Archived: Priory Highfields

Priory Highfields is a residential care home providing personal care to 8 younger adults with learning disabilities and autism at the time of the inspection. The service can support up to 8 people. Priory Highfields accommodates 8 people in three separate buildings. The service also provides a day service for one person.

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 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 using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Although people were unable to tell us about their experience of living at the home, we observed their interactions with staff. We found people were confident to approach staff for support and appeared relaxed around them. Relatives told us they were confident their family members were safe. Staff knew how to identify and report concerns relating to people’s safety. Risks were assessed and managed to reduce the risk of harm. People received support to take their medicines safely and systems used for the management of medicines were safe. Staff were available to meet people’s care and support needs and to spend time away from the home taking part in hobbies or interests.

Relatives and staff felt the service was well managed. Staff told us they felt the registered manager was approachable and they felt valued. People, relatives and staff were given opportunities to share their views about the service. The registered and deputy manager carried out regular auditing to ensure the quality of care provided was good. There was a culture of continuous learning, which was driven by the management team.

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 17 January 2018).

Why we inspected

To assure ourselves the service was meeting people’s needs, that staff had the necessary skills and experience and the management processes were effective we completed a focused inspection. We reviewed the key questions of Safe and Well Led only.

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 Priory Highfields on our website at www.cqc.org.uk.

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.

We inspected this service on 12 December 2017. It was an unannounced inspection. Priory Highfields is a care home that provides accommodation and personal care. Priory Highfields is registered to accommodate eight people. At the time of our inspection eight people were using the service. Priory Highfields accommodates people in two adapted houses and a detached bungalow, converted from a former garage. Each house and the bungalow has a lounge, kitchen and dining area and provides access to enclosed gardens. The home also provides a day care facility for one person.

The service had 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. The registered manager was absent from the service. The provider had appointed an acting manager who was working at the service during our inspection visit.

At the last inspection, the service was rated as Good. At this inspection, we found the service had improved their rating to outstanding in Responsive by demonstrating they provided tailored, flexible support that consistently met people’s individual needs and preferences and the service remained Good overall. People were supported to live full lives and received care that was personalised to their individual needs. Staff used innovative and individual ways of involving people in making decisions about their care and support and supported them to engage in varied activities which were personalised to meet their individual needs and wishes. Staff worked collaboratively with other professionals to ensure people received care based on best practice. People’s support plans reflected their views and were reviewed when their needs changed. People’s diversity was recognised and promoted by the staff and people were supported to follow their religious beliefs and to maintain important family relationships. People were supported to raise any concerns or complaints. The staff and acting manager were approachable and were confident any concerns they raised would be listened to an acted on.

People continued to receive safe care. People were protected from the risk of avoidable harm by staff who understood their responsibilities to identify and report any signs of potential abuse. We saw that concerns were taken seriously and investigated thoroughly to ensure lessons were learnt. Risks associated with people’s care and support were managed safely and relatives were confident their family members were safe and well cared for. People received their medicines when needed and there were suitable arrangements in place in relation to the safe administration, recording and storage of medicines. There were sufficient, suitably recruited staff to meet people’s needs. Staff felt valued and supported in their role.

People continued to receive effective care. Staff received training and support to meet the needs of people at the service and were supported and encouraged to develop their skills by the acting manager and professionals working with the service. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People were supported to have a varied and healthy diet and to access other professionals to maintain good health.

The care people received remained good. People looked relaxed and happy in the company of staff and had formed positive, caring relationships. Staff were kind and caring, understood how people communicated and supported them to make choices about their care. People’s privacy and dignity were maintained at all times.

The service remained well led. There were suitable systems in place to assess, monitor and improve the quality and safety of the service. These were monitored by the provider to ensure any improvements needed were made in a timely way. The provider listened to the views of people using the service and their relatives to make improvements in areas such as the environment and activities.

The home had a registered manager in place. 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.

We found that people were supported in a way that protected them from harm and abuse. Risks to individuals were managed to keep people safe. This was done in a way that respected their choices and promoted their independence. Staff had a good understanding and knowledge of safeguarding people and understood what constituted abuse or poor practice. They knew how to report concerns and were confident in doing this. There were sufficient staff available to meet people’s needs which enabled people to achieve individual outcomes. People’s medicines were managed in a safe manner.

People received care from staff that knew them well and understood how to support them in the best way. Staff received a range of training which developed their skills and understanding. People were supported to make choices and decisions. When they were not able to, decisions were made in their best interests involving people who were important to them. Where restrictions had been placed upon people these had been assessed, and applications made to ensure any restrictions were lawful.

We saw that people were supported to maintain a balanced diet and were encouraged to take part in the preparation of meals. The kitchens were open for people to access when they wanted to, with support when needed. People received support from health care professionals when needed and staff enabled people to attend appointments.

Positive caring relationships had been developed and we found that people were treated with respect and dignity. People were supported to express their views about their care and we saw that they were encouraged to be actively involved in making decisions about their day to day lives.

Each person had a staff member available to them which provided flexibility, enabling people to make choices about what they did and when they wanted to do it. We saw that the support people received was individual to them and responsive to their needs. The environment had been changed so it was suitable for the people who lived there. People who used the service and their relatives were listened to and changes were put into place following this.

Staff felt supported by the manager and provider. They told us they were approachable and responsive. Staff received a range of training to develop their skills and they showed how they put this knowledge into practice. Systems were in place to assess and monitor the quality of the service and the provider was keen to continue to make improvements.

At our previous inspection in January 2013 we had concerns that people who used the service were not being involved in their care planning, care and welfare needs were not being met and that the quality monitoring systems that were in place were ineffective. At this inspection we found that improvements had been made in all of these areas.

We were unable to speak to people who used the service as they were all participating in community activities supported by staff.

We spoke with the manager and three members of staff, looked at care plans and risk assessments for two people that used the service and checked that the services quality systems had been up dated.

We found that Priory Highfields was compliant in the three outcome areas we looked at.

We looked to see if improvements in the involvement of people who used the service had been made since our last inspection. We found although plans were in place to improve the situation for one person who used the service the standard was still not being met.

We had concerns over the care and welfare of people who used the service. Risk assessments and care plans were not up to date following recent incidents and staff were unsure as to how to care for one person at certain times in their day. This meant the care being delivered was inconsistent.

Safeguarding procedures were in place and readily available for staff to use if they suspected abuse. We had previously been made aware of safeguarding referrals the service had made when they had suspected abuse.

Staff we spoke with told us they liked working at Priory Highfields and they felt supported by their manager. They told us and we saw that they had sufficient training to complete their role effectively.

The service had implemented quality monitoring systems. We saw that these were relevant but had proved ineffective.