We carried out a review of the data available to us about Hightown House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Hightown House, you can give feedback on this service.
Hightown House is a domiciliary care service based in Hemel Hempstead providing personal care and support services to adults living in their own homes across Hertfordshire, Buckinghamshire and Berkshire. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of this inspection 176 people were receiving the regulated activity of Personal Care.
The service has been developed and designed 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. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for outcomes
People’s experience of using this service and what we found
People were safe and protected from the potential risks of abuse and avoidable harm. People were supported and encouraged to be as independent as possible following robust risk assessments. Where risks to people’s health, well-being or safety were identified staff were knowledgeable about these risks and knew how to respond safely. There were enough safely recruited, experienced, skilled and qualified staff deployed to meet people’s needs. Staff supported people to take their medicines in accordance with prescriber's instructions. Staff had received infection control training. Incidents and accidents were recorded, investigated and reviewed by the management team.
Staff received training and refresher updates in basic core areas as well as training specific to meet the needs of the people they supported. Relatives said staff were skilled and competent. Staff told us they felt listened to and supported by the management team. Staff supported people to eat a healthy, balanced diet. People had access to health and social care professionals relevant to their needs. Health professionals told us people received appropriate support from the service. Staff sought people’s consent to the care and support they received, together with that of their relatives or external advocates where appropriate.
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.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People’s relatives complimented the staff team for the care and support provided. Staff had developed positive and caring relationships with people and were knowledgeable about their individual needs and personal circumstances. People and their relatives, where appropriate, were fully involved in the planning and reviews of their care and support. People were supported to access advocacy services to obtain independent advice and guidance relevant to their needs.
People received personalised care and support that took account of their preferences and personal circumstances. Staff told us the provider encouraged them to explore any aids to enable better communication with people. Staff helped and supported people to develop the skills and confidence necessary for them to live independently in their own homes. People enjoyed a varied and active social life according to their personal preferences with the encouragement and support of staff. Staff and management routinely sought and learnt from people’s experiences, concerns and complaints in a positive and responsive way.
At the previous inspection in 2016 we had found that local level audits had not always been completed and had not always identified areas of concern. At this inspection we found significant work had been undertaken to develop workflows for every aspect of the business which meant that shortfalls in performance were swiftly identified and addressed in a timely manner. The management team were clear about the provider’s values and the purpose of the services provided. Staff also understood these values. People’s relatives were positive about how the service was managed and the management team.
The registered manager and scheme managers were knowledgeable about the people who received support, their needs, personal circumstances and the relationships that were important to them. The provider routinely distributed quality survey forms to people, staff, relatives and health professionals. Health and social care professionals told us that the staff and management team were responsive to any comments and suggestions and were committed to working collaboratively with people, their families, specialists and professionals.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good. (Published 29 September 2016)
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.
Regular audits were completed by operations and senior managers; however at the homes we inspected. We found the provider’s system of audits was not always effective in identifying areas for shortfall. For example, we found errors in documenting medicines….
People were supported by Hightown House to live in their own homes .There were staff that supported people with their individual needs.
People felt safe, happy living in their homes. Staff had received training in how to safeguard people from the risk of abuse and knew how to report concerns both internally and externally. Safe and effective recruitment practices were followed to help ensure that all staff were suitably qualified and experienced.
Staff completed regular health and safety checks that included security and fire safety. Staff received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.
People were supported to maintain good health and had access to health and social care professionals when necessary. People were supported with shopping and meal preparation where required.
Staff made considerable efforts to ascertain people’s wishes and obtain their consent before providing personal care and support, which they did in a kind and compassionate way. Information about local advocacy services was available to help people access independent advice or guidance.
Staff had developed positive and caring relationships with the people they supported and clearly knew them well. People were involved in the planning, delivery and reviews of the care and support provided. The confidentiality of information held about their medical and personal histories was securely maintained.
Care was provided in a way that promoted people’s dignity and respected their privacy. People received personalised care and support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, preferences, routines and personal circumstances.
People were supported to pursue social interests and take part in meaningful activities relevant to their needs, both at their home and in the wider community. They felt that staff listened to them and responded to any concerns they had in a positive way. Complaints were recorded and investigated thoroughly with learning outcomes used to make improvements where necessary.
People that we spoke with all made positive comments about the service and the staff. One person told us "I work in the charity shop and go to the Gateway club". Another person told us "It's good. I like everything. I feel safe here". A third person said "I get on with my neighbours and the staff". The staff we spoke with all said that they had very good support and that communication was very clear and efficient. The interactions we saw between staff and people were all positive and friendly.
We found that the service had (robust-comprehensive or detailed) care plans in place to support people in meeting their needs and that there were well structured systems in place for supporting people to take their own medicines as prescribed..
The service had robust and effective systems for supporting staff and for matching staff's skills to the needs of individual clients.
We found that the service had an effective complaints procedure that was responsive to any concerns that had been raised.
We found that the provider had robust recruitment systems in place to ensure they employed staff with the necessary qualifications, experience and of good character. There were systems in place to ensure people were treated with dignity and respect. We also found that the care plans and risk assessments reflected the individual needs of people and had been frequently reviewed and kept up-to-date.The provider had quality assurance processes in place to assess and monitor the quality of service.