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We are carrying out a review of quality at Highfield. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Good

Updated 15 January 2019

Highfield 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. The service is a large extended property. Accommodation is arranged over two floors and a lift is available to assist people to get to the upper floor. Highfield provides care for up to 34 older people living with dementia, frailty and nursing care needs. There were 30 people living at the service at the time of our inspection.

The registered manager worked at the service each day and was supported by a deputy manager. A registered manager is a person who has registered with CQC 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.

Our last comprehensive inspection of this service took place in June 2017. Following this inspection, the key areas of Effective and Caring was rated as Good, while the areas of Safe, Responsive and Well Led were rated as Requires Improvement, together with the overall rating of the service.

A further inspection of the service took place in November 2017. This was a focussed inspection concentrating only on the key areas of Safe and Well-led and did not look at whether the service was Caring, Effective or Responsive. At that inspection, staff followed correct and appropriate procedures to promote the safe management of medicines; there was clear guidance for staff and protocols about the administration of medicines which were followed. People were supported in a safe environment and risks identified for people were managed in a way that enabled people to live as independent a life as possible. Accidents and incidents were consistently reviewed, and any potential safeguarding concerns were investigated, and referrals made to the local authority. The service was clean and potential infection control risks addressed. Recruitment procedures were robust and care planning had established people's needs and reflected their wishes about how they wanted to be supported. Staff felt there was good communication and they were clear about their roles. They felt well supported by the registered manager. Feedback was sought from people, relatives and professionals about how the service was run. Audits and checks were carried out each month by the registered and area managers, which were effective in identifying and addressing concerns and driving forward improvements. Following this inspection, the key areas of ‘Safe’ and ‘Well-led’ were rated as Good.

This inspection, completed on 12 and 15 October 2018, was a comprehensive inspection. We looked at all five key areas of the service. Improvement had been made in communication. However, additional steps in the systems and processes used to assess and monitor the operation of the service needed to be taken. This was to ensure the progress made in the service was further developed and sustained. The registered manager and the provider checked all areas of the service regularly to make sure it met the standards required. However, processes were not always effective in rectifying the cause of faults.

The management of people’s medicines was safe. Risks had been identified and action had been taken to manage them. Records about people and the care they received were accurate, complete, held securely and easily accessible to staff when they needed them.

Staff were kind and caring and treated people with dignity and respect. They took time to get to know each person well and provide the care people wanted in the way they preferred. People received the care and support they wanted at the end of their life.

Assessments of people’s needs and any risks had been completed and care had been planned with them, to meet thei

Inspection areas

Safe

Good

Updated 15 January 2019

The service was safe.

People received their medicines safely from staff who were trained to do so, however, blood sugar level monitoring equipment was not checked when it should have been.

People were protected from the risk of abuse.

Risks to people and the environment were assessed, and staff took action to reduce those risks identified.

There were enough staff available to meet the needs of people, and those new to the service were recruited safely.

People were protected by the prevention and control of infection.

The registered manager took steps to ensure lessons were learned when things went wrong.

Effective

Good

Updated 15 January 2019

The service was effective.

People�s needs were assessed with them and their relatives when necessary.

Staff followed the principles of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards. People were supported to make their own decisions.

Staff were supported and had the skills they required to provide the care people needed.

People were supported to eat and drink enough to help keep them as healthy as possible.

People were supported to remain healthy.

The building was designed to support people to be as independent as possible.

Caring

Good

Updated 15 January 2019

The service was caring.

People were treated with kindness, compassion and respect.

People were supported to express their views about the support they received.

People had their privacy and dignity respected and promoted.

Responsive

Good

Updated 15 January 2019

The service was responsive.

People had planned their care with staff and received their care how they preferred, however, some care plans were contradictory in places.

People participated in a variety of activities.

Any concerns people had been resolved to their satisfaction.

People were supported in the way they preferred at the end of their life.

Well-led

Requires improvement

Updated 15 January 2019

The service was not consistently well-led.

Checks completed on the quality of the service did not always result in action to remedy any shortfalls.

People, their relatives and staff shared their views and experiences of the service and these were acted on.

Staff shared the provider�s vision of good quality care.

Staff were motivated and led by the registered manager. They had clear roles and responsibilities and were held accountable for their actions.

The registered manager worked with other agencies to ensure people�s needs were met.