Highview Residential 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

Safe recruitment practices were in place. There were enough staff to deliver safe care that promoted choice, control, and individual wellbeing. Safeguarding processes were followed, and staff were aware of reporting systems. Risks were identified, assessed and instructions for staff to promote safe ways of working were in place, this included when people moved between services. Staff knew how to safely support people around their individual risks. People were supported to make choices that balanced risks of harm with positive choices about their lives. Environmental checks and maintenance were in place to ensure people were safe. People received their medicines as prescribed.

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.

People and their relatives told us they felt reassured by the practices within the service in terms of safety and management of accidents. One person said, “The people and staff around me make me feel safe.”

Staff told us they knew how to report incidents to the registered manager and said they could keep people safe. They understood what to do in an emergency. The registered manager said, "We don’t put blame on anyone, we learn as a team and change our practices accordingly. I encourage conversations about safety at staff meetings and handovers."

Accidents, incidents and events were recorded, and people’s care plans were updated. The registered manager was informed of each incident and reviewed accidents and incidents across the service regularly to identify trends and themes. Staff completed post- incident forms to reflect on their practice and the incident they were involved in.

People and their relatives felt confident the appropriate information would be shared to ensure their care was the best it could be. Comments included, "When [person] has had to go into hospital, they want to go back to Highview. I think it is the care and attention they get. The way staff behave with them. They have got to know the other residents." Also, "The staff phone me when [person] has been in hospital, I kept staff informed and they would inform me if they heard anything. We also talked about [person] returning to the home."

Staff and the registered manager told us they had effective, working relationships with external professionals to ensure people’s needs were met well. One staff member told us, “It depends on the time of day about who we contact and how poorly the person is. For example, when we notice that a person is not themselves, the GP can then prescribe this person medication if needed. All within one day.” Another staff member said, “We have an enhanced care team Monday to Friday and if we have any concerns during the weekend we can go through 111 or 999.”

Health and social care professionals told us there was a strong channel of communication between them and the service. A health and social care professional said, “The care here is really good. If the staff have any concerns about people, they will ring us and will send us a photo if necessary. We trust that things will be done. We have a good working relationship with them.”

People’s needs, and care requirements were detailed within their care plans and risk assessments. A paper-based summary which described individual needs, wishes and preferences was available if the person was admitted to hospital. This supported safety and continuity of care.

People told us they felt safe and happy at Highview Residential Home. People and their relatives knew who to contact should they have concerns and were confident any issues would be resolved. One person told us, “The people and staff around me make me feel safe.”

Staff knew how to ensure people were protected from harm and abuse. Staff told us they were confident the registered manager would follow up any concerns. One staff member told us, “You report your concerns to the registered manager. Some of us would start an accident or incident form. For example, if it was a fall, we would do a post-fall incident form and observe the person for 24 hours.” Another staff member said, “You have to complete an accident or incident form and record it in the person’s daily notes.”

We observed safe interactions throughout our assessment of the service. Staff worked in safe ways, for example, when supporting people to move around the service.

Safeguarding procedures were in place. Safeguarding incidents were monitored, and policies and procedures were in place. The registered manager was clear about the process to follow to ensure people were protected and concerns were reported to the local authority without delay. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. All legal applications had been made in accordance with DoLS. This meant people’s rights were fully respected. The registered manager had oversight of DoLS applications.

People told us staff worked to keep them safe and understood their needs. People told us they were confident in the staff’s ability to keep them safe from the risk of harm.

Staff understood and were knowledgeable about the risks people had to their safety and wellbeing. Staff told us they had clear information and instructions to follow on how to support people. Comments included, “There is an out of hours district nurses’ team and we can access a GP through the 111 system if necessary. We also have an on-call manager on the rota”, “Because we are so small you get to know the people and treat them like a second family. Information about people’s risks is in their care plan if you need it”, and “Handovers are good if something has happened for example someone has had a fall.”

We observed staff working in safe ways with people. People were supported to move around the service safely and were supported to spend time where they chose.

Risk assessments were clear, comprehensive and up to date. Risks to people had been identified, assessed and plans were in place to ensure risks were reduced or removed. People were involved in creating their own care plans and their views and personal preferences were respected. The risks people faced were individual to them, for example, pressure areas, falls, risk of strokes, risk of developing a urinary tract infection.

People and their relatives told us they were happy with the service in terms of decoration and condition. Comments included, “It is very homely, and I like it”, “It is nice and clean. It is an old building and well maintained”, “The building is pleasant”, “I am immensely pleased with how the home is run and I have great faith in the registered manager to ensure the environment is kept to a high professional standard”, and “The environment, friendly staff and the home is a nice place.”

The registered manager and staff told us they were confident in the upkeep and condition of the service, ensuring a safe environment was important to them. One staff member told us, “I think the environment is lovely. It is very much a home from home. I think it runs very well it is a nice environment for people and for us to work in.” Another staff member said, “The environment is quite clean and is safe to work. I have never had any problems.”

We observed the service to be clean and well maintained.

Equipment and utility checks were up to date and closely monitored to ensure they were always maintained. A dedicated staff member had oversight of maintenance within the service. The service used external specialists and contractors to undertake some checks. This meant they had been carried out by qualified individuals.

Staff were there when people needed them, there were enough staff on duty. Comments from people included, “Staff are so caring here. They are amazing”, “The staff are always around, and I call them”, and “Yes, they are always around.” Comments from relatives included, “The staff are always walking around during the day and [person] sits in the lounge and calls them. Staff are very attentive and always check if [person] needs the loo. Staff are always available”, and “There are a few new staff but I know a lot of them now. The reason we got [person] into the home is because it is a small community and [person] knows who is on and can name them. That makes them feel safe because they know staff and likes them. It is perfect for [person]. It’s like a home from home. In the lounge they write who is on and meals and [person] loves the structure and doesn't get anxious or stressed.”

Staff told us there were enough staff on duty to provide safe care. The registered manager told us they often worked alongside their staff members supporting people. A staff member told us, “There are always multiple staff around. You have got time to do extra stuff like play cards or do a manicure. In the summer people go for walks – there’s always time to be able to do that.”

Staff were there when people needed them, this included when staff attended people who had pressed their call bell.

Staff were recruited safely, and recruitment records reflected this. Procedures were in place to ensure the required checks were carried out on staff before they commenced their employment. This included enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions. Training records showed staff had the necessary training, skills and knowledge to carry out their roles. The provider was continually improving and developing new training programmes to provide staff with training that is appropriate and relevant to their role.

People and their relatives told us staff worked in a safe and hygienic way. They told us they did not have concerns about infection control procedures and keeping them as safe as possible from avoidable infection. Comments included, “It is very clean. I know everyone in the small lounge and every one of the residents is clean and spotless”, “It is a nice place, and it is clean”, and “It always seems clean, tidy and bright.”

Staff were aware of the importance of cleanliness and hygiene.

The service was clean and tidy during our assessment. Personal Protective Equipment (PPE) was available for staff to use when needed. At the time of the assessment the service held a food hygiene rating of 5 which meant hygiene standards were very good and fully complied with the law.

Appropriate arrangements were in place to control the risk of infection. Staff had been trained in infection control techniques and had access to PPE. The kitchen areas were clean and well managed.

People told us they received support with their medication. One person told us, “There have been no issues as far as I know.”

Staff told us they received training in supporting people with medicine. Ongoing competency checks ensured safe practice. A staff member told us, “I have had medication competency checks fairly regularly.”

Policies and procedures were in place for staff to follow to ensure the safe administration of medicines to people. Staff received appropriate training. We observed safe storage of prescribed creams. Some people were prescribed medicines to be taken only when required known as (PRN) medicines. Guidance was in place to help staff give the medicines consistently. Medicines care plans and risk assessments we reviewed during the assessment were detailed and person-centred. They provided information to support staff to understand people's care needs and linked to care planning for specific conditions.