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Inspection Summary


Overall summary & rating

Good

Updated 5 September 2018

Highfield Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Highfield Care Home is a 53-bed residential and nursing care service providing care, treatment and support, including end of life care and support for people living with dementia. On the days of our unannounced inspection on 25 and 26 June 2018 there were 49 people living at the service. Saffron suite was a specific part of the service which catered for people with a diagnosis of dementia.

The service had a registered manager who was present during the inspection. 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.

The last inspection of the service was conducted in July 2017 and we rated the service as, ‘Requires Improvement’ overall, and we found two breaches of the legal requirements. Equipment was not always maintained at the correct setting or regularly checked to make sure that it was working effectively. Care staff were not familiar with people’s needs and the care plans did not provide sufficient direction to staff.

At this inspection, we found that improvements had been made. We found that there were clearer systems in place to check on equipment and ensure that it was safe to use when needed. Risk assessments were in place to manage risks and reduce the likelihood of harm, however further work was needed to ensure consistency of practice in relation to some of the documentation and moving and handling.

The care plans were more detailed and informative, and provided clearer guidance to staff on people’s needs and their care preferences. Staff knew people well and there were effective handover systems in place to ensure that key information was communicated to those who were supporting individuals.

There were systems in place to review any accidents or incidents and to identify any learning or improvements needed. Staff received training on how to recognise abuse and we saw that concerns about individual’s wellbeing had been appropriately escalated to the relevant authorities.

There was enough staff available to meet people's needs. Staffing numbers had been calculated based on the needs of the people using the service. There were clear processes in place to check on staff suitability prior to them starting work at the service which included references and disclosure and barring checks.

New staff received training to ensure that they had the skills and knowledge they needed to meet people's needs. Additional training opportunities were made available to staff to update their knowledge and maintain their skills and competency.

People were supported to eat and drink and maintain a balanced diet. There were clear systems in place to monitor those individuals at risk of malnourishment.

People had good access to health care support which included access to the GP, optician, specialist nurses and dietician. The service worked with other organisations in a collaborative way.

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. People's ability to make decisions was assessed in line with the requirements of the Mental Capacity Act (MCA) 2005. Where appropriate Deprivation of Liberty Safeguard (DoLS) authorisations were in place to lawfully deprive people of their liberty for their own safety.

The environment was well maintained and comfortable. We have made a recommendation that further advice is sought on creating an environm

Inspection areas

Safe

Requires improvement

Updated 5 September 2018

The service was not consistently safe.

There were systems in place to manage risk and reduce the likelihood of harm however further work was needed to ensure consistency of practice in relation to documentation and moving and handling.

People were supported by sufficient numbers of suitable staff and the levels of staff were regularly reviewed to help people to stay safe.

Recruitment processes were in place to check on the suitability of staff and offer protection to people.

The provider had systems in place to oversee and ensure the safe use of medicines.

Infection control and prevention processes were in place and implemented by staff to reduce the likelihood of harm.

Incidents were reviewed and improvements were made when things went wrong.

Effective

Good

Updated 5 September 2018

The service was effective.

Peoples care and support was delivered in line with current standards and guidance.

Staff received training to support them deliver effective care and support.

People were supported to eat and drink and maintain a balanced diet.

People had good access to health care support when they needed it.

The registered manager understood their responsibilities to protect people�s rights and ensure that they were consulted about their care.

The premises was well maintained but we have made a recommendation about creating an environment which supports people with a diagnosis of dementia.

Caring

Good

Updated 5 September 2018

The service was caring

Staff knew people well and supported people in a kind and compassionate way.

People were treated with dignity and respect.

People were encouraged and supported to be as independent as they could be.

Staff supported people and their relatives to be involved in their care and its delivery.

Responsive

Good

Updated 5 September 2018

The service was responsive

Care plans were in place to inform staff and the delivery of care. There were systems in place to ensure that staff were updated on changes to people�s needs.

Staff supported people and families with end of life care.

People had access to a range of activities and to maintain their interests.

There were systems in place to address complaints but we have recommended that these are reviewed.

Well-led

Good

Updated 5 September 2018

The service was well led.

There were systems in place to engage with staff, people who use the service and their relatives about the quality of care.

The registered manager worked with other agencies including the local authority quality team to drive improvement at the service.

Quality assurance processes were in place, which provided the registered manager and provider with oversight of the service. Responsibilities were clear and risks understood.