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Inspection carried out on 17 December 2020

During an inspection looking at part of the service

Highmarket House accommodates up to 73 people in one adapted building. The service supports older

people and younger adults with a range of conditions and includes support for people living with dementia. At the time of the inspection there were 38 people using the service.

We found the following examples of good practice.

Entry to the building was well managed, visitors temperatures were taken and identities recorded.

The management of waste PPE (personal protective equipment) was safe and well organised.

Robust cleaning schedules were clearly displayed for staff and conducted by an excellent housekeeping team.

We were assured that this service met good infection prevention and control guidelines as a designated care setting.

The provider worked closely with the registered manager to ensure safety of people living at the service.

They would only allow a new admission after a confirmed negative result of the Covid-19 test of a person.

For people living with dementia, social distancing was difficult. However, staff had taken steps that supported people with social distancing where ever possible.

The management were aware of zoning guidelines and had implemented them effectively where practicable.

The provider ensured there was a sufficient stock of personal protective equipment (PPE) and the vetted

supplier ensured it complied with the quality standards. Staff had infection control training and understood the correct donning and doffing procedure.

People were supported by a stable and committed team of staff whom they knew well. This helped people to recognize the individual staff with the need to wear face masks.

Staff were well supported and praised the management team, comments included; "We are looked after and supported by the management.”

The provider considered risks and impact of the inspection on the individual staff members, this included around their health conditions as well as their caring responsibilities.

Regular testing for Covid-19 had recently been introduced for both people living at the service and the staff.

There was a comprehensive contingency plan what to do in case of an outbreak and this plan had been successfully implemented.

The provider ensured people's relatives were able to get in touch with people, for example by using

technology.

Further information is in the detailed findings below.

Inspection carried out on 14 May 2018

During a routine inspection

The inspection was carried out on 14 May 2018 and was unannounced. Highmarket House is a newly registered purpose built residential care home. This was our first inspection of the service and we rated the service as ‘Good’ overall.

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.

Highmarket House accommodates up to 73 people in one adapted building. The service supports older people and younger adults with a range of conditions and includes support for people living with dementia. At the time of the inspection there were 17 people using the service.

There was a registered manager in post. 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.

Throughout the inspection there was a cheerful, relaxed atmosphere. We saw many kind and caring interactions which valued people as unique individuals. The registered manager led by example, promoting a positive, person-centred culture. Staff knew people well and had developed positive relationships.

People enjoyed a range of activities both inside and outside the service. Staff used their knowledge of people's life histories and likes to ensure activities met their individual needs.

Staff were well supported and felt valued. Staff completed a range of training and development activities to ensure they had the skills and knowledge to meet people's needs.

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 received food and drink to meet their dietary needs and made choices from a varied menu. Where people were at risk of malnutrition this was identified and steps taken to minimise the risk.

Care plans were person-centred and gave clear guidance to staff in how people wished their care needs to be met. Care plans were developed with people and relevant others to identify how people wished their care needs to be met. The service was responsive to people's changing needs.

Risks to people were assessed and there were plans in place to manage the risks. Medicines were managed safely and staff responsible for administering medicines were trained and their competencies regularly assessed.

The registered manager ensured there were sufficient staff to meet people's needs and staff had time to spend chatting with people and time to take them out.