Archived: Highfield

Highfield [the service] is a care home with nursing for 55 people over the age of 18 with a physical disability. Some people who use the service are living with dementia. There are two floors and people with nursing or residential needs lived on the ground floor and people living with dementia were on the upper floor. We found there were 25 people with nursing or residential needs and 14 people living with dementia in residence, at the time of this inspection.

People in care homes receive accommodation and personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

At the last inspection, the service was rated Good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

People told us they felt safe and were well cared for. The provider followed robust recruitment checks, to employ suitable people. There were sufficient staff employed to assist people in a timely way. Medicine management practices were being reviewed by the registered manager and action was taken to ensure medicines were given safely and as prescribed by people’s GPs.

Staff had completed relevant training. We found that the nurses and care staff received regular supervision and yearly appraisals, to fulfil their roles effectively.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

People were able to talk to health care professionals about their care and treatment. People could see a GP when they needed to and they received care and treatment when necessary from external health care professionals such as the district nursing team and speech and language therapists (SALT).

People had access to adequate food and drinks and we found that people were assessed for nutritional risk and were seen by the SALT team or a dietician when appropriate. People who spoke with us were satisfied with the quality of the meals.

People were treated with respect and dignity by the staff. People and relatives said staff were caring and they were happy with the care they received and had been included in planning and agreeing the care provided.

People had access to community facilities and the range of activities provided in the service ensured people could engage in stimulating and interesting social activities.

People and relatives knew how to make a complaint and those who spoke with us were happy with the way any issues they had raised had been dealt with.

People told us that the service was well managed and organised. People and staff were asked for their views and their suggestions were used to continuously improve the service.

Highfield provides accommodation with nursing and personal care for up to 55 older people, some of whom are living with dementia. The service is split in to two units with nursing care provided on the ground floor and dementia care on the 1st floor. The home is located near the village of Barkston Ash, approximately five miles from Tadcaster, in North Yorkshire. It is a two-storey building, set in it’s own extensive grounds, with a view of a lake and wooded areas for people to enjoy. Highfield currently provides a service to 37 people.

There was a registered manager in post at the time of our inspection. 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 told us they felt safe at the service. Staff were confident about how to protect people from harm and what they would do if they had any safeguarding concerns. There were good systems in place to make sure that people were supported to take medicines safely and as prescribed. Risks to people had been assessed and plans put in place to keep risks to a minimum.

There were enough staff on duty to make sure people’s needs were met. Recruitment procedures made sure staff had the required skills and were of suitable character and background.

Staff told us they enjoyed working at the service and that there was good team work. Staff were supported through training, regular supervisions and team meetings to help them carry out their roles effectively. Staff were supported by an open and accessible management team.

The manager and staff were aware of the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS are put in place to protect people where their freedom of movement is restricted. The registered manager had taken appropriate action for those people for whom restricted movement was a concern. There was a lack of clear information in people’s care records about mental capacity and how people could be supported to make decisions. We made a recommendation about this.

People told us that staff were caring and that their privacy and dignity were respected. Care plans were being developed to be more person centred and showed that individual preferences were taken into account. Care plans gave clear directions to staff about the support people required to have their needs met. People were supported to maintain their health and had access to health services if needed.

People’s needs were regularly reviewed and appropriate changes were made to the support people received. People had opportunities to make comments about the service and how it could be improved.

There were effective management arrangements in place. The registered manager had a good oversight of the service and was aware of areas of practice that needed to be improved. There were systems in place to look at the quality of the service provided and action was taken where shortfalls were identified.

There were policies and procedures in place to help to protect people from abuse. Staff knew what action they must take if they suspected abuse was occurring. This helped to keep people safe from harm. One person we spoke with said 'I feel safe with the staff.'

Recruitment processes were in place to protect people from staff who may not be suitable to work in the care industry. We saw there were enough skilled and experienced staff in place to meet people's needs, in a timely way.

The quality of the service being provided was being monitored by the management team. Any issues found were being acted upon. This helped to ensure that people remained satisfied with the service they received. A person we spoke with said 'I quite enjoy it here. There are always things you don't like usually in places, but this place is nearly perfect.'

There was an effective complaints system in place. Information about how to make a complaint was provided to people in a format that met their needs. Complaints which had been received were been dealt with appropriately. A person we spoke with said 'I could say if I was unhappy about something. The people are all nice here. I have never had any problems.'