Highbury Residential Care Home

Updated 17 May 2023

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 Health and Social Care Act 2008.

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

This inspection was carried out by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Highbury Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Highbury Residential Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 2 people who used the service and 1 visiting relative. We spent time observing staff and people within the service. We also made calls to 4 relatives of people using the service for their feedback on the care their relatives received. We spoke with 4 care staff members, the manager, and the provider. We looked at multiple documents including care and activity plans, staff recruitment files, audits, checks and policies.

Updated 17 May 2023

About the service

Highbury Residential Care Home is a residential care home providing personal care to up to 8 people. The service provides support to people with learning disabilities and autism. At the time of our inspection there were 8 people using the service.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People did not always receive safe care and support, and the environment was not always safe. People’s needs and preferences were not always met.

Risk assessments were not always in place to assess known risks. The environment was not made safe by the provider, with areas of the building that were under renovation, fully accessible to people.

Staffing levels at night did not reflect the level of need people had, should an emergency occur. We did not see evidence the building was safe in relation to fire hazards and checks within this area.

Medicines were not always appropriately documented or managed. Cleaning fluids were not always safely stored and were a known risk to people in the service.

People were not always supported to pursue their hobbies and interests. We did not see evidence people were engaged with regularly activities of their choice. Our observations were of people mostly watching television.

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.

Staff supported people to make decisions following best practice in decision-making.

Staff supported people to access health and social care services.

Right Care:

People did not receive care that was person-centred, and dignity, privacy and human rights were not always promoted.

Some staff communicated with people in a way that was not dignified or caring. Peoples’ privacy was not always respected as personal information was left accessible, and not kept securely.

Many staff had not received training in supporting people with learning disabilities and autism. Staff understood safeguarding procedures. Staff had training on how to recognise and report abuse and they knew how to apply it.

People's care plans reflected their needs and wishes and promoted their wellbeing.

Right Culture:

The ethos, values, attitudes and behaviours of the provider and manager did not always ensure people lead confident, inclusive and empowered lives.

Systems and processes were not effective in picking up and responding to any problems within the service. We saw no evidence the provider or managers knowledge within the field of learning disability and autism care and support, was up to date to ensure appropriate standards could be met.

The staff team were not always proactive in meeting people’s needs, and were reacting to people’s distress and boredom, rather than fostering an environment and atmosphere that would reduce the likelihood of any such distress happening.

People and those important to them, including social care professionals, were involved in planning their care.

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 13 March 2020).

Why we inspected

We 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 COVID-19 and other infection outbreaks effectively.

The inspection was prompted due to concerns received around the provider’s ability to meet the standards required to safely and effectively provide support to people with learning disabilities and autism. A decision was made for us to inspect and examine those risks.

The overall rating for the service has changed from Good to Inadequate based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well led sections of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, dignity and respect, person centred care and good governance, at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.