2023

About the service

Highfield Farm is a residential care home providing personal care to autistic people and/or people with a learning disability. The service can support up to 9 people, at the time of our inspection 7 people were living at the home. The main house was spacious, with ensuite facilities. The grounds contained 3 bungalows annexed to the main building.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

Staff were not always provided with up-to-date guidance to provide people with the right support. Risks to people were assessed and care plans were in place. However, some records were not reviewed in a timely manner and others contained conflicting information. Environmental risks were not always managed to keep people safe. The provider had systems in place to protect people from the risk of abuse. Medicines were safely managed, and people received their medicines as prescribed. People were supported by enough, suitably qualified staff.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Right Care

The service did not have pictorial signage in place, which may assist people with a learning disability to orientate themselves around the home. Some areas of the home required redecoration, this was identified and formed part of an ongoing maintenance action plan. People and their relatives told us staff were kind and knew them well. People’s rooms were individualised. People told us they were happy and were offered activities of their choice, including evening outings and planned holidays.

Right Culture

The service lacked consistent leadership. We received mixed feedback from people, relatives and staff regarding the leadership and communication of the service. Governance systems in place did not always promote positive outcomes for people and audits did not always improve quality and safety. People and staff were involved in regular meetings, where they could make suggestions, raise concerns and discuss any upcoming events. Accidents and incidents were monitored and overseen by the senior management team. Where people had experienced incidents of distress, debriefs were undertaken with the staff to explore how lessons could be learned from these.

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

Rating at last inspection

The last rating for this service was good (published 17 June 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We received concerns in relation to the management of medicines and restrictive practices. 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.

We found no evidence during this inspection that people were at risk of harm from this concern. However, we have found evidence in other areas that the provider needs to make improvements. Please see the safe and well led sections of this full report.

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.

You can see what action we have asked the provider to take at the end of this full report.

The overall rating for the service has changed from good to requires improvement 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 Farm on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to leadership and governance at this inspection.

Follow up

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