Highfield House

Updated 3 February 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.

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 an inspector and a specialist advisor, who specialised in nursing and infection control.

Service and service type

Highfield House 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 House is a care home with 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. The previous registered manager had recently left and a new manager had only come into post the day before our inspection site visit. They had plans to apply to become the registered manager.

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. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 2 people, 2 relatives and 16 staff, including staff from the management team (including the nominated individual), the service improvement team, the recruitment team, the training department, physiotherapy, nursing, care staff and domestic teams. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed records relating to people’s care, medicines management, staff recruitment, staff training, audits, policies and records relating to the management of the home.

Updated 3 February 2023

About the service

Highfield House is a residential care home providing personal and nursing care to up to 45 people. The service provides support to people who are living with complex neurological conditions. At the time of our inspection there were 36 people using the service. Highfield House accommodates people across three separate wings. This includes a high dependency unit for people who require ventilation. There is also a nursing unit and a unit supporting people with their rehabilitation. Included in the staff team is a dedicated therapy team, providing on-site physiotherapy to support people's rehabilitation.

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

People received safe care and treatment. Staff were knowledgeable about how to maintain people’s safety and provided care in line with best practice guidance. Care staff worked with the physiotherapy team and other specialist healthcare professionals to ensure they had the skills to support each person at the service and knew how to use the required equipment safely, this included receiving tailored training on how to meet each person’s needs. The provider reviewed their practices in response to any incidents that occurred at the service to ensure they were learnt from and action was taken to minimise the risk of recurrence.

Safe staffing arrangements were in place. There had been a large recruitment drive since our last inspection and many new staff were in post. This had reduced the reliance on agency staff and further plans were in place to continue to strengthen the staff team. Induction processes had been improved including the delivery of more clinical training, so staff had greater knowledge prior to starting to provide hands on care. There was a regular programme of training to enable staff to update their skills. However, we recommend the provider reviews their practices to ensure agency staff are competent to undertake all activities assigned to them.

The management team had been restructured. As part of this there had been additional roles created to provide further clinical leadership at the service. Governance processes had been strengthened to enable the nursing team to discuss examples of care and how they had been learnt from to improve practice. There was a commitment to continuous improvement, a regular programme of audits and review of key service improvement.

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

Rating at last inspection and update

The last rating for this service was good (published 11 August 2022).

Why we inspected

We received concerns in relation to the delivery of safe care and treatment, risk management and staffing arrangements. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from these concerns. 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.

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 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 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.