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Inspection Summary


Overall summary & rating

Outstanding

Updated 1 December 2016

We carried out an unannounced comprehensive inspection of Highfield House on 8 September 2016.

Highfield House is a care home registered to provide accommodation for up to 20 people. At the time of our inspection there were 20 people living in the home. The service provides specialist care to people living with varying degrees of cognitive impairment. Some of the people at Highfield House had complex and sometimes challenging needs. Care was provided in a safe and dementia friendly environment.

There was a registered manager in place at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

People received exceptionally person centred care from staff who knew each person well, about their life and what mattered to them. The people living at the home experienced a level of care and support that promoted their health and wellbeing and enhanced their quality of life. The service focussed on the individual needs of the people and their families. People, families and professionals all described Highfield House as a “Home from home” and praised the high quality person-centred approach to care provided by the staff.

People were supported by enough staff who were highly skilled and knowledgeable in caring for people with cognitive impairments. People and their relatives said or expressed that they felt safe in the service. Staff were clear about their safeguarding responsibilities and knew how to recognise signs of potential abuse and how to report it.

Staff carried out their roles and responsibilities effectively. Staff had an excellent understanding of managing risks and supported people to reach their full potential through inventiveness and personalised care. The attitude of the staff and their knowledge of the people clearly had a positive impact on the people and their families. Staff were skilled in helping people to express their views and communicated with them in ways they could understand.

People were treated with dignity and the greatest of respect at all times. Staff demonstrated caring and positive relationships with people and was sensitive to their individual choices. Staff focused on people's wishes and preferences and people were supported to remain active and independent.

The registered manager, provider and staff were highly responsive to the needs of the people and their families. Staff thought creatively about how people’s needs could be met and demonstrated a commitment to ensuring the service was tailor made and flexible to each individual. People and relatives and visiting professionals described the staff as ‘going out of their way’ to meet the needs of the people.

Staff worked tirelessly to meet the social, emotional and physical needs of the people they cared for. People’s lives were enhanced by being encouraged and aided to take part in activities they enjoyed and that were meaningful to them. Staff continually encouraged and supported people to remain active and independent.

People benefitted from an exceptionally well-managed and organised service and the provider and registered manager led by example. People were placed at the heart of the service though the providers clear vision and values that underpinned practice. The staff all recognised the on going importance of ensuring the vision and values were understood and implemented, without exception.

The registered manager was very approachable and well supported by the provider. There were comprehensive quality assurance processes in place using formal audits and regular contact with people, relatives, professionals and staff. Family members told us they were given the opportunity to provide feedback about the culture and development of the home and all said they were extremely happy with the service provided. The provider were responsive to new ideas and had developed links with external organisations and professionals to enhance the staff's and their own knowledge of best practice and drive forward improvements.

The provider, registered manager and staff all strived to improve the lives of the people using the service but also took an active role to increase the understanding of dementia and improve the quality of care provided to people living with dementia and their families in the wider community.

The management team and staff protected people’s rights to make their own decisions. Where people did not have the capacity to consent to care, legislation designed to protect people’s legal rights was followed correctly and confidently by staff. Staff demonstrated a clear knowledge and understanding of when Deprivation of Liberty Safeguards (DoLS) should be used and applications were made appropriately. DoLS provides a process by which a person can be deprived of their liberty when they do not have the capacity to make certain decisions and there is no other way to look after the person safely.

Inspection areas

Safe

Good

Updated 1 December 2016

The service was safe.

People were protected from the risk of abuse and staff was clear about their safeguarding responsibilities. Staff knew how to recognise signs of potential abuse and how to report it.

Risks to the people were identified and appropriately managed. Accidents and incidents were reported and actions were taken to reduce risks of recurrence.

People were supported by enough skilled staff so their care and support could be provided at a time and pace convenient for them. There were enough staff to meet people’s needs and the process used to recruit staff was robust.

Medicines were administered safety. Processes were in place to ensure that people received their medicines as prescribed. Medicines were administered by staff who had been suitably trained.

Effective

Good

Updated 1 December 2016

The service was effective.

People experienced a level of care and support that promoted their health and wellbeing.

People were cared for by skilled and experienced staff who were suitably trained. Staff received ongoing additional support with practice through regular supervision and appraisals.

People received a choice of fresh and wholesome food and were supported appropriately to eat and drink enough.

People's consent to care and treatment was sought. Staff confidently used the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and understood how these applied to their practice.

Guidance had been followed to ensure the environment was suitable for people living with cognitive impairment.

Caring

Good

Updated 1 December 2016

The service was caring.

People and their relatives said that staff developed exceptionally positive, caring and compassionate relationships with them and they were cared for with kindness and treated with consideration.

People’s privacy, dignity and independence was respected by the staff.

The attitude of the staff and their knowledge of the people clearly had a positive impact on the people and their families. Staff were skilled at helping people to express their views and communicated with them in ways they could understand.

The people were supported to have a comfortable and dignified death. People’s end of life and later life wishes were respected and acted upon.

Responsive

Outstanding

Updated 1 December 2016

Highfield House was outstandingly responsive to the needs of the people and their families.

Staff showed they had an excellent understanding of the people they cared for and people received exceptionally person centred care which promoted their health and wellbeing and enhanced their quality of life.

Care and support was planned proactively and in partnership with the people, their families and multidisciplinary teams where appropriate.

All staff went out of their way to maintain family lives and relationships and Highfield House demonstrated a strong family centred culture and approach to care.

People lives were enhanced by being supported to take part in activities they enjoyed and were important to them.

People, their relative’s and professional’s views were actively sought, listened to and acted on. People knew how to raise concerns, which were listened and positively responded to and were used to make further improvements.

Well-led

Outstanding

Updated 1 December 2016

Highfield House was outstandingly well led

There was excellent leadership. The service was well organised and provided a consistently high quality, person centred care.

The vision and values of the service were visible throughout the service and clearly demonstrated by the staff.

The service worked in partnership with other organisations to make sure they followed best practice, maintained people’s safety, continued to provide exceptional care and improve the quality of life of the people they cared for.

There was an open and transparent culture within the home and staff worked effectively with people, relatives, and other professionals. The provider actively sought feedback from people to enable continual improvement.

Exceptional quality assurance systems were in place using formal audits and regular contact by the registered manager with people, relatives and staff.