Highcroft Nursing Home

About the service

Highcroft Nursing Home is a care home which provides personal and nursing care for up to 23 people. Seventeen people were living at the service at the time of our inspection. The service is located in a large detached house, and all levels are accessible via a lift and external access.

People’s experience of using this service and what we found

We were assured that people were protected by the prevention and control of infection. This included staff safely using and disposing of personal protective equipment (PPE), safe visiting practices and isolation guidance which followed government guidance.

Medicines were safely managed and administered. People had individual plans for ‘when required’ medicines and regular checks took place to ensure medicines were managed in line with legal requirements.

People were protected from the risk of harm, and people’s relatives told us they felt their family members were very safe at Highcroft Nursing Home. Regular checks were carried out, and staff had received training in safeguarding and reporting concerns. There were enough staff to keep people safe, and staff knew people well.

Staff, relatives and people who lived at the service told us there was a positive culture which was person-centred, open, inclusive and empowering. This supported people to enjoy good health and wellbeing. People and relatives, we spoke with were very happy with the care they received. Staff we spoke with were proud of the care and service they provided and felt well supported by the management team.

There was effective communication and the management team understood their responsibilities. The service appeared organised and well run. Systems and processes were in place to regularly check quality and safety.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 20 March 2021).

Why we inspected

We carried out an inspection of this service on 25 November 2020, with follow up visits on 27 November and 10 December. Breaches of legal requirements relating to infection prevention and control were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment. At this inspection, we found improvements had been made and the provider was no longer in breach of regulations.

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service remains Good. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections, even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Highcroft Nursing Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Highcroft Nursing Home is a nursing home providing personal and nursing care for up to 23 people. At the time of the inspection 20 people were living at the home.

People’s experience of using this service and what we found

Risks relating to infection control were not all being managed safely. Staff were not all wearing their personal protective equipment (PPE) correctly. Some additional information was required for medicines administered on a ‘when required’ basis.

There were enough staff available to meet people’s needs. Staff were recruited safely. Medicines were stored securely and safely. Risks to people were identified and guidance was in place for staff to reduce the level of risk. Checks were in place to ensure the environment and equipment was safe.

People’s relatives and staff commented positively about the leadership and management of the service. Staff told us although they had experienced a difficult time, morale and teamwork remained good.

Governance systems were in place to monitor the quality of service and the health, safety and welfare of people. There were systems in place to communicate with people and relatives. People’s relatives were very complimentary about the care their family member received.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published August 2019).

Why we inspected

We received information of concern about infection control and prevention measures at this service. The provider had an outbreak of Coronavirus. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

We inspected and found there was a concern with infection control procedures, so we widened the scope of the inspection to become a focused inspection which included the key questions of Safe and Well-Led.

We have identified a breach in relation to safe care and treatment at this inspection.

Information about CQC’s response to the breach in regulations can be found at the end of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Highcroft Nursing Home on our website at www.cqc.org.uk.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Highcroft Nursing Home is a nursing home and was providing personal and nursing care to 21 people aged 65 and over at the time of the inspection. The service can support up to 23 people.

Highcroft Nursing Home is laid over three floors. The ground floor is made up of the kitchen, provider’s office, patio and area called the ‘parlour’; the parlour is an area with seating that is used for people to meet with their guests in a private setting. The first floor is made up of a dining room, lounge, bedrooms and the nurse’s office, there is also a communal bathroom and toilet. The second floor consists of a nurse’s station, communal bathroom and toilet, bedrooms and a garden area. There is a lift available for people, so they can access all floors.

People’s experience of using this service and what we found

People, staff and relatives spoke positively about the registered manager. People told us their experience of living in the home was positive and relatives confirmed this. Provider audits and checks were completed effectively and identified errors and omissions. The registered manager reviewed accidents, incidents and falls to identify themes and trends as a way of preventing a recurrence. Links with organisations in the local community included religious organisations and a school.

People told us they were supported by staff who were caring and supported them to retain their independence. People, and where appropriate, their relatives were involved with care planning and reviews. People’s privacy and dignity was respected. The registered manager ensured people were not discriminated against because of protected characteristics.

People received a service that was responsive to their needs. Staff supported people to maintain relationships that were important to them. Staff encouraged people to participate in activities they enjoyed. End of Life care was provided in a personalised way and family were invited to stay in the home when a person was nearing the end of their life. The provider made necessary adjustments to ensure people had access to information in different forms and relevant to their needs.

Care plans detailed people’s needs and provided guidance for staff about how to meet the needs of people. People told us they were supported by competent staff and the staff received training relevant to their roles. People spoke positively about the food, and those requiring a specialist diet were provided with food to meet their needs. People had access to drinks throughout the day and told us staff supported them to have enough to drink. People’s needs were met by the design and decoration of the home. Staff worked in partnership with healthcare professionals to achieve good outcomes for people.

At our last inspection we identified shortfalls in relation to the administration of medicines, we also found people’s personal emergency evacuation plans (PEEPS) did not include detail to guide staff about the support people required in an emergency. At this inspection we found the provider had acted and implemented changes in response to our findings. People told us they felt safe and received care in a safe way. Staff spoke confidently about actions they would take if abuse was witnessed or suspected. Risks were identified, and assessments guided staff about how they could lower the risk to people. Staff were recruited safely, and people told us there was enough suitably qualified staff to meet their needs. The provider acted to prevent the spread of infection, the premises were exceptionally clean. When things went wrong, actions were taken to prevent a recurrence.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection Good (Published January 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Highcroft nursing home provides care for older people with nursing and personal care needs. At the time of the inspection there were 22 people living at the home. Accommodation is arranged over three floors. It has a lounge, a dining area, manager’s office, nurse’s station, the ground floor had an additional lounge, kitchen and admin office. There is a drive way at the front and a patio area.

There was a registered manager in post who was also the provider. 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’s medicines were not always kept secure. We found although the medicines trolley was kept secure and locked in between administering medicines. Whilst people were being administered their medicines the trolley was left open and unlocked meaning people's medicines were left unsafe and could be access by anyone within the building. People’s medicines administration charts (MARs) were being signed before the person had been administered the medicines. This meant if the person chose not to take their medicines then the chart would need to be altered to accurately reflect that the medicines had not been administered.

People’s care plans contained detailed, accurate and informative risk assessments in relation to their individual needs.

People felt safe in the home and received support from staff who had appropriate checks in place prior to commencing their employment.

People were supported by adequate staffing levels and staff supported people in a kind and caring manner.

Staff received regular supervision and training to ensure they were competent and skilled to meet people’s individual care needs.

Staff felt happy and supported but the management of the home.

People were happy with the meals and had various choices each meal time.

People’s care plans confirmed if people were unable to make decisions relating to their care and treatment although people’s records could be improved with the information being in one part of the persons care plan. The principles of The Mental Capacity Act were being followed.

People were supported to maintain relationships with friends and family.

The home had a separate dining area that people could use if they wished and people booked it to have meals and parties with their friends and family.

People were supported by staff who gave people choice and control in their care and support.

People could access a range of activities each week and people were positive about what was available to them. Activities such as singing, exercise classes and aromatherapy were offered and people could have daily newspapers delivered to the home which was organised by the home.

People felt able to make a complaint to the registered manager should they need to do so.

People and relatives were involved in planning their care.

The provider had quality assurance systems in place that identified areas for improvement so that areas of improvement could be identified and planned for the forthcoming year.

People, relatives and professionals views were sought so that improvements could be identified feedback received was overall positive about the care provided and received.

We noted some people were unable to communicate with us and we observed staffs understanding of the care and support needed. We spoke with people who used the service and a family member who said that they "can't fault staff" and they are "very very nice." People told us they liked their bedroom which were tastefully decorated with their personal belongings for example "family photographs."

We looked at people's individual files which incorporated their personal profile, care plans and risk assessments and found that they encompassed the safety and well-being of people who used the service.

People who used the service told us that they knew how to raise a concern or complaints and felt confident in doing. They said if they had any issues or concerns they could "tell staff" or speak to the manager.

Staff told us they were supported by management and had received all relevant training. We saw staff were supervised regularly and were appraised annually. The quality of the service was monitored through regular audits. People who used the service, family and their representatives were given the opportunity to give feedback regarding the running of the service.

We observed staff being respectful and sensitive to people's needs. Giving people time to make decisions and gently encouraged to do things. One person told us that they are 'very good staff, we just have to ring and they come straight away' and another 'It's wonderful here staff are always ready to help you'.

We saw comprehensive and detailed care plans and risk assessments that were regularly reviewed and up to date policies and procedures.

We observed people at lunch time. People we spoke with told us that the food is 'good'. One person told us that we have 'good food, we have a choice of food and I can ask for something else if I don't like the choice on the menu'. We saw that people have a choice of where they would like to eat and staff are sensitive to individual preferences.

During lunch time we observed people given their medication. The medication and dosage was explained to the person and they were encouraged to take this when they were ready.

Staff told us that they have regular training and supervision and they received good support from the manager.