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Inspection Summary


Overall summary & rating

Good

Updated 12 August 2017

This inspection visit took place on the 27 and 28 June 2017 and was unannounced. At the last inspection on 24 August 2016, the service was rated as requires improvement. We made a recommendation that the provider should review their staffing levels against people’s individual needs to ensure there are sufficient staff at all times. Improvements were also needed to ensure the staff followed legislation when they supported people with decision making and to ensure the systems used to monitor the quality of the service were consistently effective. At this inspection visit we found the provider had made improvements however some further action was still needed.

Highfield Hall provides accommodation and personal care for up to 21 people with learning disabilities. The service is provided in three units which comprise Abbey, Kingston and the main Hall. One the day of our inspection visit, 20 people were living at the home.

There had not been a registered manager at the service since February 2016. However, the acting manager had recently applied to register with us. 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 received their medicines when they needed them. However, some improvements were required to ensure the systems used to monitor the recording of medicines were effective in identifying and correcting inaccuracies. People and their relatives were asked for their views on the service but there were no systems in place to demonstrate how this feedback was used to make improvements in the service.

People felt safe living at the home and their relatives were confident they were well cared for. If they had any concerns, they felt able to raise them with the staff and acting manager. Risks to people’s health and wellbeing were assessed and managed and staff understood their responsibilities to protect people from the risk of abuse. The provider ensured there were sufficient, suitably recruited staff to keep people safe and promote their wellbeing. Staff received training so they had the skills and knowledge to provide the support people needed. Staff felt supported and valued by the acting manager.

Staff gained people’s consent before providing care and support and understood their responsibilities to support people to make their own decisions. Staff acted in accordance with the legal requirements where people were unable to make their own decisions.

Staff knew people well and encouraged them to have choice over how they spent their day. Staff had caring relationships with people and promoted people’s privacy and dignity and encouraged them to maintain their independence. People had sufficient amounts to eat and drink to maintain a healthy diet. People were supported to access the support of other health professionals to maintain their day to day health needs.

People received personalised care from staff who knew their preferences and were offered opportunities to join in social and leisure activities. People were supported to maintain important relationships with friends and family and staff kept them informed of any changes. People’s care was reviewed to ensure it remained relevant and relatives were invited to be involved.

Inspection areas

Safe

Good

Updated 12 August 2017

The service was safe.

Improvements had been made and there were sufficient, suitably recruited staff to meet peole’s needs. Risks to people’s safety were assessed and managed and staff knew how to keep people safe. People received their medicines as needed.

Effective

Good

Updated 12 August 2017

The service was effective.

Improvements had been made and the provider was acting in accordance with legal requirements where people lacked the capacity to make decisions. Where people were being deprived of their liberty in their best interests, the correct authorisations had been applied for. Staff received the training and support they needed to care for people. People received sufficient amounts to eat and drink and had their health needs met.

Caring

Good

Updated 12 August 2017

The service was caring.

Staff had caring relationships with people and respected their privacy and dignity. People were able to make decisions about their daily routine and staff encouraged them to remain as independent as possible. People were supported to maintain important relationships with family and friends who felt involved and were kept informed of any changes.

Responsive

Good

Updated 12 August 2017

The service was responsive.

People received personalised care from staff who knew their needs and preferences. People were supported to take part in activities and follow their interests. People’s care was reviewed to ensure it remained relevant and relatives were invited to attend reviews. People and their relatives were able to raise any concerns and complaints and these were acted on.

Well-led

Requires improvement

Updated 12 August 2017

The service was not consistently well led.

The provider had made improvements to the quality assurance systems used to drive improvements in the service. However, further improvements were needed to ensure checks of medicines were effective in identifying shortfalls and making improvements. People and their relatives were encouraged to give their feedback on the service but there were no systems in place to demonstrate how this was used to make improvements. Staff felt valued and supported in their role.