Highfield

Updated 4 March 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

The inspection was completed by 1 inspector.

Service and service type

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

Registered Manager

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. A manager was registered, however they had not worked at the service for 15 months.

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 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 3 people who used the service and 2 relatives about their experience of the care provided. We spoke with 6 members of staff including the manager, quality and compliance manager and care workers.

We reviewed a range of records. This included 3 people’s care records and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 4 March 2023

About the service

Highfield is a residential care home providing accommodation and personal care for up to 6 people with a learning disability, autistic people, people with mental health needs and people with sensory impairments. At the time of the inspection 6 people were living in the home.

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.

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

Right Support:

Risk assessments and care plans relating to people’s known health conditions were out of date and not reflective of people’s current needs.

People did not always receive support that was focused on their quality of life outcomes. People’s outcomes were not regularly monitored in a meaningful way.

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 systems and processes in the service did not always support this practice. Medicines were managed safely.

Right Care:

People were supported by staff who knew them well and who had been safely recruited. However, not all staff had received the relevant training to ensure they had knowledge of people’s health needs. The provider allocated new training to all staff immediately after feedback.

People, relatives and staff were given the opportunity to feedback on the service. However, there was no evidence to show how the feedback was used to drive improvements in the service

People received kind and compassionate care from staff who used positive, respectful language which people understood and responded well to.

Right Culture:

Governance processes were not effective and failed at times to hold staff to account, keep people safe, protect people’s rights and provide good quality care and support.

There was mixed feedback from staff about whether they felt supported in their roles. Staff did not receive regular supervisions and the lack of consistent leadership at the service resulted in a decline in the quality and safety of the service.

People and relatives were positive about the attitudes and behaviour of staff.

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 28 March 2018)

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

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

Enforcement and Recommendations

We have identified breaches in relation to management oversight and governance at this inspection.

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

Follow up

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