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Inspection carried out on 6 February 2018

During a routine inspection

Highfield is a care home that provides care for six adults with learning disabilities and mental health needs. At the time of the inspection, five people were living at the home. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and we reviewed both areas during this inspection.

At our last inspection in January 2016, we rated the service good. At this inspection, we found the evidence continued to support the rating of good, and there was no information from our inspection and on-going monitoring that demonstrated any serious risks or concerns.

This inspection report is set out in a shorter format because our overall rating of the service has not changed since the last inspection.

Staff followed the procedures for safeguarding people from the risks of harm or abuse. Risk management plans were in place to safeguard people’s personal safety and manage known environmental risks.

Staffing arrangements met people’s individual support needs. The recruitment procedures ensured only suitable staff were employed to work at the service. Medicines were appropriately managed and staff followed infection control procedures to reduce the risks of spreading infection or illness.

Staff had comprehensive induction training and on-going refresher training that was based on following current best practice. Staff supervision and appraisal systems ensured staff had regular opportunities to discuss and evaluate their learning and development needs and their work performance.

Staff supported people to follow a nutritious, varied and balanced diet. The staff supported people to access health appointments as required so that people’s continuing healthcare needs were met.

Staff understood the principles of the Mental Capacity Act, 2005 (MCA) and ensured they gained people's consent before providing personal care. People were encouraged to be involved in decisions about their care and support and information was provided for people in keeping with the requirements of the Accessible Information Standard (AIS).

People had their privacy, dignity and confidentiality maintained at all times. People experienced positive relationships with staff and received care that respected their diversity as staff supported people to maintain relationships with family and friends and make new friends. The care people received from staff was kind, caring and compassionate.

The provider operated an open and transparent culture. Quality assurance processes checked all aspects of the service. Events such as safeguarding matters, accidents and incidents had been reported to the CQC and other relevant agencies as required. Complaints brought to the provider’s attention had been dealt with in accordance with the complaints procedure.

Inspection carried out on 29 January 2016

During a routine inspection

Our inspection took place on 29 January 2016 and was unannounced. At the last inspection in September 2013, the provider was meeting the regulations we looked at.

Highfield provides care and support for up to six people who have mental health needs, learning difficulties, autistic spectrum disorder, and other associated complex needs. On the day of our inspection there were five people living in the service.

There was a registered manager in post, although on the day of our inspection they were on maternity leave. In their absence, interim cover was being provided by a senior member of staff, with additional support from the operational manager. 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.

People felt safe living in the service. Staff had been provided with training to recognise the signs of potential abuse and to keep people safe. They were aware of their responsibilities in reporting any concerns. We found that there were processes in place to manage identifiable risks within and outside the service to ensure people did not have their freedom restricted unnecessarily.

There were sufficient numbers of suitable staff to meet people’s needs and promote people’s safety and independence. Robust recruitment processes had been followed to ensure that staff were suitable to work with people. There were systems in place to ensure people’s medicines were managed safely and given at the prescribed times.

There were processes in place to ensure that staff were provided with induction and essential training to keep their skills up to date and to support them in their roles.

People’s consent to care and support was sought in line with the Mental Capacity Act (MCA) 2005. Staff understood and complied with the requirements of the MCA and the associated Deprivation of Liberty Safeguards (DoLS.)

People were supported to prepare their meals and to maintain a balanced diet. People’s health and wellbeing needs were closely monitored and the staff worked very well with other professionals to ensure these needs were met.

Positive and caring relationships had been developed between people and staff who treated them with kindness and compassion. Staff were knowledgeable about how to meet people’s needs and understood how people preferred to be supported on a daily basis. Staff understood how to promote and protect people’s rights and maintain their privacy and dignity. Relationships with family members were considered important and staff supported people to maintain these. The service had systems in place to ensure that people’s views were listened to and acted on.

People received person-centred care, based on their likes, dislikes and individual preferences. Before people came to live at the service their needs had been assessed to ensure the care provided would be personalised and responsive to their identified needs.

Staff supported and encouraged people to access the community and participate in activities that were important to them. People were aware of the provider’s complaints system and information about this was available in an easy read format.

There was a positive, open, inclusive and transparent culture at the service. Leadership at the service was visible and as a result staff were inspired to provide a quality service. Senior staff regularly assessed and monitored the quality of care provided to people. Staff were encouraged to contribute to the development of the service and understood the provider’s visions and values.

Inspection carried out on 13 September 2013

During a routine inspection

We spoke with two people living at the service. We also spoke with two staff and the registered manager. We also reviewed the care records of two people who used the service.

People told us that they were happy living at the service and that they liked the staff who worked there. They also told us that they had recently enjoyed going out to the seaside with the staff and other people who used the service. One person told us that the staff were �brilliant� and provided them with the support they needed to take their medication and keep healthy and well. They also told us that they had a meeting once a week with staff to discuss and plan the meal choices and to find out if they had any concerns or complaints about living at the home.

During the inspection visit we observed that staff spent time listening to people and provided them the support they needed. We found that people were well cared for and received their medicines in a safe way. We saw that people received a nutritious diet and people told us that they enjoyed the food. We also found that staff working at the service had received robust recruitment checks, carried out by the provider to ensure the safety of people living at the home.

Inspection carried out on 21 November 2012

During a routine inspection

Most people had lived at Highfield for many years and staff said that they get on well with each other. Two people we spoke with confirmed that they were happy. One person said, "I like living here." Some people were not able to tell us what they thought but we saw that everyone was relaxed and related well to the staff on duty. Staff were knowledgeable about the needs of the people they supported. We found Highfield to be comfortable and well maintained throughout.

Inspection carried out on 20 March 2012

During a routine inspection

People said they liked living at Highfield. They told us the staff helped and supported them with life skills when they needed it. They said they were encouraged to be independent. One person commented, "I do a lot for myself. That makes me feel good."

Reports under our old system of regulation (including those from before CQC was created)