We carried out a review of the data available to us about Highbury New Park on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Highbury New Park, you can give feedback on this service.
People’s experience of using this service and what we found
A visiting relative asked to speak with us during this visit. This person praised the staff at the home for the way in which they had kept them informed during the Covid 19 pandemic. They told us that they could not have asked staff to do more and believed all staff at the service were “amazing” in the way they had cared for their relative. The felt that staff had gone above and beyond in their response to the pandemic and their commitment to caring for people in a safe way.
We found the following examples of good practice.
The home asked people as they entered the building to have their temperature taken and to sanitise their hands as well as being provided with a face mask to wear. Visitors to people using the service were asked to see them in rooms on the ground floor or the garden rather than in their own room on the nursing and residential care floors. If it was not possible for people to come down to the ground floor visitors could visit people in their room, with personal protective equipment (PPE) being provided by the service.
There were very clear guidelines displayed in the reception area of the home for people about what is expected of them when visiting to promote everyone’s safety.
People’s and staff individual needs, health and wellbeing had been considered to ensure they lived and worked in the environment that was safe from infection. Each person using the service and staff supporting them had an individualised risk assessment, including specific risks for people of Black and Minority Ethnic heritage. The risk assessments reflected individual risks, PPE required when providing care and specific risk management strategies to provide safe care.
Staff had been trained and were provided with clear guidance about the use of PPE depending on the nature of a personal care task they were undertaking at any given time.
Strict cleaning regimes were in place that helped to protect people and staff from accidental infection or cross-contamination. Domestic staff were deployed to ensure hourly, daily and weekly cleaning schedules were completed.
The provider and the home’s management team had ensured that all staff were kept up to date with the latest government guidelines and best practice on how to provide safe care during the pandemic. Advice was also obtained from Public Health England as well as from the Care Quality Commission. Staff participated in regular staff meetings, supervisions and had undertaken infection prevention and control training since the start of the pandemic.
Further information is in the detailed findings below.
Highbury New Park is a care home owned by Care UK Community Partnerships Limited providing residential and nursing care service to 53 people. At the time of this inspection there were 53 people living at the home and almost everyone was living with dementia.
People’s experience of using this service and what we found
People were kept safe from harm and if any concerns about people’s wellbeing arose the service took the necessary steps to respond. Staff knew what they should do to minimise the risks that people faced and liaised appropriately with other health and social care professionals to achieve this.
The service had a good understanding of people’s needs and made detailed plans of people’s care. The care provided was agreed in consultation with people using the service and their families.
Staff were caring. People we spoke with told us this and we observed the easy and relaxed way in which people using the service, their relatives and visitors all interacted with staff.
People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were acknowledged as individuals and were treated with dignity and respect by staff working at the home.
Management of the home was complimented repeatedly and the way in which the service was run. The way in which the home was run was kept under review by the provider. The home thought ahead about planning for events, identified things that needed to improve and change, as well as recognising what was done well.
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 Good (Inspection report published on 9 May 2017). At this inspection the service remained good.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
This inspection took place on 7 and 11 April 2017 and was unannounced. At our previous comprehensive inspection on 2 February 2015 the service was not meeting one of the regulations we looked at. The service was found to be fully compliant with regulation 9 at our subsequent focused inspection on 28 February 2016.
At the last inspection, the service was rated as good with one requires improvement action in the area of “Safe”, the service was found to be compliant in this area at the focused inspection. The service remained rated as Good.
At this inspection we found the service remained Good.
People were kept safe from harm or abuse. If any concerns had arisen these had been responded to properly and thoroughly. The service managed medicines safely and our observations demonstrated that staff who had responsibility to provide medicines, whether they were nursing or care staff, did this safely. Potential risks for people were considered, whether they were environmental or personal risks, and action was taken to minimise any risks that were identified.
All of the people at the home at present were living with dementia. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. This approach was reflected by policies and systems in the service support this practice as did staff training.
Staff were supported in their work through training, supervision and appraisal. Staff we spoke with demonstrated their knowledge and skill in providing care as well as a commitment to doing this in the most effective way that they could.
Staff understood people’s characters and personalities. Staff were seen using different approaches with each person that demonstrated that they tailored their approach to people as individuals. Staff were respectful and spoke about people in a dignified way.
Care planning and the support people required were clearly outlined in care plans and other documentation related to how people’s needs were met. There were examples of efficient identification and response to people’s needs whether these were on going or newly emerging support requirements. The service liaised appropriately with other health and social care professionals in order to ensure people’s needs were met.
The service complied with the provider’s requirement to carry out regular audits of all aspects of the service and report monthly on the findings of internal audits to the provider. There on-going three monthly quality assurance overview of the service showed that any areas requiring attention were identified and were responded to.
Our expert by experience noted that they would be happy with one of their relative using the service. They do need to apply “a lick of paint and new carpets” Relatives and people were all complimentary about the home and care provided to people.
Further information is in the detailed findings below.
This focused inspection took place on 2 February 2016 and was unannounced. At our last inspection on 3 February 2015 the service was not meeting one of the regulations we looked at. The service was not meeting Regulation 9 in respect of person centred care. Although risks were identified and reviewed there was a lack of consistency among the staff team about how to respond to all potential risks. We found at this inspection that the staff we spoke with were aware of the potential risks to people and were also aware of where to obtain further details and guidance.
At the time of our inspection the registered manager had recently left the service and the former deputy manager had been appointed as the full time home manager. We found that this person was, at the time of our visit, completing an application to register with the commission. 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.
At this inspection we looked specifically at the previous breach of regulation 9 in the key area of safe. The service had been rated as good at the previous inspection and this rating has not changed.
Highbury New Park is a care home owned by Care UK Community Partnerships Limited providing residential and nursing care service to 53 men and women from the local community. The majority of people using the service suffer with dementia.
This inspection took place on 3 February 2015 and was unannounced. At our last inspection in January 2014 the service was meeting the regulations we looked at.
At the time of our inspection a registered manager was employed at the service. 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.
The staff of the service had access to the organisational policy and procedure for protection of vulnerable adults from abuse. They also had the contact details of the London Borough of Islington which is the authority in which the service is located and only this authority places people at the service. The members of staff we spoke with said that they had training about protecting vulnerable adults from abuse, which we verified on training records and most were able to describe the action they would take if a concern arose. However, we found that two care assistant staff did not appear to recall if they had received training about this.
We saw other risks assessments concerning falls and risks associated with epilepsy. The instructions for staff were detailed and clear. However, in one example a care plan said a person should be up and in their chair in the mornings but put to bed in the afternoons. It also said they should be turned regularly. The carer we spoke with about this demonstrated no apparent knowledge of this. Risks were identified and reviewed, and acted upon, however, there was a lack of consistent awareness among the staff team about how to respond to all potential risks.
Regulation 9 (1) (b) (ii) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 9 (3) (b) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We saw there were policies, procedures and information available in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure that people who could not make decisions for themselves were protected. The service was applying MCA and DoLS safeguards appropriately and making the necessary applications for assessments when these were required.
People were supported to maintain good health. Nurses were on duty at the service 24 hours and a local GP visited the home twice each week, but would also attend if needed outside of these times. Staff told us they felt that healthcare needs were met effectively and we saw that staff supported people to make and attend medical appointments, for example at hospital.
Everyone we spoke with who either uses the service, and relatives, praised staff for their caring attitudes. The care plans we looked showed that considerable emphasis was given to how staff could ascertain each person’s wishes despite their dementia and to maximise opportunities for people to make choices that they were able to make. For example, we saw information in one person’s care plan informing staff about how the person might be more able to make decision at some times of the day rather than others, to allow time for the person to respond and to observe their physical reactions. We noted in another person’s care plan file that staff were to respect a person’s right not to join in with certain activities that they did not enjoy.
Staff said two people who chose to remain in their rooms on the 1st floor were reluctant to mix with the all-female group in the lounge. In one instance it wasn’t possible to ascertain whether this meant the person was isolated although they did spend much of the day in their own room. However, a care worker was heard asking a person who did not think there were many activities if they would like to go to a special film showing at a nearby cinema the following week. This member of staff was also seen talking with people about outings once the weather improved.
One concern about communication was raised. During the morning a group of students arrived and were dispersed throughout the facility. The assistant manager who brought them into the different floors said only that they would be doing work experience for two weeks. It was left to a carer to show them around and introduce them to people. This carer later said she was trying to find out what they could do and how much responsibility they could be given as staff had not been told anything about them.
However, we did see that there was usually clear communication between the staff team and the managers of the service. People’s views were respected as was evident from conversations that we had with staff and that we observed. We saw that staff were involved in decisions and kept updated of changes in the service and were able to feedback their views and opinions through daily staff handover meeting.
The service complied with the provider’s requirement to carry out regular audits of all aspects of the service. The provider carried out regular reviews of the service and sought people’s feedback on how well the service operated.
We saw that people experienced safe and appropriate care based on an assessment of their needs. People we spoke with said ''I didn't expect to be as good as this.'' A relative we spoke with said ''Only now are we able to settle and be confident that she is safe and we don't need to worry.''
There were appropriate arrangements in place to respond to foreseeable emergencies.
Medicines were prescribed and stored correctly. Medicines were administered by staff who had received training in medicine management. The provider had appropriate protocols in place to ensure the medicines level of effectiveness was recorded and regularly reviewed.
There were sufficient numbers of staff with the right knowledge and experience to meet the needs of people using the service.
We saw and heard evidence from relatives that people's concerns were listened to and acted upon. The provider had systems in place to deal with complaints and records we saw showed that these had been responded to sensitively and in a timely manner.
During the visit we observed the dignity and privacy of people was promoted by staff using a positive and caring approach. Staff appeared familiar with people's needs and preferences. Sensory tools were displayed and available in all areas to help engage with people using the service. A variety of planned individual and group activities was provided.
Each person using the service had been assessed prior to their moving in and their individualised care plans developed with them and their families.
The quality of the service was monitored and views of people using the service was sought through the use of internal and independent surveys. Staff we spoke with told us they felt supported and attended a range of training courses. People who use the service were protected from abuse and appeared to be relaxed and readily respond to staff caring for them.
During our visit we found that the dignity and privacy of people using the service was promoted whilst staff were supporting them.
Staff used a range of sensory tools to engage with people using the service. The staff we observed appeared familiar with the preferences and likes of people using the service. We observed frequent positive interactions between staff and people using the service. A variety of group and individual activities was provided.
Each person using the service had been assessed prior to their moving in, and an individualised care plan had been developed with them and their families. These plans were regularly reviewed and any potential risks had also been assessed. People who used the service had also been supported to access a range of healthcare services.
People who use the service were protected from abuse and appeared comfortable and relaxed with staff.
The provider employed appropriate numbers of staff who were suitably skilled and experienced. Appropriate pre-employment checks had been carried out, and a wide range of training courses had been organised for staff.
The provider had sought the views of people using the service and monitored the quality of the service provided.