CQC report explained · a residential care home
What the CQC found at High Pines Residential Home Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks were assessed and staff had guidance to reduce them. Inspectors found enough staff, safe recruitment, safe medicines systems and appropriate action after accidents and incidents.
- Effective?
- Good
- Staff had training, supervision and competency checks. People were supported with food, activities, health appointments and decisions under the Mental Capacity Act.
- Caring?
- Good
- Staff were described as kind and patient. People were treated with dignity, involved in decisions and supported to remain as independent as possible.
- Responsive?
- Good
- Care plans included people's choices and preferences. The home offered activities, supported relationships and dealt with complaints under its policy.
- Well-led?
- Good
- Audits identified shortfalls and action was taken. People, relatives and staff were asked for their views, and the manager was described as open and transparent.
What inspectors found, February 2020
Rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced inspection over two days. One inspector spoke with four people, four relatives and six staff. They also observed care and checked care plans, medicine records, recruitment files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practice, suitable training and care that respected people's choices, dignity and independence.
People had personalised care plans, access to activities and support with food, health care and end of life wishes. The home was clean, complaints were investigated and checks were used to improve the service.
The previous rating was Requires Improvement, with two breaches of regulation. Inspectors found that improvements had been made and that the home was no longer in breach.
Safe staffing and medicines
Inspectors found enough staff to meet people's needs. Medicines were stored, recorded and checked safely, and staff's competency was assessed.
“Medicines were managed safely. The temperature of the room and fridge where medicines were stored was monitored and recorded” from the report
Kind and respectful care
Staff knew people well and adapted their approach to each person. They supported privacy, dignity and independence.
“Staff treated people with patience and kindness. Staff let people have time to decide what they were going to do” from the report
Personalised support
Care plans included people's choices, preferences and routines. People and relatives were involved in developing and reviewing care.
“Care plans now contained guidance about all aspects of people's support. There was information about people's choices and preferences” from the report
Activities and relationships
People could take part in activities such as exercise, painting, gardening and shopping trips. Relatives and friends could visit at any time.
“People were supported to take part in activities that they enjoyed. There was a leisure therapist who had recently started at the service.” from the report
Improved management checks
The home had improved its records, audits and recruitment checks since the last inspection. Action plans were used when problems were found.
“At this inspection, audits had been effective and identified shortfalls, action had been taken to rectify the shortfalls.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you check that each person's care plan remains accurate when their needs or preferences change?
- 02How do you use the dependency tool to decide how many staff are needed on each shift?
- 03How would you support my relative if they had diabetes, a risk of falling or difficulty swallowing?
- 04What activities would be suitable for my relative, and how would you support them to stay involved and independent?
- 05How would you record and follow my relative's end of life wishes, and involve the family in those decisions?
This was an unannounced inspection covering all five CQC questions, including the premises and the care provided; the previous inspection was published on 28 February 2019. This explanation was written from the published report of 4 February 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2019
Rated Requires Improvement; inspectors found kind care and good support, but weaknesses in risk records, recruitment and oversight.
This was an unannounced inspection on 12 and 13 December 2018. Inspectors spoke with people, relatives, staff and managers. They looked at care records, risk assessments, recruitment files, medicines records and the care people received.
People were treated kindly and with respect. The home had enough staff, medicines were administered safely, staff were trained and people were supported with food, drinks and healthcare. People enjoyed a range of activities and could give feedback or make complaints.
The overall rating was Requires Improvement. Safe, Responsive and Well-led were also Requires Improvement. Effective and Caring were rated Good. Inspectors found two breaches because records and quality checks were not reliable enough, and recruitment checks were incomplete.
Kind and respectful care
Inspectors saw staff speaking kindly with people and respecting their privacy, dignity and choices.
“People were supported to be involved in decisions relating to their care and treatment.” from the report
Enough staff and safe medicines
People and staff said staffing levels were sufficient. Medicines were stored, administered and recorded safely.
“People received their medicines when they needed, by staff that had the relevant training and competency checks to administer medicines.” from the report
Good support with health and nutrition
People were offered food and drinks suited to their preferences and were referred to health professionals when their needs changed.
“People were supported to eat and drink sufficient amounts to maintain a balanced diet.” from the report
Meaningful activities
The home offered activities linked to people's interests, memories, faiths and wishes. Inspectors saw people enjoying quizzes and art activities.
“People were engaged in meaningful activities that they enjoyed.” from the report
Positive culture
People, relatives and staff gave positive feedback about the atmosphere and management, although the quality systems still needed improvement.
“People, relatives and staff told us there was a positive culture within the service.” from the report
Incomplete risk guidance
seriousSome care plans did not explain clearly enough how staff should reduce risks such as falls, skin damage or unstable diabetes. One person's hourly checks had been set up as two-hourly until this was corrected.
“Risks to people had been assessed, however, there was not always clear, detailed guidance for staff to follow to mitigate the risks to people.” from the report
Incomplete recruitment checks
seriousTwo of three recruitment files had gaps in employment histories, and one lacked a suitable risk assessment. This meant the provider had not consistently checked whether staff were suitable to work with vulnerable people.
“The provider failed to operate a robust recruitment process.” from the report
Weak quality checks
seriousAudits did not identify problems with care records, risk assessments, monitoring checks or recruitment files. This reduced the home's ability to find and correct problems promptly.
“The provider had failed to fully assess, monitor and improve the quality and safety of the service.” from the report
Care plans still being updated
needs fixingCare plans were being moved to a computer system and rewritten, but they did not yet contain all the guidance needed to support people consistently.
“Care plans we reviewed did contain person centred detail, however, they did not contain all the guidance and documentation staff would need to support people well.” from the report
No registered manager in post
needs fixingThere was no registered manager at the time of the inspection. The manager had applied to become registered but had not completed the process.
“At the time of the inspection there was not a registered manager in post at the service.” from the report
- 01What changes have been made to risk assessments and care plans since the inspection, especially for falls, skin damage and diabetes?
- 02How do you now check that required employment histories, background checks and risk assessments are complete before staff work with residents?
- 03How do you audit care records and monitoring checks, and what evidence can you show that the improvements have lasted?
- 04Has the manager completed registration with CQC, or what is the current position?
- 05How will you make sure prescribed creams and other topical medicines are recorded clearly?
This was an unannounced comprehensive inspection covering all five key questions, the premises and the care provided; inspectors reviewed records for four people and observed care in communal areas. This explanation was written from the published report of 28 February 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of High Pines Residential Home Limited
4 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- February 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at High Pines Residential Home Limited →
- February 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at High Pines Residential Home Limited →
- March 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 9 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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