Highgrove

We found the following examples of good practice.

The premises were clean. Enhanced cleaning had taken place since the start of the pandemic.

Staff had been trained and regular checks took place on how they wore and disposed of personal protective equipment (PPE). There were good stocks of PPE available and this was stored correctly.

People and staff were tested regularly in line with government guidance. People and staff were supported to self-isolate as appropriate. The registered manager monitored staff test results to ensure they returned to work only when they were able to do so.

The service was meeting the requirement to ensure non-exempt staff and visiting professionals were vaccinated against COVID-19.

Staffing levels at the home were good. There were no issues with staff retention or recruitment.

The provider had reviewed contingency arrangements at the start of the pandemic. The registered manager said they were very well supported by the provider.

Highgrove is a residential care home providing personal care for up to 67 older people, some of whom are living with dementia. At the time of the inspection there were 42 people using the service.

We found the following examples of good practice.

The home had clear guidance, polices and processes to help minimise the risk of an outbreak and manage any which occurred.

The service was accessing the government testing scheme.

The service was working with the local authority infection control team and other health professionals to ensure people's needs were met.

Cleaning schedules had been increased during the outbreak, to ensure high contact areas, such as door handles, light switches and appliances were regularly cleaned during the day.

Staff had received specific training in managing the risk of the COVID-19 pandemic and how to safely use and dispose of personal protective equipment (PPE). This had included sessions run by the local authority.

The registered manager was open and pro-active in sharing information with friends and family, so they understood decisions around visiting and restrictions.

Staff supported people to stay in contact with relatives and friends via phone and video calling.

Further information is in the detailed findings below.

Highgrove is a residential care service providing personal care to a maximum of 67 older people, some of whom are living with dementia. At the time of this inspection there were 56 people using the service.

People’s experience of using this service and what we found

People and their families told us they felt safe living at the service. A person told us, “Oh yes I do feel safe living here.” Staff had a good understanding of safeguarding procedures. People were supported by sufficient numbers of staff. Medicines were managed safely. We found risks assessments connected to legionella and the kitchenettes needed to be further strengthened, assurances provided confirmed this would happen.

Staff received an induction and on-going training to support them in their roles. People had access to services they required to maintain their health and staff supported them accordingly. The design and decoration of the service took account of dementia best practice. People lived in a clean environment.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People told us staff were caring, kind and treated them with dignity and respect. People were encouraged to develop and maintain their independence skills. Visitors were made to feel welcome. A relative said, “I can’t fault this place, it’s absolutely amazing and [person’s name] is happy and that’s all that matters.”

People received personalised care. Care plans were regularly reviewed and updated to ensure they contained accurate information about people's needs. The service worked with a variety of health and social care professionals to help people achieve good outcomes and promote their wellbeing. There was a variety of activities on offer.

The positive culture of the service was led by a dedicated registered manager who knew the service very well. People, staff, relatives and other agencies said they felt the management of the service was good and their views were listened to and valued.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 29 May 2018). There was also an inspection on 20 and 22 May 2019 however, the report following that inspection was withdrawn as there was an issue with some of the information that we gathered.

Why we inspected

This is a planned re-inspection because of the issue highlighted above.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Highgrove is a ‘care home’. 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. Highgrove is a care home registered to provide accommodation and nursing care for up to 67 people who may have dementia care needs. The home was built in 2009, is purpose built and provides all single bedrooms with en-suite facilities. On the day of our inspection, there were 62 people living at the home.

There was a registered manager in post when we inspected. 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.

People told us they felt safe at Highgrove. We saw risks associated with care and support were assessed, but found inconsistencies in the quality of information in care plans.

We found processes to recruit staff were safe, and staff were deployed in sufficient numbers to respond to people’s needs. Staff understood how to recognise and respond to concerns about potential abuse. People received their medicines safely.

We received good feedback about the staff’s skills and knowledge, and we saw staff received regular training and support from management.

People gave positive feedback about the food in the home, however we found risks associated with people’s nutritional health were not always well managed. Adapted equipment was available to enable people to remain as independent as possible with eating, and we saw people received assistance when this was needed.

The provider recognised when they needed to apply for Deprivation of Liberty Safeguard (DoLS) authorisation, however we found documentation relating to people’s capacity was not always effective. We saw the provider had recognised this, and we made a recommendation about reviewing and updating this information in people’s care plans.

People told us the staff were caring, and our observations confirmed this. People’s privacy, dignity and independence were well supported. There was a good approach to equality and diversity principles which ensured people did not experience discrimination.

We found information in people’s care plans was not always kept up to date with changes in their needs, although staff practice reflected knowledge of these.

Care plans were available in alternative formats such as larger print or braille if people required these, and arrangements were in place to ensure there was equality of access to activities. We received good feedback about the activities provided at Highgrove.

We saw complaints and concerns were resolved appropriately, and saw evidence the home received compliments from people and their relatives about their experiences of care.

We received positive feedback about leadership in the home. There was a clear vision for how the service provided care for people.

Although there was a programme of audit in place, the provider acknowledged they had identified improvement was required in this area.

People, their relatives and staff were consulted in the running of the home, and we saw a high level of satisfaction reported through survey activity.

We identified two breaches of regulation during this inspection relating to safe care and treatment and good governance. You can see what action we have told the provider to take at the back of the full version of the report.