Highlands Borders Care Home

Updated 18 December 2020

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

We were assured that this service met good infection prevention and control guidelines.

This inspection took place on 27 November 2020 and was announced.

Updated 18 December 2020

Highlands Borders is a residential care home providing personal and nursing care to 27 people at the time of the inspection. The service can support up to 28 people in an adapted building with a purpose-built extension.

There was an experienced registered manager who was responsible for the home. 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. The provider, Highlands Care Home Limited, also has two other care homes in Exeter.

At this inspection we found the service was meeting all regulatory requirements and we did not identify any concerns with the care provided to people living at the home.

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

People were positive about their experience of living at the home. For example, people said the home was “friendly”, “well-organised” and the staff “make you feel at home.” People said they felt safe; they received their medicines on time. People were protected from abuse because staff understood their safeguarding responsibilities. The registered manager took this role seriously and liaised with other health and social care professionals to ensure people’s legal rights were protected.

Staffing levels delivered responsive support to people. However, we made a recommendation linked to staffing levels and end of life care.

Our discussions with the registered manager demonstrated their empathy towards the people using the service; they recognised people’s emotional needs. Staff were attentive, whatever their role in the home, this was because they worked as a team to promote people’s well-being. Positive, meaningful relationships had been developed between staff, people and their families. The service respected and recognised the value of people’s life experience and their values, so people were supported to participate in events important to them. A number of people valued their independence and were pleased staff recognised this was important to them. This meant people still felt in control, which was important to their well-being.

There was a stable and attentive staff group; people described staff as “wonderful” People were supported by staff who respected their privacy and dignity and understood the need for a personal approach to reflect people’s individuality. Staff relationships with the people they assisted were caring and reassuring.

Care staff were kept up to date with changes in people’s health and spoke respectfully about the people they supported. They understood how they contributed to both people’s physical health and mental wellbeing. Staff received training at the start and throughout their employment to ensure they had the skills to provide effective care. Staff said they were well supported by the registered manager. However, the registered manager said due to some key staff leaving they were finding it difficult to ensure training and supervisions were up to date, which was reflected in staff records. Since the inspection, a full-time deputy manager now works at the home to assist with the running of the home.

Care staff were recruited to suit the caring values of the service and recognised the importance of team work to provide consistent and safe care. The home was well maintained, clean, and staff understood the importance of good infection control.

The registered manager and care staff worked well with community health professionals to ensure people received effective care. Referrals were appropriately made to health care services when people’s needs changed. People’s care needs were regularly reviewed. Risk assessments identified when people could be at risk. They covered people's physical and mental health needs and the environment they lived in. People's nutritional needs were met, and people socialised as they ate their meal in an unrushed atmosphere.

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. Information was in place to ensure people’s legal rights were protected. There were systems in place which enabled the registered manager and the providers to monitor the quality of care. For example, through regular reviews, surveys, meetings and observations of staff practice. Feedback from people using the service and quality assurance records showed this approach had been effective.

Rating at last inspection: The last rating for this service was Good (published July 2017). At this inspection, the rating remained the same.

Why we inspected: This inspection was scheduled for follow up based on the last report rating.

Follow up: We will continue to monitor the intelligence we receive about the service. If any concerning information is received, we may inspect sooner. For more details, please see the full report which is on the CQC website at www.cqc.org.uk