Highfield House Residential Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Managers had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff reported all incidents and accidents on the provider’s system. Staff also had the opportunity to contact a manager through an on-call system for out of hours guidance. Relatives were kept informed of any accidents or incidents which occurred.

Accidents and incidents were routinely reviewed by the management team to identify trends and opportunities for improvement. Lessons learnt were shared with the staff team through daily handovers, a message area on the provider’s reporting system and during staff meetings. Staff told us, “There is always a lessons learnt following any accidents.” For example, one person’s mobility had been declining, and they had an assisted fall. Their mobility was reassessed, referrals made to appropriate professionals, and new equipment put in place to assist the person safely.

This meant that the service had an open and accountable safety culture and embedded good practice across the staff team.

Managers worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People experienced safe and well-coordinated admissions to the service. One person told us, “It’s very good, I chose to live here by myself and had a couple of weeks trial here.” Relatives were also involved and provided information about individuals’ social histories including their likes and dislikes, and hobbies. One relative told us, “We were involved with the move." People had plans which contained vital information to share with healthcare staff, to support continuity of care. Managers ensured when a person moved in, relevant information was shared promptly across the staff team. One staff member told us, “When a new person moves in, we will all read their care docs profile, staff will be emailed and informed during handover about the person's needs." This meant care was delivered in line with people’s needs and preferences.

Managers worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Managers shared concerns quickly and appropriately.

Safeguarding concerns were reported promptly. Managers told us, “Staff are good with reporting concerns.” Staff were trained in safeguarding and knew how to raise concerns. One staff member told us, "Anyone can be an abuser", and another told us, “I would speak with the manager who would then complete a formal investigation." Staff were also aware of other routes to escalate their concerns, and one staff member told us, “If I was not listened to, I would go higher up, to the CQC, police or the local authority."

Staff had the opportunity to discuss safeguarding topics during their supervisions and team meetings. Staff worked in partnership with people to address concerns, taking their wishes into account and improving their safety and well-being. One relative told us, "If had concerns, I would speak with the manager."

Deprivation of Liberty Safeguards (DoLS) authorisations had been applied for. Authorisations were requested where certain restrictions were required to keep people safe from harm. The registered manager had a tracker to monitor applications. This meant people were protected from harm and had their human rights respected.

The provider did not always work well with people to understand and manage risks. We identified not all risks to people had been appropriately assessed. This meant the provider could not be assured that suitable control measures were in place. For example, bowel management plans did not contain sufficient detail to guide staff, and this created a risk that deterioration in people’s health may not be recognised. In addition, 1 person had chosen not to have window restrictors in place in their own room. Whilst this reflected their preferences, the associated risks to other people who could access the room had not been fully considered. This meant that people may be exposed to avoidable harm and staff did not have clear and consistent guidance to ensure their safety. However, managers immediately acted on our feedback to address this safety issue.

Managers detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

During our visits, we observed the environment was nicely decorated and well maintained. There was a garden which people could use if they wished. Regular health and safety checks were carried out, and contractors had visited to carry out essential gas and electrical safety checks. This meant people lived in a well-maintained home where any environmental issues were addressed promptly.

We reviewed fire safety measures. People had personal emergency evacuation plans in place and evacuation procedures were discussed with each person. However, regular evacuation drills were not carried out, despite being recommended in the last fire safety assessment completed in 2024. This meant there was a risk people may not be effectively supported to evacuate in the event of a fire. Managers acted on our feedback and planned a fire drill to take place.

Staff had received fire safety training. Staff told us, “Fire alarms are tested regularly.” There was clear signage throughout the service showing exit points to use in an emergency. At a recent team meeting staff discussed evacuation procedures and identified an area of improvement was needed, this was acted on by the managers.

Managers made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff told us, “There are enough carers on shifts.” Staff spoke positively about the training available to them and recently employed staff felt supported during their induction. One member of staff told us, “Induction was good, it gave me confidence to work as a carer.” Staff had opportunities to develop and obtain additional qualifications. A staff training plan was in place with new training courses recently added for staff to complete. One relative told us “Their staff are very well trained, and they have the right people [staff] in.”

Staff worked in harmony together. One person told us, “Staff are absolutely brilliant; there’s not one member of staff I don’t like. I get on with all of them.”

Staff supervision took place regularly and annual appraisals were carried out. There was a safe system in place to recruit new staff to ensure they were suitable to care for vulnerable people. This meant people were consistently supported by suitable, skilled and competent staff.

Managers assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. During our visits we observed the home was clean and hygienic. Personal Protective Equipment (PPE) was available throughout the home and staff told us they had enough PPE to use. There was an infection prevention and control (IPC) policy which was accessible to staff. Laundry was well managed and cleaning products were stored safely in a locked cupboard. The kitchen was clean, with food stored safely and labelled appropriately.

Managers did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

We observed medicines were administered in a dignified manner. Medicines were stored safely, and regular storage temperature checks were carried out daily. We observed in 1 person’s room their medicines cupboard exceeded the safe temperature limit, and this was acted on immediately by staff. Medicines which required additional security were managed, stored and returned safely. The provider worked closely with the local pharmacy, engaging in medicines reviews.

Some ‘as required’ (PRN) medicines were not always administered in line with best practice guidance. For example, some people were having their PRN medicines regularly instead of as required. This had not been identified internally and reviewed. Some PRN medicines protocols needed to be updated to reflect current prescribing. For example, 1 person’s medicine had been changed from tablet form to liquid, but their protocol still referred to tablets. PRN protocols for a newly admitted person were not in place despite them being prescribed. We found that anticoagulant risk assessments and support guidance was not in place. There were also instances where time specific medicines were not administered as prescribed. This meant medicines were not always managed in a safe and consistent way, placing people at risk of harm. However, managers acted immediately on the concerns we identified to ensure people’s safety.