Highfield

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last inspection we rated this key question good. At this inspection the rating has remained good.

This meant people were safe and protected from avoidable harm.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Systems were in place to record accidents and incidents, and learning was taken from these and where possible, actions were taken to reduce risks of reoccurrence.

Staff told us the management team listened to any concerns they had about safety. For example, the assistant manager told us staff had noticed 1 person became anxious when they saw their reflection in their bedroom mirrors and this new behaviour was attributed to them now living with dementia. Immediate action was taken to add a discreet covering to the mirrors which reduced the person’s anxiety.

One staff member told us, “If anything happened my priority would be to make sure the person was okay. If they needed an ambulance I would call and I would ring management to get (shift) cover. If it was a tumble with no injury, I would check the person was okay and I would keep checking, observing for any change. I would fill in the report on the electronic records, and I would let the manager know I had filled it in. We talk about these in our ‘theme’ meetings and if something needed to change quickly then the manager would come and talk to us.”

The provider worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was continuity of care, including when people moved between different services.

One person had recently sustained an accidental injury and spent a period of time in hospital. During this person’s hospital stay, staff had visited them recognising that for this person, seeing familiar faces was important to their wellbeing. When the person was fit for discharge, the registered manager acknowledged the person would need more support than their supported living home was able to give, so had negotiated, with the commissioners of the person’s care, a short stay at the provider’s respite residential care home. The person was happy with this and therefore a lengthy discharge from hospital was avoided.

Most people supported by the provider lived in a shared home of 2 or more people. People had developed friendships and were happy to live together. The management team were mindful of friendships within shared homes and how any changes, such as a new person moving in, may impact upon the others living there. The management team told us that where a vacancy may occur in a shared home, they would work together with people living there and time would be taken to develop relationships before a person moved in.

During 1 person’s recent review meeting, they had shared that they would like to move out of their supported living home and back to an area they used to live. Polesworth Group Homes did not cover the area and explained this to the person and that they would have a different provider for their care and support. The person accepted this, telling the assistant manager, they liked Polesworth Group Homes, but just wanted to move location. The assistant manager told us they were currently working to support this person’s move and safe transition between services.

The provider worked well with people and healthcare partners to fully understand what being safe meant to them and the best way to achieve that. Staff had a clear focus on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider always shared concerns quickly and appropriately.

The provider encouraged people using the service to speak up about any abuse they felt may have taken place. Where an allegation of material abuse had been made, the provider listened to the person and undertook a full investigation, also reporting the incident to the local authority and Care Quality Commission, as required. The provider was pro-active in using incidents to continually promote awareness in safeguarding people from abuse and as an effective means for staff to understand policies and procedures.

The assistant manager told us they had worked with 1 person and learning disability healthcare professionals to try to reduce risks of avoidable harm to the person and others through their ‘online’ activities in ‘following’ members of the public. The assistant manager explained they had raised an awareness with the person and their use of social media and explained what appropriate and inappropriate behaviour was, and that inappropriate behaviour could potentially lead to a member of the public making a complaint to the police. An online safety support care plan had been developed to safeguard this person, giving staff the tools to remind this person of the guidance that had been shared with them.

Everyone felt safe with the staff supporting them and with the other people they lived with. During our inspection, some people invited us to meet them in their homes. During this time, we observed they were at ease with staff and managers. Everyone spoken with told us they liked their support from Polesworth Group Homes and the supported living care arrangements made them feel safe.

Staff had received training on how to protect people from the risks of abuse and understood their role in reporting any concerns they had.

Some people had a Deprivation of Liberty Safeguard (DoLs) in place, which had been applied for and agreed by the local authority based on the person’s ‘best interests.’ One staff member told us, “Both people I support have a DoLs authorised by the Court of Protection. They have no concept of risk inside or outside the home, so would be at risk if they were left alone. They are always accompanied when they go out and there is always a member of staff on duty. It’s 24-hour supervision at all times.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risks of avoidable harm were identified, and staff knew people well and how to protect them. One staff member told us about 1 person’s behaviour that could be perceived as challenging. The staff member explained, “I use my skills to deescalate the situation. With [name] you have to talk in a low tone and offer to give a cuddle. Then offer reassurance. If there is an incident you have to log it all on the ‘tablet’ (electronic care records). There is a care plan with everything written down explaining what approach staff need to take to de-escalate situations but because we know [name], we know what we need to do to help them.”

Plans of care contained risk management plans for staff to refer to when needed. Some people had health conditions and staff understood these and the support people needed.

The provider detected and controlled potential risks in people’s living environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Staff had completed fire safety training and people had individual personal emergency evacuation plans. Staff understood the actions to take in an emergency. One staff member told us, “In the home every week I check the carbon monoxide detector and the smoke detector to check they are all working.” They added, “About 4 times a year we do a mock fire evacuation to see how people living here respond and to make sure they know what to do.”

People we met and spoke with were happy living in their shared home. A staff member told us, “If there are any repairs we report them to our manager straight away, say a piece of equipment was damaged or a paving slab was uneven. I reported a leak in the conservatory, and it was repaired quickly.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff were recruited in a safe way. We reviewed 1 employment record for a new member of staff and saw pre-employment checks, including a criminal record check and references, had been sought by the provider before the staff member commenced work.

There were enough staff to meet people’s needs and fulfil their care hours. Some staff worked alone on shift and a ‘lone working risk assessment’ was in place. On-call support was provided by the management team. One staff member told us, “We absolutely do not use agency staff. We are a very good team; we all pull together. If someone if off, we cover. I have done shifts in other homes to help out. I had met the service users before, but I was given time to read their care plans, and I was given a direct telephone number in case I wasn’t sure about anything.”

Staff spoken with felt happy with the mix of online training and face to face training sessions they completed and felt they had the skills needed to do their jobs. One staff member told us, “I had to do lots and lots of training before I could work on my own, safeguarding, Mental Capacity Act, infection prevention and control, fire training, lots. The managers are red hot on training. One of the managers checked in with me to make sure I was okay and to see if I had any questions.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff had been trained in infection prevention and control and understood the importance of reducing risks of cross infection. Personal protective equipment (PPE) was available for staff to use when needed.

One staff member told us, “Basically, we have plenty of gloves, aprons and masks. We don’t use the masks very much, but they were important during COVID. We sanitize the bathrooms after each use, and we use aprons and gloves when we assist with personal care and food preparation. We have to keep on top of cleaning the house; it helps protect from the spread of any germs or infections and we record it on the cleaning chart. [Managers] can pop in at any time and will check to make sure we have done what we have recorded on the chart.”

Some people enjoyed taking part in looking after their home and cleaning. One person told us, “I clean my bedroom every day, I vacuum it and keep it clean and tidy. I like doing that.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Staff had been trained in the safe handling of medicines and their competencies were checked. One staff member told us, “All medication is kept securely, and we hold the keys whilst we are on shift. When you give a medication, you observe it’s taken and then record it on the Medication Administration Record (MAR). The manager checks the MARs when they visit. Even though I had worked for the NHS I had to do my medication training and I get checked to make sure I’m doing it right.”

We reviewed 2 people’s MARs, and these reflected they had been supported to take their medicine as prescribed. Some people had ‘when required’ pain relief, such as paracetamol, and protocols were in place for staff to refer to.

One person had diabetes and was involved in monitoring their own blood glucose levels through their sensor device. This is a continuous glucose monitoring system worn as a sensor applied to the upper arm.