Background to this inspection
Updated
17 November 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
Two Inspectors 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
Highfield Hall is a ‘care home.’ People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Highfield Hall is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
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.
Inspection activity started on 22 September 2022 and ended on 3 October 2022. On 26 September 2022 we spoke with the audit and compliance officer. On 3 October 2022, we spoke with relatives by telephone.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
At the time of the inspection visit we spoke with one person who used the service, three care staff, the registered manager and one relative. After the inspection visit, we spoke with the audit and compliance officer and five relatives. The majority of people who used the service were unable to tell us about their experiences of living in the home. However, we observed staff's interaction with people.
We reviewed a range of records. This included three people's care records and a random selection of medication records. We looked at a variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
17 November 2022
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Highfield Hall is a residential home. They were providing personal care to 18 people at the time of the inspection. The service supports adults with learning disabilities and autism.
The home is divided into three units, the Hall, Abbey View and Kingston each providing bedrooms, a lounge/dining area, kitchen and a bathroom. People had access to a large garden area and an allotment.
People’s experience of using this service and what we found
Right support
People were not always supported by staff to pursue their interests.
People did not always receive care and support in a safe, clean, and well-maintained environment.
Staff enabled people to access specialist health and social care support in the community.
Right Care
The service did not always have enough appropriately skilled staff to meet people’s needs. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.
Right Culture
People did not always lead inclusive and empowered lives because there was not always enough staff on duty to support them.
Staff did not ensure risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.
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 requires improvement published 15 April 2020. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This was a planned inspection based on the previous rating.
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.
As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to regulation 12, Safe care and treatment and regulation 17, Good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.
You can see what action we have asked the provider to take at the end of this full report.