Highfield House Residential Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Managers made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Managers told us that "Involvement starts with the pre-admission assessment" with a focus on understanding the individual as fully as possible. Assessments were holistic, involving the person, their relatives and professionals. One relative told us, “I wrote a short piece about [person’s] life, so that staff could get to know her and know what to have a chat about."

The provider had an ethos of “nothing about me without me.” Staff demonstrated a good understanding of this principle outlining the importance of involving people not just in their care planning, but in their day to day lives. Some staff were key workers (designated staff for certain people who coordinated their care) and spoke about getting to know people well through monthly reviews. This ensured that care was tailored to people’s individual needs.

There were systems in place to communicate changes in people’s needs, including structured staff handovers. Staff spoke confidently about the people they supported and gave examples of signs of deterioration or changes in people’s health. This meant people’s needs were assessed thoroughly and understood in a holistic and inclusive way, ensuring each person remained actively involved in all aspects of their care and support.

Managers planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff had received relevant training, including in dementia care and diabetes to ensure people’s needs were met. Managers also enabled relatives to engage in training such as dementia care. This meant care and treatment was delivered with current evidenced based guidance enabling positive outcomes for people.

Risks to people’s health and well-being were assessed and monitored using recognised clinical tools, such as to assess the risk of malnutrition and pressure damage to people’s skin.

People at risk of weight loss had their weight monitored regularly and their food and fluid intake was monitored. When required, people were supported with nutritional supplements prescribed by their GP.

People spoke positively about the quality and variety of meals provided. One person told us “The foods nice. If you do want something special, you can tell them and they will get it. They know what I like and don’t like.” People had food and drinks when they wanted them. During our visits we observed lunch was served at a relaxed and unhurried pace, promoting a positive dining experience. Staff were knowledgeable about individuals who required additional support at mealtimes, and this was provided.

Kitchen staff had up-to-date information about people’s dietary requirements, including any specific needs such as textures and allergies, and people’s preferences.

Managers worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff worked well together to deliver coordinated care and support to people. There were effective systems in place to ensure information was shared appropriately and care plans were easily accessible to staff. All staff spoke positively about the team and managers. One staff member said, "It's like a second family."

Relatives told us they were kept informed and notified promptly of any changes or incidents involving their family members. One relative told us “I really have no concerns. I know my mum is safe in their hands, and that's all that matters."

Staff made referrals to other health and social care professionals when required. One professional told us they felt information was communicated well and described the staff team as a "Tight ship." This meant staff worked collaboratively to provide coordinated, person-centred care to people.

Managers supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Feedback from people was consistently positive and emphasized being enabled to lead active lifestyles through various opportunities such as in house activities and by accessing the local community. One person told us, “We have trips out, Burnham, Cheddar, there’s the memory café every other Wednesday, quizzes, I sing at the Market House.” One person felt well supported by staff with their emotional wellbeing, highlighting the caring approach of the team they told us, “Staff take time and talk to me.”

People were encouraged to stay active through daily exercises. Staff told us, "We have daily exercises which people really enjoy" and "People are given a choice." Staff worked closely with a physiotherapist and obtained a list of exercises from them which they encouraged people to complete.

People were supported to access healthcare services for routine appointments, such as visiting the optician. One relative told us, "Home generally deals with all the appointments so mum gets the care she needs." Care plans included information about people’s healthcare needs. This meant people were supported in a holistic way to maintain both their physical and emotional wellbeing, promoting their independence and quality of life.

Managers monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

Systems and oversight in place were highly effective in ensuring people received care focused on achieving positive outcomes. People were fully involved in regular care reviews with their key workers, and their relatives where appropriate. People had meaningful relationships with staff who strived for positive outcomes for people.

Staff effectively supported people to maintain their health and well-being. For example, staff ensured people living with diabetes had their condition closely monitored and well managed. Staff were excellent in recognising early signs of deterioration in people’s health and knew when people were “not their usual self”, ensuring prompt intervention.

Communication between staff enabled managers to maintain clear oversight of people’s care, and a prompt response to any changes in needs.

One relative told us about their family members’ change in needs and the positive impact of staff support, "I don't think she [their family member] would have survived on her own [without support from staff]."

People’s strengths, preferences and personal wishes were embedded into their care and day to day lives. Staff actively supported individuals to achieve their wishes, promoting their independence and enhancing their quality of life. One person told us, “My key worker arranged a special lunch for me in the conservatory, just me and [staff member]. She asked me about my wedding day, and it brought back memories in a lovely way.” Another person wanted to fly in a helicopter so they could see Castle Cary from above, so the managers were in the process of organising a virtual experience for them due to an in-person event not being safe.

Clear records were maintained in relation to positive outcomes, providing examples of how care had a meaningful impact on people’s lives. For example, 1 person was supported with overcoming anxiety through appropriate referrals, being encouraged to take on responsibilities within the home, and participating in staff interviews.

This meant people experienced highly personalised outcomes which were continuously reviewed and improved.

Managers told people about their rights around consent and respected these when delivering person-centred care and treatment.

People's care was provided in line with the principles of the Mental Capacity Act 2005 (MCA) and this was documented throughout their care plans. Staff received appropriate training and understood the principles of the MCA. One staff member told us, “We show cards and pictures to support their understanding” when discussing how to support people in making decisions.

Where people lacked the capacity to make certain decisions, assessments had been undertaken and best interest decisions made on people's behalf. Relatives were involved in this process where appropriate.