Highfield Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Requires improvement.

At this assessment the rating has changed to Good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Action was taken to address concerns when they arose. For example, following an incident between two people action was taken to reduce the risk of concerns re-occurring.

How incidents were recorded had been improved and it was now clearer as to what had occurred. There was an improved system in place to review incidents and accidents looking for trends and patterns and also areas where recording of incidents could be improved. Lessons were learnt to continually identify and embed good practice. Findings were now shared with staff where appropriate. Staff told us communication at the service was improved and they felt better informed. One staff told us, “Communication between the office and staff and between staff has all improved. It means things run smother.”

One relative told us, “[My relative], is always saying they’re very kind, [they do] feel safe.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Staff greeted people when they moved to the service. People, including people moving in were allocated to a specific member of staff so the person knew who was looking after them and had support to settle in.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Staff knew what concerns to raise and how to raise concerns. Staff knew the signs and symptoms there might be something wrong. People knew how to raise concerns if they had any.

When concerns had been raised, they had been investigated, reported and action had been taken. People and their relatives were positive about how concerns were received and delt with. One relative told us, “The care home has been fabulous, any concerns are acted on, there’s no feeling of criticism, they’re very approachable.”

Where people were deprived of their liberty an appropriate application had been made to the DoLS office for authorisation to do so legally.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. However, care plans were not always updated or clear in some places.

Staff were now following care plans and protocols to support people with their health needs. For example, when people’s blood sugar levels were elevated staff followed the protocols in place and encouraged the person to drink water and monitored to check their sugars lowered.

There was information about people’s mental health needs as well as physical needs. For example, there was information on how to support people when they were upset, and staff knew how to support people. For example, staff told us one person would feel calmer when offered and given a cup of tea and we saw this was the case.

However, there were areas were care plans could be clearer. For example, one person’s care plan stated they had seizures, there was no information about what these seizures looked like. The person had not had a seizure since they had left hospital many years prior and staff were aware of this. However, this was not clear in the person’s care plan.

One relative told us, “[My relative] is treated very respectfully and they are friendly. It’s a good standard, no pressure sores or wounds, [they are] always clean and [the] personal care is good.”

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

The management of environmental risks had improved. For example, fire drills were now being carried out more frequently and there was a greater understanding or the purpose of undertaking drills. There were minor changes needed to further improve how fire drills were recorded, this was addressed during the inspection.

The maintenance cupboard was left unlocked and opened when we arrived at the inspection. Some people living at the service had dementia and the cupboard could have been accessed by people. This was a risk as the cupboard contained sharp tools and chemicals. We discussed this with the provider who explained the actions they had already taken to address this and agreed further actions were needed to reduce this risk.

Checks on the environment were undertaken such as gas safety checks and checks on the electrical system to ensure these utilities were in good repair and operating correctly.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff recruitment had improved and staff were now recruited safely. For example, Disclosure and Barring service (DBS) checks were undertaken. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

There was enough staff to provide support to people. The provider used a dependency tool to help calculate how any staff were needed to support people. One relative told us, “I think there are enough staff, there’s always someone around”. Another said, “I think they take their time with people, I haven’t witnessed them rush in and out, they always have time for a talk.”

Staff had now undertaken the training they needed to support people. This included mandatory training such as health and safety and safeguarding and learning about supporting people with specific health needs, such as diabetes and catheter care. Staff were knowledgeable when we asked them about people’s health conditions and how they should be supported. Staff had supervision and there was clinical oversight for nursing staff. One staff told us, “We get the training we need and the supervision and things are going well.”

Staff competency had been assessed for areas such medicines administration, manual handling and supporting people who use feeding tubes.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service was clean and free from unpleasant odours. Staff had access to personal protective equipment (PPE) and there were appropriate bins in which to dispose of these. Red bags were used to separate out some washing to reduce the risk of contamination, where this was needed. Staff had undertaken training in infection control and knew what to do if there was an outbreak of infection to reduce the risk of the infection spreading throughout the home.

One relative told us, “Staff are excellent, as are the cleaning staff, they’re all very nice. Everything is clean and tidy.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicine administration had improved and people’s medicine was now administered as prescribed. Staff followed best practice guidelines ensuring medicines were stored correctly and accurate records were kept when medicine was administered.

Where people had as an when medicines (PRN) such as pain medicine there was guidance in place for this medicine, so staff know when to administer this.

Medicines such as pain patches were now applied correctly being rotated so they were not on the same area of skin risking irritation.

The blood sugar monitor was now regularly calibrated to ensure it maintained accuracy. Medicines were destroyed and or disposed of correctly in line with guidance for a nursing home.