Archived: High Peak Residential and Nursing Home

Updated 5 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was unannounced and the site visit activity started on 25 October 2018 and ended on the 31 October 2018.

The inspection was undertaken by two adult social care inspectors and one 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. In this case of older people requiring residential or nursing care.

Prior to our inspection, we requested the registered provider to complete a ‘Provider Information Return’ (PIR). A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We looked at all the information which the Care Quality Commission already held on High Peak Nursing Home such as intelligence, statutory notifications and / or any information received from third parties. We also contacted the local authority and the clinical commissioning group to provide us with any information they held about the care home. We took any information provided to us into account.

During the inspection we used a number of different methods to help us understand the experiences of people living in the care home and to gather information.

We spoke with the regional manager, clinical development manager, registered manager, deputy manager, one registered nurse, a senior care assistant, two care assistants, the home’s administrator and the maintenance person.

We also spoke with seven people who lived in the care home, eight relatives and a visiting general practitioner.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We looked at a range of records including three care records belonging to people who lived in the care home. This process is called pathway tracking and enables us to judge how well the service understands and plans to meet people’s care needs and manage any risks to people’s health and well-being.

Updated 5 December 2018

The inspection took place on the 25 and 31 October 2018 and was unannounced.

This was the first inspection of High Peak Residential and Nursing Home following a change of service provider.

High Peak Residential and Nursing Home is a ‘care home’ run by Sanctuary Care (UK Limited). People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care home provides accommodation, personal and nursing care for up to 41 people in one adapted building. The majority of double rooms are used as single rooms with a maximum of 34 places provided. Most of the rooms have en-suite toilet facilities and communal bathing and toilet facilities are located throughout the care home. At the time of our inspection, the care home was accommodating 29 people.

The care home 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.

The registered manager was present during the two days of our inspection and was supported by their regional manager and deputy manager. The management team were open and transparent throughout the inspection process and demonstrated a commitment to the ongoing development of the service.

The care home provided a warm and caring environment for people to live in. Overall, we observed that staff were responsive to the needs of people living in the care home and that people were treated with dignity and respect. We observed two occasions when the lounge area was not supervised by staff and saw people calling for help. We raised this feedback with the management team who arranged to review the staff deployment system and amend the staffing levels in the home to ensure the same number of staff were on duty throughout the day.

We found that information on people's assessed needs and the support they required from staff had been recorded within care plans. This included risk assessments and other supporting documentation. The care planning system was in the process of being updated at the time of our inspection to ensure the registered provider’s current documentation was utilised. This work is due to be completed by December 2018. Nevertheless, care plans viewed had been kept under monthly review to ensure the information recorded was up-to-date and accurate.

Policies and procedures had been developed to ensure staff were aware of their roles and responsibilities for ordering, storing and administering medication and to ensure safe systems and practice.

People were offered a choice of nutritious and wholesome meals. People were able to socialise and eat their meals at their preferred pace and support was available when required.

A programme of activities was in place. The activities coordinator was absent during the period of our inspection so alternative arrangements were put in place to ensure people continued to benefit from social and recreational stimulation.

Systems had been established to ensure that staff working in the care home had been appropriately recruited and to safeguard people from abuse or harm.

A complaints policy and procedure had been developed and people's views, concerns and complaints were listened to and acted upon.

People were supported to attend healthcare appointments and staff liaised with people's GPs and other healthcare professionals as necessary to maintain people's health or support them at the end of life. We observed that a GP visited the care home on a regular basis to ensure the healthcare needs of people were monitored and reviewed.

Staff had access to regular supervision and completed induction, mandatory and service specific training to help them understand their roles and responsibilities. Progress in completing training was kept under review and dates had been set for staff to attend outstanding training.

Staff had access to policies and procedures and had completed training in the Mental Capacity Act to help raise awareness of this protective legislation. We saw that mental capacity assessments were undertaken if necessary and if applicable DoLS applications were completed. These were only completed if a person was deemed to be at risk and it was in their best interests to restrict an element of liberty. Where people did not have capacity, and could not give consent, we saw documentary evidence that specific decisions had also been made in people’s best interests and were the least restrictive option.

The registered provider had developed a range of management information and quality assurance systems to enable oversight and scrutiny of the service. This involved seeking the views of people who used the service and their representatives. Quality assurance systems were in the process of being updated at the time of our inspection to improve oversight, accountability and drive continuous improvement.

Some parts of the care home were in need of maintenance and refurbishment. We noted that capital expenditure plans had been developed and that work had commenced to improve the environment.