Highfields Nursing Home

Updated 10 January 2024

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

This inspection was carried out by 3 inspectors and 1 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

Highfields Nursing Home 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. Highfields is a care home with 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 a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 26 September 2023 and ended on 10 October 2023. We visited the location’s office/service on 26 and 27 September and 10 October 2023.

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 and professionals 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 contacted Healthwatch for information they held on their database about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to plan our inspection.

During the inspection.

We spoke with 4 people who used the service and 3 relatives about their experience of the care provided. We spoke with 10 members of staff including the operations manager, registered manager, deputy manager, registered nurses, 1 care coordinator, carers, domestic staff, laundry staff and the cook. We reviewed a range of records. This included 6 people's care plans, multiple medicines charts, staffing rotas and meetings records. We reviewed recruitment records of 4 staff and supervision and training records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection.

We continued to seek clarification from the provider to validate evidence found. We looked at policies and procedures and supplementary documentation sent to us by the provider.

Updated 10 January 2024

About the service

Highfields Nursing Home is a residential care home providing personal and nursing care for 27 people aged 60 and over at the time of the inspection. Some people living in the service live with dementia. The service is registered with the Care Quality Commission for up to 42 people. Highfields Nursing Home accommodates people in one adapted building over 2 floors. There were communal lounges and dining facilities for people within the service.

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

Infection control standards were poor due to the lack of robust cleaning processes. There was a lack of provider checks on cleaning, equipment and environmental safety.

Medicines management and administration was not always safe. Medicines audits to identify errors, staff training and competency were out of date.

Quality monitoring processes and systems in place were not up to date and there was a lack of ongoing improvement in place.

Records relating to people's care contained information and guidance to enable staff to provide the safe care and support people required. Risk management was in place for people who were at a high risk of falls and who may present a risk to others from their behaviour.

Staff knew people well and showed kindness and compassion towards people. We received positive feedback from relatives and visiting professionals about the service.

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 policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 21 October 2022) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

This service has been rated requires improvement for the last 7 consecutive inspections.

We will describe what we will do about the repeat requires improvement in the follow up section below.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

The inspection was prompted in part due to concerns received about shortfalls in responsiveness to people’s health care needs and effective working with health partners. A decision was made for us to inspect and examine those risks.

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.

We found evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe, Effective 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.

We carried out an unannounced inspection of this service on 26, 27 September and 10 October 2023. At our last inspection, breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (good governance).

We undertook this inspection to check they had followed their action plan and to confirm they now met legal requirements.

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

Enforcement and Recommendations

We have identified breaches in relation to the administration of medicines and infection and prevention control measures; Regulation 12 (Safe Care and Treatment), the failure to ensure people were protected from the risk of harm and abuse, Regulation 13, (Safeguarding); systems and processes to monitor the quality of care, Regulation 17 (Good Governance) ; the failure to ensure staff were suitably trained and competent, Regulation 18 (Staffing) this inspection.

The provider has taken prompt action to mitigate the risks identified at inspection and has provided evidence of improved processes and risk management which they are implementing. We will review this at our next inspection.

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

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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 work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.