Highfield House

Updated 15 October 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of one inspector.

Service and service type

Highfield House 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 had a manager who was in the process of registering with the Care Quality Commission. This means that once their registration is complete, they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. Due to pressures from COVID-19 we gave the service 24 hours notice of the inspection. This was to ensure that people and their relatives would be available to be contacted by the inspector via telephone and that the service director and home manager would be available during the inspection. Inspection activity started on 29 September 2020 with a visit to the care home and continued with desk top activity which ended on 30 September 2020.

What we did before the inspection

We reviewed the information we held about the service since the last inspection. We reviewed information we had requested from the services director in relation to the service’s infection prevention and control arrangements and pandemic contingency plan. We used this information to plan our inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

On 29 September 2020 we visited Highfield House. We spoke with the service's director and home manager, deputy manager and a member of care staff. We also spoke with two people who lived there. We reviewed a range of records which included three people's care records and medicine administration records. We also completed an audit of infection prevention and control that included housekeeping and social distancing arrangements. We looked at three staff files in relation to staff recruitment. A variety of records relating to the management of the service were also reviewed.

After our site visit

On 30 September 2020 we spoke with one person's relative, the director, the home manager and two additional staff by telephone to validate the evidence found.

Updated 15 October 2020

About the service

Highfield House is a residential care home providing accommodation and personal care for up to seven adults with a learning or physical disability, in one adapted building which has an enclosed garden. At the time of our inspection four people were living there.

The service was developed and designed before Registering the Right Support came into existence. Despite this, the service was managed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.

People’s opportunities to follow their goals and live as full a life as possible had been impacted by COVID-19. The service had reviewed restrictions on people’s activities and movements in line with national guidance and additional internal activities had been set up to ensure people were protected from feelings of isolation.

Highfield House is a large home, bigger than most domestic style properties. The negative impact of the size of the service on people was mitigated by the buildings design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when supporting people.

People's experience of using this service and what we found

Since our last inspection, systems to assess, monitor and improve the quality and safety of the service had been implemented. An external auditor had also been commissioned to support the service in identifying any shortfalls and to ensure any identified actions were rectified without delay. In some areas, the new systems introduced required further review to ensure that these systems were consistently applied.

Staff told us they felt supported and that the new manager was leading an improving service. Staff told us the culture was open, and we saw evidence people were supported to achieve positive outcomes. Under this new leadership structure, the services visions and values are being reviewed with a focus on person centred care and developing a culture that is fair and open. More time is needed to ensure that these changes have the desired effect on staff morale and service culture.

People were supported to take their medicines as prescribed. Staff received training to enable them to administer medicines and processes were in place to ensure staff were competent, however, the system of auditing medicines stock needed to be improved to ensure the audit sheet matched available stock.

The service was clean, tidy and odour free. There were robust infection control processes being observed and systems were in place to reduce the risk of any visitors to the service in relation to COVID 19.

The service provided sufficient numbers of trained staff to meet people's needs. People's relatives told us the service was safe and homely.

Staff had received training to ensure they could recognise the signs of abuse and told us how they would report these. Records showed people had risk assessments in place and that these were reviewed regularly.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People’s capacity to make decisions had been assessed and where required, external health professionals were involved in planning support strategies to meet people’s mental health needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

We undertook this focused inspection to check the service had followed their action plan and to confirm they now met legal requirements. We also looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Highfield House on our website at www.cqc.org.uk.