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Teamcare Limited t/a Highcliffe Residential Home Good

Inspection Summary


Overall summary & rating

Good

Updated 5 December 2017

The inspection visit took place on 24 and 25 October 2017. The first day of the inspection was unannounced.

Highcliffe Residential Home is located in Whittle le Woods near Chorley in the county of Lancashire. The home is registered to provide accommodation and support for up to 24 people and cares for elderly people including those living with dementia. At the time of our inspection 23 people were using the service.

There was a registered manager in place who had been registered since 26 October 2012. 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.

At our previous inspection on 8 and 9 September 2016 we found several breaches of legal requirements. We found that some records related to medicine management could be improved. Potential safeguarding concerns were not being reported to the local authority and some care plans did not contain important information about people.

We also recommended that risk assessments were individualised particularly around the use of bed rails, that reviews were completed around do not attempt resuscitate (DNAR) documents and that audits at the home were reviewed to ensure that they picked up on issues found at the inspection.

In addition, it was noted that in some cases staff had not received refresher training for up to three years.

We asked the provider to make improvements in all of these areas and they kept CQC informed of the changes that had been made.

At this inspection we found that significant improvements had been made in most these areas.

We found that medicine’s record keeping had improved but that some management issues around controlled drugs were ineffective and could give rise to issues. This has resulted in a recommendation in the 'well-led' section of this report.

At this inspection we noted that any incidents that may have given rise to safeguarding concerns had been reported appropriately.

Risk assessments were personalised to reflect individual risks and support needs and audits were being completed that were effective in highlighting issues and concerns to management.

All training was up to date and there was a program in place to regularly provide staff with refresher training that the service deemed to be important.

People using the service said they felt safe and that staff treated them well. There were enough staff on duty and deployed throughout the home to meet people’s care and support needs. Safeguarding adult’s procedures were robust and staff understood how to safeguard people they supported. There was a whistle-blowing procedure available and staff said they would use it if they needed to. Appropriate recruitment checks took place before staff started work.

We found that people and their relatives, where appropriate, had been involved in planning for their care needs. Care plans and risk assessments provided clear information and guidance for staff on how to support people using the service with their needs. There was a range of appropriate activities available for people to enjoy. People and their relatives knew about the home’s complaint’s procedure and said they were confident their complaints would be fully investigated and action taken if necessary.

The registered manager conducted regular checks to make sure people were receiving appropriate care and support. The registered manager took into account the views of people using the service, their relatives and staff through meetings and surveys. The results were analysed and action was taken to make improvements at the home. Staff said they enjoyed working at the home and received appropriate training and good support from the registered manager.

Inspection areas

Safe

Good

Updated 5 December 2017

The service was safe.

People were receiving their medicines as prescribed by health care professionals.

People told us they felt safe and well cared for.

There were arrangements to deal with emergencies and staff were aware of signs of abuse and what action they should take. There was a whistle-blowing procedure available and staff said they would use it if they needed to.

There were arrangements in place to deal with foreseeable emergencies.

There were enough staff deployed within the service and appropriate staff recruitment procedures were in place.

Effective

Good

Updated 5 December 2017

The service was effective.

Staff had completed an induction when they started work and received training relevant to the needs of people using the service.

The provider supported people to eat and drink sufficient for their needs and to protect against the risks of inadequate nutrition and dehydration.

Staff sought consent from people when offering them support. The registered manager and staff understood the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and acted according to this legislation.

People had access to a wide range of healthcare services to ensure their day to day health needs were met.

Caring

Good

Updated 5 December 2017

The service was caring.

Staff spoke with people in a respectful and dignified manner.

Staff knew people well and were aware of their preferences and routines.

People and their relatives were involved in making decisions about their day today care.

There were arrangements in place to meet people’s end of life care needs.

People's records were held securely and confidentially.

Responsive

Good

Updated 5 December 2017

The service was responsive.

People’s needs were assessed and care files included detailed information and guidance for staff about how their needs should be met.

People were provided with a range of appropriate activities.

People knew about the home’s complaint’s procedure and said they were confident their complaints would be fully investigated and action taken if necessary.

Well-led

Requires improvement

Updated 5 December 2017

The service was not always well-led.

Although there were arrangements in place for monitoring the quality and safety of the service, they were not always effective in identifying a medicine’s issues seen at the inspection.

Staff said they enjoyed working at the home and received good support from the management team.

There was an out of hours on call system in operation that ensured that management support and advice was available to staff when they needed it.

The provider and registered manager sought feedback from people to improve service delivery.