Background to this inspection
Updated
24 July 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Highview Oast is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided. A manager was in post who had submitted an application to CQC.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We received feedback from the local authority and other health professionals. We used all of this information to plan our inspection.
During the inspection-
We spoke with two people who used the service and two relatives about their experience of the care provided. We spoke to the manager, provider, a nurse and three care staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We reviewed care plans and other documents relating to four people’s care. We also looked at documents relating to the running of the service including, two staff recruitment files, staff training records, safety checks and audits.
Updated
24 July 2019
About the service
High View Oast is a nursing home providing personal and nursing care to 22 people aged 65 and over at the time of the inspection. The service can support up to 33 people.
People’s experience of using this service and what we found
There had been change of provider and a number of changes to the management team since the last inspection and this had resulted in staff feeling unsettled. Although the new provider had made positive changes to the service these had yet to be embedded into the culture and the provider acknowledged there was more work to do. The provider and manager were accessible and open to people’s views. Surveys had been completed and actions taken to address shortfalls. Regular audits were completed. Regular visits to the service and weekly reports enabled the provider to have oversight of the service.
Staff told us they felt they would benefit from more training and more regular supervisions. There was a new training plan place and supervisions were being planned. People’s health care needs were managed well and the manager had begun working closely with the local GP to improve people’s access to health professionals. Some people had hospital passports which they could give to hospital staff to explain their needs and preferences, however, this was not in place for everyone. People had access to food and drinks which met their needs and where necessary their intake was monitored and actions taken when required. People were supported to have maximum 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’s care plans were now more consistent and gave detailed guidance for staff about their needs and how they preferred to be supported. People’s end of life care plans would benefit from more detail about what makes them feel comfortable and reassured. People could take part in a range of activities; however this could be expanded. An activities co-ordinator had recently been employed to improve this. Complaints were dealt with in line with the providers policy. However, the complaints policy and other documents were only available in normal or large print. No other options were available to make information accessible to people.
People told us that staff were kind, caring and respected their wishes. Staff knew people well and used that knowledge to engage with people and reassure them. Relatives told us they were always made welcome and kept informed about any changes in their loved ones needs. People were encouraged to be independent and their dignity and privacy was respected.
People told us they felt safe at the service. Staff understood their responsibilities in relation to safeguarding people form abuse. Risks had been assessed and guidance was in place to minimise risk without restricting people. Staffing levels were appropriate to meet people’s needs and staff had been recruited using safe practices. People’s medicines were managed safely and in the way they preferred. Infection control measures were taken by staff and the service was clean. Accidents and incidents were reviewed for learning and actions were taken to reduce the risk of reoccurrence.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 07 July 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. This is the fifth time the service has been rated inadequate or requires improvement.
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.