Highfield House

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect. People were treated with respect and staff were kind and caring in their approach. Relatives told us the staff group were all kind and had good relationships with the people they supported. A relative told us, “Dignity and respect is important to the staff.” Another relative told us, “I can’t speak highly enough of the staff who are with [person’s name] on a regular basis.” Staff understood when people wanted to interact and were observed taking their lead from people in how they engaged with them. Staff were positive in our conversations about people and showed warmth and affection when speaking about people. The manager told us they were confident in the approach taken by staff as they regularly observed their interactions.

The provider did not consistently ensure staff recorded how they followed individual care plans and documented the individualised support people received. Some daily notes were either not completed or lacked detail to show how people had been treated individually in line with their care plan. Where a weekly review was required, these were not consistently completed to show the outcomes from the care people received and if this had been effective in meeting individual needs. The provider said people were usually able to do things they enjoyed and were disappointed this had not been reflected in the care records. They confirmed plans were in place to improve how the activities people were engaged in were captured. However, people were able to freely move around the home and chose where to spend their time. Some people spent most of the day in the garden with others spending time in the communal lounge and their bedrooms. A staff member told us, “We have the care plans in place, and this will share info about peoples likes, preferences and other aspects. I feel like I know people well.” Care plans gave guidance to staff on meeting people’s individual preferences including their protected characteristics.

The provider was not consistently able to ensure people could maximise their independence and access community activities. The current staffing levels meant people were sometimes restricted in how often they could do the things they enjoyed. A staff member told us, “Sometimes there is not enough staff to take people out, we always have cover, but it has meant nothing much is planned.” Only 1 person went out into the community on the day of the inspection. Records showed people were spending most of their time at home. However, relatives told us people did get some opportunities to do the things they enjoyed. A relative told us, “They take [person’s name] out, they can go into the garden which they love. One of the staff gets in touch with me by phone and have told me they have done a big feature wall with photos.” Staff could describe how they supported people to communicate their wishes and make choices. A staff member told us, “We have to work with people to understand their communication needs, we offer choices by presenting options and we take people to the kitchen to choose.” The manager told us, “Staff use observation and people’s history to understand what people like and want they want to do. For example, [person’s name] will get their bag from their room when they wish to go out.” We saw care plans had information to guide staff on how to support people to make choices and promote independence, describing people’s abilities and the areas they needed help with.

The provider listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. People were observed being supported by staff in the moment. Staff were responsive to a person who displayed body language which indicated they needed a drink. Staff responded quickly to any change in how people presented, using the information they knew about people to determine what people wanted and needed and provided this without delay. People had access to dedicated staff members and staff were observed ensuring they were always at hand without being overly intrusive. Relatives told us staff were responsive when things changed. A relative told us, “I was in twice daily contact whilst my relative was in hospital. The staff stayed with them in hospital 24 hours a day and they would call me when they swapped over shifts and that was quite reassuring.”

The provider did not consistently ensure staff received regular opportunities to discuss their wellbeing. Staff had not received regular supervision. Staff could not confirm when they had received their last supervision session, with most saying it had been some time. The manager confirmed staff supervisions were not up to date and records we saw supported this. However, staff told us the management team were approachable, and they could seek support if needed. The manager told us staff also had access to support from a counselling service if they needed it.