Highbury Residential Home

Updated 30 November 2022

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 two 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 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 is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. However, a manager had been appointed and was in post. They were in the process of applying for registration with the Commission.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed on-going monitoring, information received and feedback from partner agencies to plan this inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. The registered manager was given the opportunity to share this information as part of this inspection visit.

During the inspection

We spoke with 12 people who used the service and 5 relatives to understand their experience of the care provided. We also spoke with 7 staff including the manager, head of care, care staff, activities staff and the cook. We reviewed care plans and records for 4 people and sampled medicines records and staff recruitment files. We undertook a video call with the manager on 29 September 2022 as they were not available during our inspection visit. Following this discussion, we continued to review a range of records around staffing, staff training and other records relating to the day to day management of the service.

Updated 30 November 2022

About the service

Highbury Residential Home is a residential care home providing personal care for up to 27 people. The service provides support to older people, many of whom are living with dementia. At the time of our inspection there were 23 people using the service.

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

We have made a recommendation that the provider consider current guidance within the Accessible Information Standard to develop information systems.

The provider had introduced improvements to the environment people lived in to help ensure it was clean, well maintained and appropriate equipment was in place. Further improvements were needed in areas relating to food preparation and storage and some furnishings. Staff followed safe procedures in using and disposing of personal protective equipment (PPE).

Risks to people's safety were assessed and were monitored but care plans did not always reflect the detailed information and guidance staff needed to keep people safe. For example, some risk assessments were not personalised to the individual person and did not fully reflect changes in people's needs. Risks were mitigated as staff demonstrated they understood how to keep people safe. Staff understood safeguarding processes and were confident to report any concerns.

Care plans and records did not fully reflect people's involvement in the development and review of their care. Systems and processes had been implemented or were planned to address this. These were in the early stages and were not fully embedded into working practices at the time of our inspection

Peoples' medicines were managed safely. There were systems in place to monitor stock control. The amount of medicines received and administered were recorded. Medicines audits were being completed.

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 knew people well and understood their needs. They completed training to give them the skills and knowledge they needed in their roles. Staff described readily available support and guidance from managers which helped to develop their working practices.

People were supported to have enough to eat and drink in line with their preferences and needs. Staff enabled people to access a range of specialist and routine health and social care appointments to maintain their health and well-being.

People were encouraged and supported to do things they enjoyed and spend time with people who were important to them. This reduced the risk of people becoming socially isolated. People described staff as kind and caring; valuing each person as an individual and consulting them at all stages about their care.

Staff were able to support people through their end of life care. Further training was planned to develop the quality of end of life care and ensure people's physical and spiritual needs were met.

There was a new manager in post who had applied for registration with the Care Quality Commission. They had identified issues and concerns prior to our inspection and were in the process of implementing these. They demonstrated a clear commitment to providing people with good care that enabled them to achieve the best possible outcomes. People and staff spoke positively about management changes and described a culture that was open, approachable and supportive. The service sought out partnership working with other agencies to provide people with high quality care.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 6 August 2021) and there were breaches of regulation. This service has been rated requires improvement for three consecutive inspections. At this inspection we found improvements had been made but the provider remained in breach of Regulation 12 as, although significant improvements had been made in infection prevention and control, these were not fully embedded at the time of our inspection.

Why we inspected

We carried out an unannounced focused inspection on 14 June 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve. We undertook this comprehensive inspection to check they had followed their action plan and to confirm they now met legal requirements.

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.

Follow up

We will request an action plan and meet with the provider to understand what they will do to improve the standards of quality and safety. We will continue to monitor information we receive about the service, which will help inform when we next inspect.