The Highgate Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We did not look at this key question during this assessment. The score below is based on the previous rating for this key question.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Minutes from resident meetings evidenced feedback was sought, acted on and outcomes were communicated. People and staff that we spoke to told us they felt people are involved in their care and contributed to decisions. The GP has been the NHS practice GP for the home for 10 years. She told us that the registered manager is very responsive. They believe the home is doing very well and staff “accept my advice.” Staff and people using the service all expressed they felt able to be open about any concerns and felt they would be listened to and treated fairly. Complaints reports further evidenced responsiveness and transparency. Staff were aware of how they could speak up if they had any concerns about the service and knew where they could escalate those concerns externally. The service encouraged staff to do so.

The service had positive relationships with relevant professionals and services. This was evidenced during a meeting we observed between agencies and professionals to discuss the safe arrival of a new resident, to ensure continuity of care. Feedback from professionals we spoke to further confirmed this. Risk assessments were regularly reviewed and audited by management, this included individual and operational risk. Business continuity plans were robust and clearly identified a multitude of scenarios and solutions. Identified places of safety in case of emergency were regularly contacted to ensure continued suitability and maintain communication of procedures.

Safeguarding incidents were recorded and reported to relevant agencies. Records were detailed including causes, actions and prevention. All staff working at the service we spoke to shared a collective desire to keep people safe. Safeguarding policies promoted open communication of concerns. Staff we spoke to understood their role in keeping people safe and regularly undertook safeguarding refresher training and were aware of the safeguarding policy. Staff spoke confidently about their knowledge of safeguarding and were clear about what they should report and how to do so, including external escalation points.

People we spoke to felt able to be open about their preference and voice the choices they wished to make. They felt care staff would listen and support them.

5 care plans were reviewed whilst on site. These were for residents with varying needs, from a range of ages and included long term and newer residents. Care plans were managed online. Care plans were clear, updated regularly with the input of residents and/or their families/advocates where necessary. Care plans were person centred and included the preferences of each person as well as details of their personal/family life and interests. Consent was requested at each care visit in those with capacity to consent. One resident declines care sometimes and this was always recorded and monitored. This person centred, individualised approach enabled people to have open discussions about their preferences and talk about risk

Our observations were of a clean and well maintained environment. The home is in an old building which until recently had just one small lift. An extension has recently been completed to house a second larger lift that can be used to safely transfer people in bed if required. Funding has been secured to carry out building work which will improve the whole site, which it is hoped can begin this year. Pest control measures were in place as mice have been a problem in the past, again due to age of the building. There is currently no sign of any rodent activity and pest control are visiting regularly to monitor. Environments for storing medicines were safe and secure with room temperature monitored and recorded. An electronic medicine recording system had recently been implemented to support the safe recording and delivering of medicine. Emergency pull cords were present in communal areas as well as within rooms and records showed staff responded promptly when these were activated.

People we spoke to raised no concerns about the safety of their environment. People expressed that staff were responsive when they had need to use their call bell.

Staff expressed they were pleased about the new system in place to help with managing medicines safely. The installation of a second, larger lift had made the environment much more accessible, particularly for those with reduced mobility.

Fire safety checks and records are up to date. These are audited and any defects/actions recorded and acted upon. There is a clear fire evacuation plan, that includes individual plans for those with reduced mobility or cognition. Gas safety records are up to date and completed annually.

We did not look at Safe and effective staffing during this assessment. The score for this quality statement is based on the previous rating for Safe.

People we spoke to did not have any concerns about staff showing good practice in relation to infection prevention and control.

An extensive monthly infection prevention and control audit was conducted by the home manager. This included action plans and reviews if any issues were identified. Cleaning records were completed daily with any issues/requirements noted, this was audited weekly by the home manager. Annual Legionella risk assessment was conducted by external agency, any risks were highlighted and any required work was detailed with date for completion.

Staff were aware of their responsibility in relation to infection prevention and control, undertaking regular training in this area. Staff underwent observation in their practice at regular intervals. Steps are taken to ensure safe use and sufficient stock of PPE items. In the event of an outbreak of illness, action is taken to minimise any possible transmission until the cause is known.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.