The Highviews

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good. This meant people were safe and protected from avoidable harm.
 

This service scored 75 (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 a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People told us they were supported by the staff team, and that staff learned from any safety events that happened. A relative told us, “I feel that my [relative] is as safe as can be living at The Highviews. Unfortunately, he had a few falls last year. I was informed immediately and I couldn't fault the aftercare he received. We all worked together with different suggestions to enable his future safety.”

Staff provided support in a safe and calm way. Staff followed safety guidelines as required. Staff were encouraged to report incidents. Staff we spoke with told us the processes they followed to record safety events.

Incidents and accidents were reported. Actions arising from incidents were transferred into care plans to inform staff how to reduce the risk of an incident happening again. Incidents were investigated and we saw examples in records.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People said the service supported them to attend external appointments, such as hospital appointments. People told us they had access to GP services. Records showed people were reviewed by health professionals, when required.

Staff told us they worked well with health and social care professionals and had developed good working relationships. We spoke with health professionals who worked with the service. They said they had a good relationship with the staff. One professional said, “I have had very positive experiences of the service, and I am confident that it keeps people safe and provides care and support which meets their assessed needs. I feel that they now understand their safeguarding duties including when to raise concerns, and why it is safe and appropriate to follow the guidance of professionals.” There were clear processes to ensure people’s current information was safely shared with health and social care professionals.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People we spoke with told us they felt safe. A relative told us, “There will never be anywhere that is 100% safe, but I feel Highviews at this present time is as close as it gets.”

Staff had been trained and understood their responsibilities to keep people safe. There was a safeguarding and whistleblowing policy that gave staff clear guidance to follow in the event they needed to refer any concerns to the local authority. Referrals had been made to the local safeguarding team appropriately. We checked whether the service was working within the principles of the Mental Capacity Act, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. All legal applications had been made in accordance with Deprivation of Liberty Safeguards (DoLS). This meant people’s rights were fully respected. The manager kept a record of DoLS applications and authorisations, and this was regularly reviewed to make sure authorisations were current.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People did not raise any concerns about how their risks were managed. Potential risks to people’s health and welfare had been assessed and risk assessments had been reviewed regularly. For example, people accessed the local community, had volunteer work opportunities and were supported to make what could be considered unwise decisions.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People did not raise any concerns about the environment. The environment was clean, and a routine maintenance programme was in place. Staff were able to report any maintenance requirements. Equipment that we looked at was fit for purpose, in good condition and clean.

We reviewed records of checks carried out to ensure the premises were safe. This included gas, electrical and fire safety checks. Regular checks of equipment were carried out. Personal evacuation plans were in place. These had been regularly reviewed to reflect people’s support needs in the event of needing to evacuate the building in an emergency.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People and staff were positive about staffing levels, and our own observations supported this. Staff attended to people in a timely manner. Staff did not appear rushed and took their time with people. A member of staff told us, “We have enough staff and we use bank staff too. We sometimes use agency staff if we need extra support for outings.”

Staff had the skills to meet people’s physical and mental health needs. Staff told us they attended training specific to their roles, including medicines management and safeguarding people from abuse. Safe recruitment processes were followed. There was a process in place for staff to receive regular supervision. There was oversight of staff training at manager and provider level.
 

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People and staff told us the service was clean, and our own observations supported this. Staff had received appropriate training, and we observed staff following infection control procedures. There were stocks of personal protective equipment (PPE) available for staff to use. There were effective processes to prevent and control infection. Regular infection prevention control audits had been carried out. These included audits of the environment, equipment, and staff spot checks.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Previous areas requiring improvement identified at the last inspection had been met in respect to the management of medicines. Staff were trained in the administration of medicines. A member of staff described how they completed the medicine administration records (MAR). We saw these were accurate. They also showed us how they ensured that stock levels of medicines were accurate. People told us they had no concerns about their medicines, one person said, "The staff help me with my medicine."

Regular auditing of medicine procedures had taken place, including checks on accurately recording administered medicines as well as temperature checks of medicines storage areas. This ensured the system for medicine administration worked effectively and any issues could be identified and addressed. Medicines were stored appropriately and securely, in line with legal requirements. We checked that medicines were ordered appropriately and medicines which were out of date or no longer needed were disposed of safely.