Archived: Highbury House Care Home

Updated 30 June 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 25 April and 3 May 2016 and was unannounced. The inspection team consisted of two adult social care inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience for the inspection at Highbury House had experience of services for older people and people living with dementia.

Before our inspection we reviewed the information we held on the service. This included notifications we had received from the registered provider about incidents that affected the health, safety and welfare of people who lived at the home and previous inspection reports. We also checked to see if any information concerning the care and welfare of people living at the home had been received.

We spoke with a range of people about the service. They included the registered provider, the newly appointed manager of the home, six members of staff on duty and ten people who lived at the home. We also had contact with five relatives.

We looked at care and the medicine records of four people, the previous four weeks of staff rotas, recruitment and staff training records and records relating to the management of the home.

We also spoke with health care professionals, the commissioning department at the local authority and contacted Healthwatch Blackpool prior to our inspection. Healthwatch Blackpool is an independent consumer champion for health and social care. This helped us to gain a balanced overview of what people experienced whilst living at the home.

Updated 30 June 2016

This inspection took place on 25 April and 3 May 2016 and was unannounced.

At the last inspection in October 2015 the registered provider did not meet the requirements of the regulations of the Health and Social Care Act 2008 (Regulated Activities) 2014 and was rated as ‘Inadequate’.

During the last inspection, we found multiple breaches of legal requirements. This was in relation to safeguarding people from unsafe care, abuse and improper treatment, dignity and respect; premises and equipment; infection control; staff recruitment; staffing; record keeping; consent and capacity; governance of the home and notifications to the Care Quality Commission (CQC).

As a result of our findings the service was placed in ‘special measures’ by CQC. This report only covers our findings in relation to the latest inspection. You can read the report from our last inspections in October 2015, by selecting the 'all reports' link for Highbury House on our website at: www.cqc.org.uk.

During this inspection on 25 April and 03 May 2016, we found the provider had made improvements and was meeting the fundamental standards inspected with the exception of Regulation 19 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Fit and proper persons employed.

You can see what action we told the provider to take at the back of the full version of the report.

During this inspection the service had demonstrated improvements and is no longer rated as inadequate for any of the five key questions. As a result of the improvements made, the service has been taken out of special measures. The service will be expected to sustain the improvements and this will be considered in future inspections.

Highbury House is located in South Shore, Blackpool. The home is registered to accommodate up to 28 people who require assistance with personal care. The property is a large detached house with accommodation over two floors. There is a passenger lift for ease of access and the home is wheelchair accessible. The majority of the bedrooms are single occupancy and en-suite. There are private parking facilities at the front of the building and garden areas at the rear. During this inspection there were 24 people living at Highbury House.

There was not a registered manager in place. The previous registered manager left the service after the last inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

A new manager had been appointed in February 2016. She was in the process of applying to be registered with CQC.

People told us they felt safe at Highbury House. Procedures were in place and risk assessments completed to reduce the risks of abuse and unsafe care. However recruitment and selection practices were not always carried out safely which put people at risk of being cared for by unsuitable staff.

People said there were enough staff to support them well and give them help when they wanted this. Staff had been trained and had the skills and knowledge to provide support to people they cared for. They received regular support and supervision from senior staff.

We looked at how medicines were managed and found appropriate arrangements for their recording and safe administration. People were given their medicines as prescribed and they were stored safely.

Records were available confirming gas appliances and electrical facilities and equipment complied with statutory requirements and were safe to use. The environment was well maintained, clean and hygienic. There were no unpleasant odours. People told us the home was much cleaner than previously.

We saw the manager and management team had improved the care provided to people in the home, particularly people living with dementia.

Most of the people we spoke with were positive about the meals but three people felt there was a lack of choice. We observed staff interaction and support given to people during the lunchtime meal. Only two staff were on hand to serve meals, assist people with their lunch and try to calm one person exhibiting behaviour that challenged.

People we spoke with told us staff were caring and helpful. They told us they were treated with respect and valued. We saw staff behaving in a respectful way.

We looked at activities to encourage people to interact and socialise. We saw steps had been taken to develop activities, although these were still limited. We asked what people did during the day. One person said “word search/puzzles, I like reading.” Another person told us “Sometimes my [relative] takes me shopping, otherwise just sitting here watching the traffic.”

We recommended the registered provider continued to develop suitable person-centred activities within the service and in the community.

People said they knew how to complain. However four relatives told us complaints were not always resolved to their satisfaction. They said they found it difficult to get answers to concerns and did not get a positive response if they expressed concerns.

We recommended the registered provider and management team developed a responsive and reflective complaints practice.

People told us the manager was approachable and supportive and listened to their views. Although undated we saw that surveys were sent to people who lived at the home, relatives and staff.

The manager showed us the quality assurance audits the management team had completed. We saw a number of improvements had been made as a result of these. However we needed to see these were established to be confident the service was well-led.