On the day of our unannounced inspection, we found that 33 people were living at this nursing home. We subsequently spoke to six people who lived there, nine relatives, four members of staff and the manager of the home. We found that some people were not able to give us their views on the service because of their complex needs and health conditions.We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;
' Is the service caring?
' Is the service responsive?
' Is the service safe?
' Is the service effective?
' Is the service well led?
This is a summary of what we found:
Is the service safe?
We found that care was provided in an environment that was safe, accessible, clean and adequately maintained. People were safe and their health and welfare needs were being met because there were sufficient numbers of staff on duty who had appropriate skills and experience.
We spoke to several people who lived at the home. People told us they felt safe. Comments included, 'I feel safe here and staff look after me very well.'
We found that the home's safeguarding procedures were robust and staff understood their role in safeguarding the people they supported. We checked staff training records and saw that staff had received recent training in safeguarding vulnerable adults.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care and nursing homes. While no applications have been made under this legislation for any person living at Highbury Nursing Home, we found that the provider understood their responsibilities in relation to the law.
We checked people's care plans and found them to be detailed, relevant and up to date. This meant that people were receiving safe and appropriate care.
We found that there were arrangements in place to deal with foreseeable emergencies and staff were trained and understood the emergency procedures at the home.
We concluded that people were safe at Highbury Nursing Home and protected from harm.
Is the service effective?
People were supported by care and nursing staff who had the necessary skills and knowledge to meet their assessed needs, preferences and choices. We found that staff had effective support, induction, supervision, appraisal and training. Care staff told us that they were well trained, competent and able to safely meet the needs of the people who used the service.
People's day to day health needs were met. This is because people's needs were assessed and care and support was planned and delivered in line with their individual care plans. We saw that people had regular access to a range of health and social care professionals which included general practitioners, dentists, chiropodists and opticians.
People and their relatives told us that they were happy with the care they received and the care staff who supported them.
We concluded that care staff had the appropriate skills and knowledge to ensure that people received safe, effective and appropriate care and support.
Is the service caring?
People were supported by kind and attentive staff. It was apparent to us during our inspection that care and nursing staff were attentive, polite and sought consent before providing care and support. We saw that staff were patient with the people they were supporting and treated them with respect and dignity.
We spoke to relatives of people who lived at the home. They were very complimentary about the standards of care being delivered and the competence of staff delivering care and support. Comments included, 'My relative receives excellent care thank you, I have no worries here.'
The staff we spoke with demonstrated to us that they knew the people they were caring for well including their preferences and personal histories.
We concluded that people who lived at Highbury Nursing Home received care which was delivered with compassion and respect for their dignity and human rights.
Is the service responsive?
People receive care, treatment and support with their valid consent when they need it. We found that there was enough suitably trained and experienced staff on duty to provide safe and appropriate care to people when they needed it. We did not see people kept waiting for assistance.
People know how to share their experiences or raise a concern or complaint. We found that people were encouraged to make their views known about the care, treatment and support they received at Highbury Nursing Home. This was achieved by holding group meetings, sending out survey questionnaire forms and seeking feedback on a variety of topics that were important to people who lived at the home. We found that the home had a detailed complaints policy which was fit for purpose.
We found that care and nursing staff had regular meetings with the manager of the home and had the opportunity to discuss their training and development needs, welfare and any concerns they might have about the people they were caring for.
We concluded that people who lived at this home were involved in their care and listened to in a way that responded to their needs and concerns.
Is the service well-led?
We found that the manager had worked at this nursing home for several years and knew all her staff and the people who lived there very well.
We found that the staff we interviewed were motivated, caring, supported and open. All were complimentary of the manager of the home and told us that they would have no hesitation in recommending Highbury to their family and friends.
People who lived at the home and their relatives were very complimentary about the manager. Comments included, 'I have a good working relationship with the manager, she keeps me informed about issues I need to know about' and 'The manager and staff keep me informed about any changes.'
A check of records showed that the provider had an effective system to regularly assess and monitor the quality of service that people received and a system to manage and report accidents and incidents.
We concluded that there was effective leadership at Highbury Nursing Home and that people received care and support in a safe environment and were treated with respect, care and consideration.