Highfield Residential Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.
At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person centred care.
 

This service scored 61 (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 did not make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People’s care plans had not been effectively reviewed to record accurate information about people’s care needs. They did not give clear guidance to staff about how to support people with their needs and preferences as they contained contradictory information. Care plan reviews were not specific to the care plan they were recorded against. They contained a review of many care needs, such as diet, mobility or changes to a health condition, and copied across each care plan. This meant the most up to date information may be missed. Care plans had not been updated with the most recent changes in need. One person’s mobility care plan clearly stated they mobilised independently and staff should be aware of their whereabouts. However, a different care plan recorded they needed to mobilise with 2 staff. We observed the person walking with 2 staff, however, not in the way described in their care plan and not using good practice techniques. This meant people were at risk of not receiving care that was safe and met their current needs. Staff did not have the most up to date information to follow and care plan reviews were not reliable, as the information was not recorded in the most appropriate places. Another person’s care records contained contradictory information, stating in one care record they ate well with no problems but required a staff member to support them, and another care record stating they were losing weight, meals needed to be fortified, with high calorific snacks and staff must monitor all food intake.
Some people’s care records included another person’s name which did not provide assurance of a person-centred approach. A relative told us when they logged in to the relatives’ gateway of the electronic care records system, “Entries appear to contradict one another or seem as though they may relate to another resident, which can understandably cause confusion and anxiety for family members.”
Although staff appeared to know people well, they could not be assured they were looking at the most up to date information which posed a risk of people not receiving individual and person-centred care. One person’s behaviour care plan described how to approach the person and what they liked and didn’t like, in order to avoid things that triggered them. However, this was not a consistent approach to the quality of person-centred care planning.
 

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

There was a stable staff team, and staff could describe people’s needs. Although this mitigated the impact of incomplete and contradictory guidance in people’s care plans, a risk remained that staff may not provide consistency when providing people’s care. For example, how they supported people’s mobility to encourage a return to independence.
People told us staff understood and knew them well. Comments included, “Yes they know how I like things to be done” and “They look after me the way I want them to”.
Referrals were made to healthcare professionals who visited to give advice and guidance to people when necessary.
 

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider kept people up to date with information, about the service and the things that affected them. Meetings were held with people and relatives where updates were provided and the registered manager kept in touch by email with those who couldn’t attend. Regular newsletters were produced for people and relatives to keep them in touch with what was going on.
Staff knew people well and would discuss changes and updates with them to make sure they understood. For example, some improvements were being made to the environment, so people needed to know and understand this.
 

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

Visitors could share their feedback when they were leaving the building by commenting on an electronic sign in system. Meetings were held for people and relatives and people told us they could speak with the registered manager.
People and relatives were confident to raise concerns or share feedback and felt they would be listened to. One person said, “They are good at listening to me.”
Relatives commented, “I am informed promptly of any issues that arise and am kept fully updated regarding any changes to her care plan. Communication from the home has always been very good” and “I haven’t had any concerns but would talk to the staff if I did.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People told us they were happy with the care and support they received and they generally had access to help when they needed it, from care staff and from external healthcare professionals. People commented, “I can use my buzzer if I need them, but I will go and find them” and “The Doctor would come and see me if I was unwell.”
The experience of people and their relatives was that their needs were met in a timely way.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The feedback we had from people and their relatives suggested people had equal access to care and support. People who had more complex care needs, such as not being able to independently mobilise, or were cared for in bed, did not experience less access. We were told there were a number of various activities people could join in with, and all were welcome. We observed an entertainment afternoon, with singing. The communal area was full. We saw staff assisting people who usually stayed in their rooms and needed help to mobilise, and people who sometimes became anxious and distressed, all joining in.
People told us, “I like to take part in the activities when they are on, but I enjoy watching the television in my room” and “I enjoy taking part in all the activities that are on if I feel up to it especially the singing.”
Staff knew people’s interests and we saw staff sitting chatting with people. One person told us they had attended a remembrance event, and a staff member showed us a photograph of the day.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Although people had a care plan in place to record their wishes when the end of their life approached, the information was basic and generic. Most care plans included similar information and did not provide individual choices and decisions. For example, a person’s care plan included generic information about arrangements for verifying death during the COVID-19 pandemic. The inclusion was no longer relevant and was an inappropriate addition to what should be an important and personal record. This meant if people had specific wishes for the end of their life, they may not be met.