Highfield Care Home

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent. People’s needs were assessed but this information was not always used to ensure care plans were up to date. Staff told us communication needed to be improved to enable staff to work together more effectively. People were not always offered effective support to manage their health conditions. People’s health and care were not always effectively monitored. Staff had a good understanding of the Mental Capacity Act (2005) and how to provide support to people to make decision.

The service was in breach of legal regulation in relation to safe care and treatment.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s needs were assessed regularly. However, care plans had not always been updated when people’s needs changed. For example, one person’s care plan stated they needed to be repositioned every two hours. The registered manager told us this was no longer the case as the person did not have a pressure injury at the time of the inspection and this meant instructions to staff on what tasks needed to be completed and when were not clear. Care plans were electronic, and staff were reminded electronically when tasks needed to be completed. However, we found tasks were not always completed when they should have been. Assessments of people’s needs included information on how people communicated, their physical and emotional needs and needs related to their protected characteristics.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. People and their relatives were involved in planning people’s care. Best practice tools were used to assess people’s needs, such as tools to assess if people were at risk of malnutrition or skin integrity concerns.

However, care plans were not always kept up to date. Best practice was not always followed. For example, protocols, for where people with diabetes had high blood sugar, were generic rather than tailored to people’s individual circumstances. Risk assessments should be reflective of people’s personal health care needs, which vary from person to person, to ensure people’s health is managed as well as possible.

Staff told us communication needed to be improved to enable staff to work together more effectively. Staff said there was not always a handover when they started their shift where they could learn about what happened during the previous shift and any changes to people’s needs. We raised this during the first day of the inspection and the registered manager asked staff to ensure a handover was completed from each shift change. On the second inspection day staff told us this had already made an improvement and staff felt more informed about changes to people’s needs.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. There was a lack of healthier food options for people, for example, puddings and snacks which were lower in sugars. Where staff offered people a choice of snacks these did not always include healthier options. We raised this with the registered manager and provider during the inspection. The menu was reviewed following the inspection and information was provided for staff to support people more effectively.

The new activity co-ordinator was planning activities with people. They told us this would include activities which focused on improving health such as armchair exercise.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. For example, there were gaps in weight records for people where people’s weight needed to be monitored. An electronic system had been introduced to record the care provided to people. This enabled the provider and registered manager to run reports and review people’s care. However, care had not always been well monitored, and we identified areas where improvement was needed.

Staff understood how to support people to make choices. For example, where people found having fewer choices helped them to make decision for themselves. They understood people with capacity had the right to make decisions for themselves, even when they did not agree with these decisions. People’s capacity was assessed where appropriate. Where people were not able to make decision for themselves these had been made in people’s best interests and appropriately recorded.