Highwell House Care Home with Nursing

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 outstanding. At this assessment the rating has remained outstanding. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 89 (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 was exceptional at making sure 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.

Staff demonstrated exceptional commitment, knowledge and enthusiasm in delivering personalised care. This was underpinned by strong leadership from the registered manager, who promoted a culture where people were consistently supported in ways that reflected their individual needs, preferences and what mattered most to them. A relative told us the manager had explained that while staff could not change a person's health diagnosis, they could adapt the way care and support were provided to ensure the person's needs and wishes continued to be met.

We observed people receiving highly person-centred care that was responsive to their individual needs, preferences and circumstances. Activities and daily support were tailored to reflect people's interests, hobbies and life experiences, helping to ensure opportunities for meaningful engagement and wellbeing. For example, staff supported one person to maintain regular contact with a close family member who was no longer able to visit independently due to a change in circumstances. To support this important relationship, staff facilitated weekly visits and had also arranged a family trip to the seaside, enabling them to spend quality time together and create valued memories.

People were at the centre of the care and support they received. They, and their family members where appropriate, were involved in creating care plans and making decisions about any changes to their care and support as their needs and wishes changed. People told us they regularly spoke with staff about their support and felt involved in the process. One person told us they reviewed their support needs with staff on a regular basis and felt listened to. A relative said, "They are very open about how (name) is cared for and supported. They tell us about any changes, and we discuss them together."

Care plans were detailed and person-centred, reflecting a holistic approach to care and support. They clearly identified people's strengths, needs, preferences and goals, and focused on enabling them to live fulfilling lives, maintain independence, and achieve the outcomes that mattered most to them.

This approach was evident in the support provided to 1 person living with a severe health condition. Staff recognised that when the person became unwell, increasing anxiety often worsened their symptoms and contributed to a higher risk of hospital admission. Rather than responding only when the person's health deteriorated, staff took a proactive and person-centred approach. Working closely with healthcare professionals, they developed a tailored plan that reflected the person's preferences and gave them confidence in how their condition would be managed. As a result, the person felt reassured, safe and more in control during episodes of ill health. This significantly reduced their anxiety, improved their overall wellbeing and helped to reduce the likelihood of hospital treatment. This example demonstrated how staff went beyond meeting people's immediate care needs and used a personalised approach to achieve meaningful improvements in people's quality of life and health outcomes.

The provider had an exceptional understanding of the diverse health and care needs of people and the local community they served. Care was joined-up, flexible and responsive, supporting people to experience continuity, maintain choice and achieve positive outcomes.

There was strong evidence of effective partnership working with a wide range of health and social care professionals to ensure people received coordinated and responsive care. Records demonstrated regular involvement from services including GPs, Parkinson's specialist nurses, physiotherapists and community nurses. These relationships enabled staff to access specialist advice promptly and adapt support in line with people's changing needs. This supported the registered manager's aim of avoiding unnecessary hospitalisation by taking a proactive approach to people's health needs.

The provider had established strong arrangements with the local GP surgery, who carried out weekly visits to the service. Feedback from the surgery was highly positive. Professionals described staff as proactive in identifying concerns, seeking advice and implementing recommendations to achieve the best possible outcomes for people. They told us staff worked collaboratively and maintained clear communication, ensuring people's health needs were effectively monitored and managed.

One example of the positive impact of integrated working involved a person who was newly admitted to the service following a prolonged period of poor dietary intake linked to their health condition. Staff quickly recognised the significant risks associated with the person's weight loss and increasing frailty and took a proactive approach to coordinating support. Rather than relying solely on routine referrals, they brought together a range of healthcare professionals, alongside the person and their relatives, to develop a personalised nutritional plan tailored to the person's needs, preferences and longer-term goals.

Staff played a central role in coordinating advice from different professionals, ensuring recommendations were implemented consistently, reviewed regularly and adapted in response to the person's progress. They also worked closely with relatives, helping them to better understand the person's condition and empowering them to play an active role in achieving agreed outcomes. This collaborative approach ensured everyone involved was working towards goals that were meaningful to the person.

The impact was significant for both the person and their family. The person gained a substantial amount of weight, their appetite improved and they became increasingly engaged at mealtimes. As their physical health improved, they were able to participate more fully in daily life and social activities, resulting in greater confidence, improved wellbeing and a better quality of life.

The person's relatives also benefited from the support provided. Increased understanding of the person's condition and regular involvement in care planning reduced feelings of uncertainty and isolation, enabling them to feel more informed, reassured and optimistic about the future. This demonstrated how staff went beyond simply coordinating services. They acted as effective advocates and partners, bringing people together around shared goals, strengthening family involvement and achieving meaningful and sustainable improvements in outcomes, wellbeing and relationships.

People and their relatives consistently described a well-coordinated service delivered by a stable staff team. This consistency enabled staff to develop positive relationships and an understanding of people's preferences and support needs. Professionals also recognised the benefits of this continuity. One professional told us, "The staff know the residents well, which in turn means we know them well. It makes a huge difference to the care and support provided."

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider and staff understood their responsibilities under the Accessible Information Standard (AIS), which requires care providers to ensure information and communication are provided in ways that meet people's needs and can be understood.

People's communication needs were identified during the assessment process and clearly recorded within their care plans. Staff had access to detailed guidance and consistently adapted their communication to meet people's individual needs, helping to ensure they could understand information and express their views and choices.

A range of visual prompts were used throughout the service to support people's independence and understanding. These included clear signage for bathrooms, toilets and garden areas, as well as noticeboards displaying daily activities and menus.

The provider was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff always involved people in decisions about their care and told them what had changed as a result.

Staff invested time in building positive relationships with people and getting to know their life histories, interests and what was important to them. Through these conversations, they learned that one person had particularly enjoyed reading stories to children in the past. Recognising the significance of this for the person, the provider arranged for local schoolchildren to visit the service and spend time listening to stories told by them. Staff reported that the children were fully engaged in the activity, and that the person clearly enjoyed the opportunity to share their stories and experiences. Following the visit, the person spoke warmly about how the experience had brought back happy memories of reading to family members when they were younger. This experience provided the individual with a meaningful opportunity that reflected their interests and life experiences, allowing them to enjoy positive social interaction and reminisce.

The provider and staff had created a culture where listening to people was a central part of how the service operated. A range of methods were used to seek and act on feedback, ensuring people's views, experiences and preferences shaped the care and support they received. Initial assessments were thorough and tailored to each individual's needs, helping to ensure support was planned around what mattered most to them from the outset.

Relatives described being fully involved in the assessment and planning process. One relative told us the transition into the service involved ongoing discussions and several visits from the registered manager to the person's home. The person was also supported to visit Highwell House before moving in, allowing them to become familiar with the environment and the staff who would be supporting them. The care plan was shared with both the person and their relative before care commenced, giving them the opportunity to review the information, make changes and add any additional details. This collaborative approach helped ensure people felt listened to, reassured and confident that their care would reflect their individual needs and wishes.

People were regularly encouraged to share their views and contribute to the ongoing development of the service. A variety of forums were used to gather feedback, including resident meetings, relatives' meetings and staff meetings, providing regular opportunities for open discussion and engagement. The provider also sought feedback through surveys completed by people, relatives and staff. Feedback was carefully reviewed and analysed to identify themes, understand people's experiences and highlight opportunities for improvement. The provider acted on the findings and shared the changes made as a result, demonstrating a commitment to listening and responding to people's views. This helped ensure the service continued to develop in line with people's needs, preferences and desired outcomes, with people able to see how their feedback directly influenced improvements to the support they received.

For example, through the survey some people expressed that they would like to better understand the medicines they were taking. In response, medication passports were made available to anyone who wanted one, providing people with accessible information about their medicines. The nursing team also offered dedicated time to discuss people's medication, answer questions and address any concerns. This helped people feel more informed, involved and confident in decisions about their health and treatment, supporting them to take a more active role in their care.

The provider and staff not only sought people's views but acted on them in meaningful ways, ensuring people remained at the centre of decisions and experienced positive outcomes that enhanced their independence, wellbeing and quality of life.

The provider ensured people could access the care, support and treatment they needed in a timely way.

Accessibility and inclusion had been considered when planning and delivering care. People’s individual needs were assessed prior to admission, including their ability to mobilise safely and how their independence could be maximised while managing identified risks. For example, the layout of the home and the availability of adaptations, such as a lift, handrails and accessible bedrooms, enabled people to maintain their independence safely and in line with their needs. Care plans reflected people’s individual requirements and identified any reasonable adjustments needed to ensure equitable access to care and support.

Records demonstrated that people had access to a range of healthcare professionals, including emergency services, when required. The management team operated an on-call system, providing staff with access to advice, guidance and support during emergencies or other unforeseen situations, helping to ensure people received timely and appropriate care.

Staff and leaders actively listened to information about people who may be at greater risk of experiencing inequalities in their care or outcomes and tailored care, support and treatment to meet their individual needs.

People’s care plans contained clear, personalised guidance for staff, demonstrating consideration of protected characteristics and individual preferences. This helped ensure people’s communication needs, cultural backgrounds and religious beliefs were recognised and respected in the delivery of care. Detailed planning supported staff to meet people’s needs consistently and in accordance with their wishes, while promoting wellbeing, independence and quality of life.

Staff had completed Equality, Diversity and Inclusion training and demonstrated a commitment to helping people achieve their desired outcomes. This included supporting people to participate in meaningful activities, pursue personal interests and access new opportunities and experiences.

People were given exceptional support to plan for important life changes, enabling them to make informed decisions about their future care, including their wishes and preferences at the end of their lives.

Feedback from relatives and professionals consistently reflected the exceptional quality of support provided. One family member told us, "(Name's) end-of-life care was exceptional. Everyone should have the care (Name) had at the end of their life." A healthcare professional shared this view, telling us, "The approach to end-of-life care is exceptional."

The provider worked closely with healthcare professionals to make sure people's nursing needs were met. When people developed new or more complex health needs, senior staff received additional training and support to ensure they had the skills and knowledge required to provide safe and effective care. For example, the provider worked with St Michael's Hospice to develop staff competence in the safe administration of pain relief medication and the delivery of palliative care. This helped ensure people received care that reflected current best practice and met their changing needs.

Staff supported people to have open and sensitive discussions about their future wishes, which were reflected in personalised and comprehensive advance care plans. People's individual preferences, values and choices were clearly documented and regularly reviewed to ensure they remained relevant and accurately reflected their wishes. This ensured people remained in control of decisions about their care and support.

The provider demonstrated a long-standing commitment to excellence in end-of-life care, maintaining Gold Standards Framework accreditation for a number of years and achieving the highest Platinum status. During their 2025 assessment, the service was nominated for Care Home of the Year by their assessor, reflecting the exceptional quality of care provided. This prestigious national recognition highlights organisations that demonstrate outstanding practice in supporting people at the end of their lives.

The provider fostered a culture of compassion that extended beyond meeting people's clinical needs. Staff were committed to ensuring people and those important to them experienced the highest standards of care, dignity and support during the final stages of life. People's wishes were explored in detail, and every effort was made to fulfil these, helping them achieve the best possible experience at the end of their lives. Relatives and friends were also provided with ongoing emotional and practical support, ensuring they felt valued, included and cared for throughout the person's journey.