We carried out a review of the data available to us about Highfield Hall on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Highfield Hall, you can give feedback on this service.
People’s experience of using this service and what we found
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.
Staff had received safeguarding training and were aware of their responsibilities. Risks to individuals, staff and within the environment were identified and well managed. There were safe systems of recruitment in place. We received mixed feedback regarding staffing. The provider had recently taken action to improve levels and consistency of staffing. People received their medicines as prescribed. Risks associated with COVID-19 were well managed. On the first day of our inspection some staff were observed wearing face masks incorrectly. Managers took immediate action and throughout the rest of our inspection all staff were observed to wear face masks correctly.
People’s needs were assessed, and clear support plans and risk assessments were in place to guide staff. Staff received the induction, training and support they needed to carry out their roles. People’s nutritional needs were met. The home was clean and there was a programme of redecoration and building improvements in place.
Most people told us staff were caring and spoke positively about living at the home. One person said, “The staff work hard. They are nice and pleasant.”
There was a range of activities on offer for people both within the home and in the wider community, which people told us they enjoyed. There was an appropriate system in place to manage complaints.
The nominated individual and provider had good oversight of the service and demonstrated a clear passion and commitment to improving the quality of the service. The nominated individual had started the application process to register with CQC as the registered manager for the service on a temporary basis, until a new permanent manager was recruited and inducted.
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 12 August 2021).
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.
The inspection was prompted in part due to concerns received about staffing, safeguarding, management of falls, medicines management and pressure care. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection that people were at risk of harm from these concerns.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Highfield Hall is a residential care home which provides personal care and nursing care for up to 75 older people and people living with dementia. Nursing care is provided on the upper floor and there is a separate unit for people living with dementia. Accommodation is provided in single en-suite rooms. A passenger lift is available to provide access to both floors. At the time of the inspection 56 people were living at the home.
People’s experience of using this service and what we found
People felt safe living at the home, and most were happy with staffing levels. Staff had completed safeguarding training and knew how to protect people from the risk of abuse and avoidable harm. The registered manager recruited staff safely. People’s medicines were managed safely and effectively. Staff followed safe infection control procedures. Most people told us staff wore appropriate personal protective equipment (PPE). However, some told us staff did not always wear their masks as they should, and the registered manager assured us she would address this with staff. The safety of the home environment was checked regularly.
Staff supported people in a way which reflected their needs and risks. Staff received the induction and training they needed to meet people’s needs. 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. People received support with their dietary and healthcare needs and were referred for specialist support when they needed it. The environment was purpose built to enable people to remain as independent as possible. The provider had made some improvements to the home environment since taking over the service and further improvements were planned.
People and relatives told us staff were caring and respectful. People told us staff encouraged them to be independent and make decisions about their care when they were able to. Staff respected people's right to privacy, dignity and confidentiality. Care plans included information about people’s backgrounds and diversity, to ensure staff were aware of what was important to them.
Staff provided people with personalised care that reflected their needs and preferences. Staff knew the people they cared for and encouraged them to make choices when they could. Staff reviewed people's care needs regularly. Concerns and complaints were managed appropriately. People were happy with the range of activities and entertainment available at the home. People were asked about their end of life care wishes and we received positive feedback about the end of life care provided at the home.
The registered manager and staff were clear about their responsibilities. They had a focus on providing people with personalised, high quality care. The service worked in partnership with community agencies to ensure people received any specialist support they needed. People’s views about the service were sought and acted upon. People, relatives and staff felt the service was managed well. The registered manager and provider completed regular checks to ensure appropriate standards of quality and safety were maintained at the home.
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 and update
The last rating for the service was good (published 31 August 2018). Since this rating was awarded, the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
We also completed a targeted infection prevention and control inspection of the service on 9 February 2021 (published 2 March 2021) and were assured that people were receiving safe care which protected them from the risk of cross infection.
Why we inspected
This was a planned inspection based on the service’s date of registration under the new provider.
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.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
At the time of the inspection there were strict rules in place throughout England relating to social restrictions and shielding practices. The ones that applied to the area this home was located were commonly known as 'Tier Four Rules'. This meant the Covid-19 alert level was high and there were tighter restrictions in place affecting the whole community.
We found the following examples of good practice:
The provider and registered manager had comprehensive processes to minimise the risk to people, staff and visitors from catching and spreading infection. Any authorised visitors were checked at the door of the home to make sure they were safe to enter. In addition, there was weekly testing of staff and every 28 days for people living in the home. Hand sanitiser and personal protective equipment (PPE) were available throughout the home. There were signs to remind staff, visitors and people about the use of PPE, the importance of washing hands, regular use of hand sanitisers and appropriate social distancing.
Where appropriate, ‘socially-distanced' visits had been taking place before the inspection. At the inspection however, and consistent with enhanced restrictions, these visits had been restricted and were only allowed in exceptional circumstances. There was a visiting pod that had been created at the front of the home so that visitors did not have to enter the home itself. The registered manager said it was hoped this facility and social visits could be resumed when restrictions were lifted.
Infection control policy and people's risk assessments had been completed and revised during the pandemic so that people were protected in the event of becoming unwell or in the event of a Covid 19 outbreak. The registered manager insisted people were tested before admission and consistent with local guidance, people were not being admitted to the home at the time of the inspection. This will be reviewed as appropriate and in line with any changes in restrictions. We were satisfied the service, staff, people and visitors were following the rules.
People's mental wellbeing had been promoted by innovative use of social media and electronic tablets so people could contact their relatives and friends. Where required, staff supported people with this technology.
Policies and infection control processes were regularly reviewed when guidance changed. The home was clean and hygienic. Staff also had comprehensive knowledge of infection prevention, access to good practice guidance and had attended Covid 19 specialist training hosted by a local GP's surgery. There were sufficient staff to provide continuity of support and ensure safeguards were in place should there be a staff shortage.
If required, staff could receive Covid 19 related supervision and had access to appropriate support to manage their wellbeing. The registered manager had a good understanding and knowledge of the staff team. During inspection, we noted good examples of support of staff and a caring approach to their welfare.
Further information is in the detailed findings below.