Highview Home

Updated 5 January 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.

Inspection team

Two inspectors carried out this inspection.

Service and service type

Highview 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. Highview Home 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a manager in place as they had recently left their post at Highview Home. The service was being managed by the Nominated Individual.

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 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 used all this information to plan our inspection.

During the inspection

We spoke with seven people and five relatives about their experience of the care provided. We spoke with five professionals who have contact with the service. We spoke with 12 members of staff including the nominated individual, senior carers, carers and an activity coordinator. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included six people’s care plans, medicine administration records (MAR) and two staff recruitment files. We viewed a variety of records relating to the management of the service including audit systems.

Updated 5 January 2023

About the service

Highview Home is a residential care home providing accommodation and personal care for up to 24 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 21 people using the service.

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

Medicines were not managed safely which placed people at risk of harm. Risks to people from the environment were not always highlighted or effectively monitored. When people were involved in an accident or incident, the provider didn't always review this to learn lessons and reduce risks to people in the future. Despite this, people felt safe at Highview Home and there were enough staff to meet their needs.

Quality assurance systems were not always effective for people. Audits monitoring the quality of the service were not consistently completed and up to date. This meant the action taken by the provider had not always ensured people received consistent, good and safe care. However, people spoke positively about Highview Home and relatives felt their loved ones were well cared for. Systems were in place to seek feedback and resolve people's complaints.

People's care plans and risk assessments did not always assess their person-centred needs. People living with dementia weren't always supported with accessible information to assist them to make choices. However, people and relatives felt staff knew them well and understood their likes and dislikes. The provider ensured daily activities took place and these were tailored to what people found enjoyable.

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 08 September 2022) and there were breaches of regulations. 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.

Why we inspected

The inspection was carried out to follow up on breaches found at the last inspection. The inspection was also prompted in part due to concerns received about the management of accidents and incidents and the governance of the service. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

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

Enforcement

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 how people’s safety was managed and how the service was run at this inspection.

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.