Archived: Highfield Residential Home

Updated 28 October 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 carried out by 2 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

Highfield Residential 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 Residential 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 new manager had been in post for 3 months but had not submitted an application to become the registered manager. We recommended that the manager applies to register as soon as possible.

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 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 living at the service, 5 relatives, 4 care staff, a kitchen assistant, activities co-ordinator, and the manager. 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 reviewed a range of records. This included three people's care records, daily records and 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 28 October 2023

About the service

Highfield Residential is a residential care home providing accommodation and personal care to up to 26 people. The service provides support to people aged 65 and over, and people living with dementia. At the time of our inspection there were 9 people using the service. The service currently accommodates 9 people in 1 building, across 3 floors. There is a communal lounge, a dining area, and a large garden area.

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

People were not always supported safely. Systems and processes were not always in place and effective in managing risks to people. We found that allegations of abuse were not always responded to appropriately, leading to a poor culture within the service. There was a lack of training for staff.

People were not always supported in a person-centred way. We observed interactions where staff did not respect people’s equality and diversity. People were not always offered choices. Relatives gave mostly positive feedback, although some raised concerns around lack of engagement and activities for people.

We identified concerns around the culture of the service during our inspection, in terms of the way staff supported people and the way the service was run. There was a lack of quality monitoring and support for staff.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. We saw that many people living at Highfield had sensor mats, to alert staff when a person stood up and to reduce the risk of falls. There was no evidence of any mental capacity assessment or best interest decisions relating to these at the time of inspection.

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 1 April 2019).

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

Why we inspected

The inspection was prompted in part due to concerns received about the culture of the service. As a result, we undertook a focused inspection to review the key questions of safe, caring and well-led only.

The overall rating has changed from Good to Inadequate based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, caring and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the safety of people using the service, managing risks, good governance, personalised care, and consent for people. We have issued two warning notices to ensure the provider makes improvements.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. 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.

Special Measures:

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review.

If the provider has not made enough improvement when we re-inspect and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.