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High View Care Services Limited Good

Reports


Inspection carried out on 20 September 2018

During a routine inspection

This unannounced inspection of High View Care Services Limited took place on 20 September 2018. High View Care Services is a ‘care home’ for adults with brain injuries, mental health and substance misuse needs. 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 accommodates 12 people in one adapted building and there were 12 people using the service when we visited.

The last inspection of the service took place on 19 and 21 July 2017 where we rated the service requires improvement as there was a breach of regulation relating to the management of medicines. We also found that the quality assurance systems in place were not effective. Following the inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe, effective, caring and well-led to at least good. The provider sent us an action plan on how they would improve.

At this inspection, we found that the service had made the required improvements and complied with our regulations. We have rated the service good.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.

Medicines were managed and administered in a safe way. Medicine administration records were completed fully by staff. Regular audits took place to identify any gaps or errors and these were addressed.

Risk assessments were completed and management plans put in place to reduce the likelihood of harm to people. Incidents and accidents were reviewed and lessons were learned from them. The environment was safe; and health and safety checks were carried out periodically. Staff followed infection control procedures. There were suitable facilities available for people to use.

Staff were trained in safeguarding people from abuse and demonstrated that they understood the signs of abuse and how to report any concerns in line with the provider’s procedures. There were enough staff to support to people with their care and support needs in a timely manner. Staff employed at the service had undergone thorough checks to ensure they were fit to work with people. Staff were trained, supervised and supported to be effective in their roles.

People’s needs were assessed in line with best practice guidelines. People were supported with their nutritional needs. People had access to a range of health and social care professionals to maintain their health and well-being. The service ensured people’s care and support was coordinated effectively.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff understood their responsibility under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

Staff treated people with consideration and respected their dignity. People were supported to learn new skills and to maintain their independence. Staff supported people to express their views and people were involved in planning their care and support. Care records included people’s end of life wishes.

People received care and support tailored to meet their individual needs. Staff understood people’s needs and how to support them. People were encouraged to participate in activities they enjoyed. People were supported to maintain relationships they choose to. Staff supported people to maintain their religious and cultural requirements. Regular reviews took place to ensure support delivered to people continued to meet their needs.

People knew how to make a complaint if they were unhappy with the service. The provider investigated complaints in line with their procedure. The provider made information accessible to people in various formats.

People and staff told us that the culture of the service was open and transparent. Staff received the support, direction and leadership they needed. People and their relatives were regularly asked for their feedback on the service. The provider monitored the quality of the service through audits and checks. The service worked in partnership with other organisations.

The service complied with the requirements of the registration. They notified us of significant incidents as required.

Inspection carried out on 19 July 2017

During a routine inspection

This inspection took place on 19 and 21 July 2017 and was unannounced

At the last inspection on 7 and 8 September 2016, the Mental Health Inspection Team inspected the service but did not rate it as we do not currently rate independent standalone substance misuse services. However, we found that robust recruitment checks had not been carried out for all staff because for one member of staff there was no explanation for a gap in employment. For another person only their previous job was listed and no other employment history was given. At this inspection of 19 and 21 July 2017, we found appropriate recruitment checks had been undertaken for all staff.

High View Care Services Limited provides accommodation and support for people with acquired brain injuries or substance misuse for up to 12 people. At the time of our inspection, 12 people were using the service. The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.

At this inspection on 19 and 21 July 2017, we found a breach of regulation as Medicine Administration Records (MAR) charts were not always completed. Quality assurance systems were in place to monitor the quality of the service, but these were not always carried out and were not always effective in identifying shortfalls and driving improvements. Annual resident surveys were carried out. However, the last survey carried out in March 2016 had not been analysed to identify if there were any necessary improvements that needed to be made at the service. You can see the action we have asked the provider to take in respect of this breach at the back of the full version of the report.

The service had appropriate safeguarding adults procedures in place and staff had a clear understanding of how to safeguard people. There was also a whistle-blowing procedure in place and staff said they would use it if the need arose. There were enough staff deployed to meet people’s needs. Staff had appropriately been inducted into the service and were provided with appropriate training. Staff demonstrated a clear understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People were supported to have a balanced diet. People had access to a range of healthcare professionals when required in order to maintain good health.

Staff were kind and caring. People’s privacy, dignity and confidentiality were respected and people were encouraged to be as independent as possible.

People were involved in their care planning. Care plans were reviewed on a regular basis and detailed people’s preferences and wishes. People were supported to participate in a range of different activities both inside and outside of the service. People were aware of the complaints procedure should they wish to make a complaint.

Regular staff meetings were held. Staff said there was an open culture in the service and that the management team were supportive.

Inspection carried out on 7 and 8 September 2016

During a routine inspection

We do not currently rate independent standalone substance misuse services.

We found the following areas of good practice:

  • Staff said they felt supported by colleagues and managers and that morale was high. Staff received regular supervision and were provided with a range of mandatory and specialised training to meet the needs of clients.

  • Clients and carers/relatives gave positive feedback about staff and the service. Care plans were personalised, detailed and contained the views of clients. Staff had a thorough knowledge and understanding of the needs of each individual. There were activities available to clients on a daily basis that were specific to their cognitive ability and encouraged independence.

  • Medicines were stored and administered safely.

  • Staff had an understanding of how to identify and report incidents, including safeguarding incidents. Clients said they felt safe at the service. Staff regularly reviewed risks and care plans for each client in order to manage risks appropriately.

However, we also found the following issues that the service provider needs to improve:

  • Information leaflets were available, but only in English. There was no written guidance to explain how information could be obtained in other languages.

  • Not all staff were aware of the process for ensuring medical equipment was calibrated.

  • Staff had not explored the option of easy read care plans for clients. Clients working towards discharge did not have discharge plans in place.

Inspection carried out on 21 January 2015

During a routine inspection

This inspection took place on 21 January 2015 and was unannounced. At our previous inspection 16 June 2014, we found the provider was meeting the regulations in relation to outcomes we inspected.

High View Care Services Limited provides accommodation and support for people with acquired brain injuries or substance misuse. The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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 and associated Regulations about how the service is run.

People using the service said they felt safe and that staff treated them well. Safeguarding adult’s procedures were robust and staff understood how to safeguard the people they supported. The manager demonstrated a clear understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). Appropriate recruitment checks took place before staff started work.

Risks to people using the service were assessed; care plans and risk assessments provided clear information and guidance for staff on how to support people with their needs. People using the service had been fully involved in planning for their care needs. Medicine records showed that people were receiving their medicines as prescribed by health care professionals.

People said their views and opinions were valued by staff. Staff encouraged people to be as independent as possible. There were regular meetings where people were able to talk about things that were important to them and about the things they wanted to do. They knew about the home’s complaints procedure and said they were confident their complaints would be fully investigated and action taken if necessary.

The provider took into account the views of people using the service through surveys. They recognised the importance of regularly monitoring the quality of the service provided to people using the service. Staff said they enjoyed working at the home and they received good support from the manager. There was a whistle-blowing procedure available and staff said they would use it if they needed to.

Inspection carried out on 16 June 2014

During a routine inspection

We gathered evidence against the outcomes we inspected to help answer our five key questions. Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

Safeguarding vulnerable adults from abuse procedures were robust and staff understood how to safeguard people they supported. People told us that they felt safe living at the home and that staff treated them well.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There was an out of hours on call system in operation to ensure that management support and advice for staff was always available.

Is the service effective?

We found that people’s health and care needs were assessed with them, and they were involved in writing their plans of care.

The provider employed an assistant psychologist and councillors. The assistant psychologist told us they provided advice to staff on how to support people with their behaviours and needs. The councillors encouraged people to tell their life history, build on relationships and partake in social and domestic activities.

Is the service caring?

We observed positive interactions between staff and people using the service during the course of our visit.

A person using the service said “The staff treat me absolutely wonderfully, they look after me properly. They talk to me about all the things I need, it’s all lovely jubbly.” A visiting relative said “I am very happy with this place. They talk to me about what my partner needs. The manager is very good and we communicate well.”

Is the service responsive?

There were regular residents meetings where people using the service were able to express their views and opinions about the home. The minutes from the last residents meeting indicated that the meeting was well attended and people using the service discussed their upcoming holidays, activities and health and safety issues.

A relative of a person using the service said knew how to make a complaint if they needed to. They said they had raised concerns with the registered manager in the past and these had resolved promptly and appropriately to their satisfaction.

Is the service well-led?

We found there were effective systems in place to regularly assess and monitor the quality of service that people received.

A visiting relative said “The staff are very good here. The manager in particular works very hard and is really committed to the home.”

Staff told us they enjoyed working at the home and they were well supported by the registered manager and the registered provider. They said they were up to date with their training and that they received regular supervision and an annual appraisal.

Inspection carried out on 12 September 2013

During a routine inspection

All the people we spoke with told us that they were happy living at the home. One person told us that it was the “best” home they had ever lived in and that they had en-suite facilities and staff were “friendly” and “polite”. Another person told us “I like it here because staff are good to talk with” and that staff had “plenty of time” for them. People told us that they were involved in their care planning and knew what support staff should provide.

We found that people using the service were adequately supported to achieve their goals. Each person had a care plan with relevant risk assessments and action plans in place to mitigate any potential risks. There were arrangements in place to ensure that people were protected against the risk of abuse. People were cared for in an environment that was safe and comfortable. There were enough qualified staff on duty to provide the appropriate support people required. We found that people's care and support plans, staff records and other records relevant to the management of the services were accurate and fit for purpose.

Inspection carried out on 11 January 2013

During a routine inspection

We saw that staff were respectful and involved people in making decisions about their day to day lives, including activities, meals, developing independence skills and in planning their future development. For example all of the people who lived at the home had experienced periods of mental and physical trauma, and were supported by counsellors who were employed by the provider to help them to improve their memory skills, and to engage in activities they wanted to, such as using computers, cooking and playing music.

We saw staff were regularly interacting positively with people who lived at the home, and sharing experiences in playing games such as pool and cards, and in chatting while preparing meals and snacks.

Care planning and reviews took place regularly with involvement from people, and had been signed as agreed by people who used the service or their representatives. People told us that they were always speaking with staff about things they needed to do, and that the staff were always very respectful and helpful.

We found that the staff understood people’s care needs and how to protect them from risk and harm. Staff had adequate training and supervision, and worked with people to develop their confidence and independence.

Appropriate checks were being done by the provider to ensure that the quality of people’s care was maintained.

Inspection carried out on 23 March 2012

During a routine inspection

People we spoke with who used the service said they had been asked by the staff at High View about the support they needed. They said the staff were aware of how to support them, and that they were good at listening to them. They said they knew there was a care plan for them, and that they were happy that we examined it as part of the inspection.

They told us they had been visited by the home’s management before deciding to move in, to ask them about their care needs. They were also able to visit the home before making a final decision. They said they were able to ask staff when they needed help or advice and staff listened to them.

People who used the service told us the staff were respectful, and they felt safe when being supported. People said staff were very helpful and always were quick to sort out any problems they had. They said that they were very happy at the home, and that daily planning meetings each morning helped them to organise their day and to ask for the help they needed.

People who lived at the home said the therapeutic activities such as music and games provided in a separate room in the garden were very enjoyable and relaxing.