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.

This is the first assessment for this service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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 learning culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Accidents and incidents were recorded and reviewed to identify lessons that could be learned to improve the service. Lessons were learnt to continually identify and embed good practice.

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 and managers demonstrated an understanding of the importance of sharing information and working closely with other organisations and health care professionals.

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 had received training in safeguarding people from abuse and understood their responsibilities. They knew how to raise any concerns and were confident any concerns would be dealt with very promptly and effectively.

People told us they felt safe living at the home. A relative said, “It’s amazing, I really feel [person] is safe. I am confident the best has been done for [person].”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes/hospitals, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that assessments of people’s capacity, and Deprivation of Liberty Safeguards (DoLS) applications had been made where required.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risks were well managed and care plans and risk assessments were person centred. They provided staff with a holistic view of people, their support needs, preferences, likes, dislikes and what was important to and for them. Staff understood how to support people in a way that ensured risks were managed, whilst respecting people’s choices and individuality. People, and where appropriate their relatives, were involved in all decisions about their care and support.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The home had been purpose built. The building, furnishings and equipment were well maintained.

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.

All required checks were completed prior to staff starting to work at the home and staff received the training and support they needed to undertake their roles effectively. Staff told us they felt supported and were positive about the training they received.

People told us the staff were well trained and understood their roles. One person said, “They do seem to know what they are doing and do it well.”

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 home was very clean, with no malodours. People told us staff wore personal protective equipment (PPE) when required. They said, “They keep [the home] very clean. They do wear aprons and gloves when they are helping me wash and in the shower” and “It’s clean and it’s very new. It’s wonderful.”

On the first day of our inspection, we found medicines were managed and administered safely on one of the homes units but not always on the other.

A staff member had signed to confirm administration of a steroid medicine on the morning of our inspection. No stock was available in the medicines trolley, and the medicine had not been given. Stock was found in a medicine stock cupboard. We could not determine if this medicine had been administered on the two days prior to our inspection. Missed doses of this medicine can put people at risk of serious health issues. Temperature records of storage of medicines were not completed in accordance with national guidance. Staff had incorrectly signed a duplicated medicines administration record (MAR) for 1 person prescribed an eye ointment and had also signed an expired MAR. Eye drops that exceeded the manufacturer’s recommended period of use after the date of opening had been administered to 1 person. Accurate stock balances of medicines were not always recorded on this unit.

However, we found no evidence of impact or that anyone had been harmed despite the shortfalls identified. Managers and members of staff, qualified to handle medicines, regularly completed audits to make sure that procedures were followed. The concerns we found had happened after the most recent audit. We discussed our findings with the registered manager and senior managers during our first day. The registered manager responded immediately, and action was taken during the first day of our inspection to increase oversight and put in extra checks and systems to immediately respond to our findings. The registered manager completed a reflective practise with staff, a lesson’s learned exercise and, with senior managers, developed an improvement plan. Both were in place by the morning of our second day. They were robust, very detailed and covered all areas found during inspection.

We found the service had individual fire risk assessments in place for people who were prescribed paraffin-based skin products. Detailed protocols for ‘as and when’ medicine people required, known as ‘PRN’, were in place. There were appropriate arrangements in place for the management of controlled drugs.