Archived: Highfields Care Home

We found the following examples of good practice.

• We found robust infection control procedures were in place. Cleaning had been increased to ensure high touch surfaces were cleaned regularly and additional cleaning was taking place to maintain good hygiene standards.

• Systems were in place to prevent visitors from catching and spreading infections. Visitors were screened, including temperature checks on arrival, Visitors were required to follow the provider’s infection prevention and control procedures.

• People were supported to maintain contact with relatives through social media and telephone. The registered manager was exploring ways in which face to face visits could resume safely.

• Staff promoted and practised safe social distancing throughout the home as far as is reasonably practical. Clear systems were in place to shield and isolate people should outbreaks occur.

• Staff worked between this service and the sister service, accessed through the rear garden. Safe infection prevention and control practices were observed. The registered manager was developing more robust protocols for this staff deployment which enabled people to have consistency in care.

• Staff were provided with information and support to enable them to feel confident in their roles. The registered manager was developing individual risk assessments for staff to ensure measures identified to keep them safe were maintained and kept under review.

• Staff were observed wearing appropriate personal protective equipment (PPE). Sufficient supplies of PPE were in place. Staff received training in infection prevention and control measures and appropriate use of PPE.

• Clear systems were in place to admit people safely into the home. Staff worked collaboratively with other professionals to keep people safe as they moved into the service.

• People and staff were regularly taking part in the Covid testing programme. People's consent was sought through best interest decisions. People, relatives and staff were kept well informed on the need for testing and any changes in infection prevention and control guidance.

• Audits and checks were in place to ensure people received the care they needed and were kept safe. These were regularly reviewed.

Further information is in the detailed findings below.

There was a registered manager in the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service remained safe and people’s care continued to be planned to meet their needs and minimise risks to their safety. Staff understood their role in protecting people from harm and people received their medicine as required. Recruitment practices ensured staff were suitable to work within people.

The service remained effective and staff had access to training and support to maintain and improve their knowledge of care and enhance their skills. People were supported to eat and drink what they liked and receive nutrition to keep well. People had access to healthcare services and necessary referrals were made to ensure new health concerns were reviewed.

The service remained caring because staff knew people well and spent time learning what was important to people. People received the care they preferred because staff asked them and their relatives about their likes and dislikes. Staff understood the importance of gaining consent from people.

The service remained very responsive. People had access to a wide range of tailored support to meet their needs and to interest and them and had opportunities to do the activities they enjoyed including spending time out of the home being involved with new experiences. People had consistency in their care as there was a small team of staff people and their family knew well and their views were listened to. Care planning was personalised so that people were placed in the heart of their care and this was regularly reviewed to ensure it was still suitable for them. People and relatives could discuss any concerns or complaints with the staff and the provider and staff explored different ways to support people to communicate and express their views.

The service remained well led. The manager was approachable and relatives were given opportunities to comment on the care they received and to be involved with plans for the future. There were quality assurance systems in place to monitor the quality of the service to drive improvements in care.

The service is registered to provide accommodation and personal care for up to five people with a learning disability. At the time of our inspection, four people were using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were supported to experience positive life experiences and take responsible risks, have new experiences and do the things they liked. People were protected from unnecessary harm by staff who knew how to recognise signs of abuse, how to identify if people were unhappy and how to report concerns to improve the care and support for people and prevent potential harm.

People had developed positive relationships with staff who knew people well. The staff helped people to express themselves to be able to choose what they wanted to do and to let them know if they were happy. The staff support was arranged flexibly so people could do the things they wanted to do, when they wanted to do this. People continued to be involved with activities they enjoyed and to try new activities. People supported charitable events and members of the local community were welcomed to their home to join events and develop new relationships with people. People were supported to maintain existing relationships with friends and family who were important to them.

Consent was sought before staff provided support and people were supported to make decisions. Where people needed help because they did not have capacity to make an important decision, they were supported to make decisions that were in their best interests. People could also be supported by an advocate who helped to express their views where they may have difficulty. Where people had restrictions placed upon them as they were not able to go out alone, applications to ensure these restrictions were lawful had been made and to safeguard their welfare.

People were supported to take their medicines and systems were in place to ensure that people received their medicines as prescribed and to keep well. Where people needed specialist medicines in the event of a medical emergency, staff had received training so they could give these medicines safely.

People were supported to eat and drink the food they liked and staff knew how to support people so they could eat a variety of foods safely. Some people had all food and drink through an artificial feeding system. Staff knew how to use this feeding system and how to identify problems which could lead to poor health.

People were treated with kindness and compassion by staff who knew them well. People were given time and explanations to help them make choices. Staff knew people’s likes and dislikes and how they communicated so they could express their feelings. The staff could identify where people may be concerned and raised this on people’s behalf. Any complaint raised by people or relatives was acted upon to improve the quality of the service.

Staff were supported by the registered manager and provider who displayed strong positive values and demonstrated a commitment to providing best practice support for people. The staff team were committed to ensuring people were part of the community and had their rights upheld. Staff were proud of their role in providing support and promoting the service in the community.

Quality checks were completed to continuously develop the service. People, relatives and professionals could comment on the service and could comment on the quality of service provision to bring about improvements.

Is the service safe?

Family members of the people who used the service told us their relatives felt safe living at the service. They also thought their relatives were able to communicate with staff if they were worried about anything. Staff had received training on keeping vulnerable people safe.

Family members who we spoke with told us that staff talked things over with their relatives while carrying out their care and support. However, adequate arrangements were not in place for decisions to be made on people's behalf when they did not have the capacity to consent. We have asked the provider to tell us what they will do to meet the requirements of the law in relation to mental capacity.

Is the service effective?

Care plans provided staff with detailed guidance in meeting most people's needs. Recorded risk assessments were in place to address risks to which people may have been exposed. However, these records were not always up-to-date and did not all accurately reflect people's current needs. We have asked the provider to tell us what they will do to meet the requirements of the law in relation to assessing people's needs and risks they may be exposed to.

Staff had positive views on the service. One member of staff told us that the service was good at, 'keeping the needs of people in mind at all times.'

Is the service caring?

People's privacy and dignity were respected. One family member told us, 'Staff don't talk across [my relative].'

Family members told us that staff respected their relatives' personal preferences and interests and thought that their needs were being met. Staff confirmed this and one member of staff told us that the people who used the service had a, 'brilliant quality of life.'

Is the service responsive?

People's personal records showed that staff were encouraged to take an approach to people which was centred on their individual needs. People's personal preferences, and likes and dislikes, were recorded and support was provided that met people's wishes.

Family members and staff we spoke with gave us several examples of actions the service had taken to address concerns raised in the past. Staff told us they felt listened to by management.

Is the service well-led?

The service had a quality assurance system which identified, assessed and managed risks to people's health, safety and welfare.

Staff described a sound set of values upon which the service was based. These included: 'keeping the needs of people in mind at all times' and providing care centred on people's individual needs.

We spoke with people's family members to get their views on the services provided; they told us they were happy with the support provided to their relative.

We found that the support provided to each person was individualised and comments received from professional visitors also confirmed this such as, 'Highfields promote a very person centred approach to the care of their residents.'

The variety of meals available were based on people's dietary requirements and preferences. People's nutritional needs were monitored appropriately and professional advice and guidance was sought when needed.

People received their medication as prescribed and staff had undertaken the appropriate training to ensure this was done in a safe way. Medication audits were undertaken to identify any errors or improvements required.

Records seen demonstrated that robust recruitment practices were followed to ensure the staff employed were suitable to work with the people using the service.

Systems were in place to monitor the quality of services provided and further develop them as required; this included obtaining the views of people's representatives.