Background to this inspection
Updated
5 September 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
One inspector and an expert by experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type: Highbury House Nursing Home is a care home with nursing. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection: This inspection was unannounced.
What we did:
Before the inspection, we reviewed:
• Information we had received about the service since the last inspection. This included details about incidents the provider must notify us about, such as abuse.
• Feedback from the local authority and professionals who work with the service.
• We assessed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection:
• We spent time with people in the communal areas of the home and in their rooms and we saw how staff supported the people they cared for.
• We spoke with five people who lived at the home, to gain their views about the care provided.
• We also spoke with the registered manager, seven care and senior staff and a domestic staff member.
• We reviewed a range of records. This included two people's care records and multiple medication and records, and records about safeguarding people’s liberty and freedoms.
• We also looked at records relating to the management of the home. These included systems used to check the quality of the care provided, such as residents and relatives surveys. We also checked how complaints and any accidents and incident were managed. In addition, we saw checks made on medicines administered, and checked the systems in place to manage Deprivation of Liberty Safeguards.
Updated
5 September 2019
About the service: Highbury House Nursing Home is a care home that was providing personal and nursing care to 20 people at the time of the inspection. Care is offered to people living with learning disabilities, mental health needs, including those detained under the Mental Health Act, sensory impairments and people who misuse drugs and alcohol. Care is offered to both younger adults and older people.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 21 people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the local area. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service:
• Services that provide health and social care to people are required to inform the Care Quality. Commission (CQC), of important events that happen in the service. Provider checks had not identified this did not always happen promptly, and the registered manager had not understood all their responsibilities to notify CQC of some important events.
•People told us they considered Highbury House Nursing Home to be their home and were positive it was managed and the care provided.
• People and staff told us they saw the registered manager often and found them approachable.
• Staff knew people’s health and well-being needs well, and acted as advocates for people, which helped to ensure people’s health and well-being needs were met.
• There were sufficient staff to care for people at times people wanted assistance.
• Staff understood risks to people’s safety and supported them to stay as safe as possible.
• People were supported to have their medicines safely and checks were undertaken to ensure these were administered as prescribed.
• The risk of infections and accidental harm was reduced, as staff used the knowledge and equipment provided to do this.
• People had developed strong bonds with the staff who cared for them, and enjoyed expressing their affection for staff. People were confident to ask for assistance and reassurance from staff when they wanted this, and staff took time to provide this in the ways people preferred.
• Staff knew what was important to the people they cared for and spoke warmly about them, and ensured their rights to dignity, independence and privacy were respected.
• People made their own decisions about their lives and care. Where people needed support to make some decisions staff assisted them, using people’s preferred ways of communicating.
• Staff had received training and developed the skills they needed to care for people, through induction and on-going training. People told us staff knew how to help them.
• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this.
• Staff ensured people had opportunities to do things which they enjoyed and which responded to their individual needs.
• The views of people and other health and social care professionals were considered when people’s care was assessed, planned and reviewed, so people’s needs continued to be met.
• Systems were in place to take any learning from complaints and to further improve people’s care.
• People’s wishes for their care at the end of their lives had been planned and the views of their relatives considered.
• The registered manager and provider checked the quality of the care provided and developed the service, and people’s individual care, based suggestions from people and staff.
• The registered manager kept up to date with best practice developments, so they could improve the care provided further.
• We found the service met the characteristics of a “Requires Improvement” overall.
Rating at last inspection: Good. The last report for Highbury House Nursing Home was published on 24 December 2015.
Why we inspected: This was a planned inspection based on the rating at the last inspection.
Enforcement: Full information about CQC's regulatory response to concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk