Highbury Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained the same. This meant people’s needs were not always consistently met.

This service scored 54 (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 made improvements in ensuring people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. However, we found inconsistencies in how well people’s assessments considered and addressed their needs. We found some examples of care plans not being updated in line with people’s changing needs, whilst other care plans were accurate. Reviews of incidents and accidents did not always result in care plans being updated accurately.

People’s care plans had been developed with them to reflect their needs and preferences. Where we did identify some aspects of people’s care plans which required updating, the registered manager took immediate action to update the care plan.

Staff we spoke with could tell us about people’s preferred routines and their likes and dislikes. A notice board in the ground floor hallway included a photograph and welcome message to the person who had most recently moved into the home. This told everyone a little about the person’s story and helped them to understand more about their individual needs and preferences. Work had been done to improve and personalise people’s bedrooms.

The provider’s understanding of people’s diverse care needs was not always consistent.

Guidance for staff on a specific health condition was not sufficiently detailed for two people living at the service. The management team did not have a good understanding of people’s care needs in these specific cases. This meant in the event of people needing emergency care or being transferred to another care provider, there was a risk people may not get the support they needed.

However, the staff and management team were knowledgeable and had a good understanding of other care needs people had. We saw examples of good joined up care with other health care services. This meant people had in some cases, benefited from the right care at the right time because staff understood their needs.

The provider did not always supply people with appropriate, accurate and up-to-date information

The provider had failed to ensure they were complying with data protection laws. People had not been given information about the CCTV in the home, appropriate signage was not in place, and they were being recorded without their consent or knowledge. However, we saw other examples of effective information sharing in accessible ways. For example, meal options were presented with pictures to help people living with dementia understand their choices. We saw posters in each person’s room displaying a photograph of their key worker and their name. The poster also explained clearly the role of the key worker so people understood how they could help them. Information about how to complain was presented in large print with simple instructions throughout the home. Additionally, information about the role of the safeguarding team and how to contact them was available in an accessible format in each person’s room.

Although systems were in place to receive, investigate and respond to people’s concerns and complaints, they were not consistently responded to.

Efforts had been made to clearly communicate the provider’s complaint process and procedure to people and their relatives. People we spoke with knew how to raise a complaint. However, we saw examples where concerns had been raised but not investigated or responded to fully and effectively. For example, records showed a person had complained about the care they had received. Documentation around the complaint showed missed opportunities to ensure the person had not been subject to abuse. We did see other examples where people’s complaints had been investigated and responded to appropriately.

The provider had put in place other means to gather people’s feedback and opinions. For example, people and relatives were invited to complete surveys to give their views on the service. Meetings were held with relatives and people living at the home to discuss ideas for service improvements. We saw examples of changes made to people’s care as a result of feedback given. For example, it was identified that some people were struggling to communicate effectively with their key workers. Changes were made to people’s allocated key workers to ensure everyone could communicate as well as possible.

The provider made sure that people could access the care, support and treatment they needed.

The building had been adapted to ensure people could move around the home safely. With the exception of an airflow mattress which did not fit the bed frame, equipment to support people’s mobility needs was checked and maintained to ensure its safety. For example, hoists and wheelchairs were maintained to ensure they were safe for people to use. A room which was larger had been adapted so that it could provide specialist bariatric care if needed. Technology was used to alert staff if people who may need support got up during the night. People who preferred to remain in their room or be cared for in bed, had the option to leave their room if they wished because the equipment was available to support them.

Staff and leaders gathered information about people who are most likely to experience inequality in experience or outcomes and tailored their care. However, in practice people did not always consistently experience equally good outcomes.

For example, most people’s beds, bed rails and bumpers had been risk assessed and were new and well maintained. However, 1 person’s bed did not fit their mattress. The risk this posed to that person had not been considered and was missed as part of regular environmental checks in the home. We found no evidence of deliberate discrimination in how people’s rights were protected and their views considered. The inconsistencies resulted from a lack of oversight and governance to ensure people received a consistently effective level of support.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Care records showed that people were consulted about their future care wishes. Documentation had been completed detailing how they would like to be supported in the event of needing emergency care. People’s wishes about end-of-life care were also reviewed and documented. This information was available for nurses to access easily in the event of an emergency. People had medicines available for future need to help them manage any possible pain. Staff received training in supporting people with care at the end of their lives.