CQC report explained · a residential care home
What the CQC found at 9 High View Road
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People received the right support in relation to their risks, but several risk assessments were incomplete or not kept up to date. Medicines, staffing, safeguarding and infection control were otherwise managed well, with some smaller improvements still needed.
- Effective?
- Good
- This area was not inspected at this visit. Its previous rating was used to calculate the overall rating.
- Caring?
- Good
- This area was not inspected at this visit. The report says care was person-centred and staff engaged well with people.
- Responsive?
- Good
- This area was not inspected at this visit. Its previous rating was used to calculate the overall rating.
- Well-led?
- Requires improvement
- Managers and staff understood their roles and the culture was person-centred, but governance systems had not reliably identified or corrected weaknesses in risk, mental capacity, recruitment and other records.
What inspectors found, June 2023
High View Care Services Limited - 9 High View Road is rated Requires Improvement; inspectors found kind, person-centred care, but risk records and management checks were not reliable.
The inspection was unannounced and took place on 26 April 2023. One inspector spoke with one person, managers and a rehabilitation team leader. They reviewed care, medicine and staff recruitment records, along with other management records.
People were supported safely in many respects. There were enough staff, medicines were given as prescribed, the home was clean, and staff understood safeguarding and infection control. People said they felt safe and staff knew them well.
However, risk assessments were not always complete or up to date. Checks for water-borne infection had not been properly carried out since 2018. Records about mental capacity, staff employment gaps, medicines and some cleaning equipment also needed improvement. The overall rating changed from Good at the previous inspection to Requires Improvement.
Enough staff
The home had enough staff to support people safely and did not need agency workers. People said staff knew them well.
“There's always enough staff. Staff are really good and know me well.” from the report
People felt safe
People told inspectors they felt safe and comfortable. Staff were trained to recognise abuse and understood how to report concerns.
“I do feel safe here and staff are respectful to me.” from the report
Person-centred care
Staff understood people's individual needs and were observed to be calm and engaged. People were supported to build independent living skills.
“Staff understood people's individual needs well and we observed they were unhurried and engaged well with people.” from the report
Clean and hygienic
The home was clean, tidy and hygienic. Staff followed infection control and food hygiene procedures.
“The premises were clean, tidy and hygienic and staff followed current infection control and hygiene practice to reduce the risk of infections.” from the report
Specialist support
Psychologists and occupational therapists worked with people to improve their lives, emotional wellbeing and daily living skills.
“The provider had a team of psychologists and occupational therapists who worked with people to improve their lives.” from the report
Incomplete risk assessments
seriousSeveral assessments, including those covering medicines, distress-related behaviour and mobility, were not completed in line with best practice. Some records also contained inaccurate information because they had not been reviewed.
“Individual risks to people were not always assessed in line with best practice and several risk assessments were lacking in key area including medicines, behaviour which shows distress and mobility.” from the report
Overdue water safety assessment
seriousA Legionella risk assessment had not been commissioned in line with best practice since 2018. Inspectors had raised the same concern at the previous inspection.
“However, the provider had not commissioned a Legionella risk assessment in line with best practice since 2018.” from the report
Weak management checks
seriousThe provider's systems had not ensured that mental capacity decisions, recruitment gaps and other records were properly checked. This led to a breach of Regulation 17 on good governance.
“These issues form a breach of Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014.” from the report
- 01Have all residents' risk assessments, including those for medicines, mobility and behaviour that shows distress, now been reviewed and updated?
- 02Has the Legionella risk assessment been completed, and how often will water safety checks now be reviewed?
- 03How are best interests decisions and mental capacity assessments now recorded and kept under review?
- 04How do you check and document gaps in new staff members' employment histories?
- 05What extra checks are now in place when a person takes a medicine dose late?
This was an unannounced focused inspection of Safe and Well-led only; the other ratings were carried forward from the previous inspection published in September 2018. This explanation was written from the published report of 10 June 2023 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, September 2018
Rated Good; inspectors found safe, kind and well-managed care, but staff lacked training to protect themselves from physical aggression.
The inspection was unannounced and took place on 17 August 2018. One inspector visited, spoke with people, staff, managers and health and social care professionals, and checked care records, medicines records, staff files and other records.
The home supported up to five people with acquired brain injury, substance misuse histories and mental health issues. Inspectors found suitable staffing, safe medicines arrangements, good care planning and positive relationships between staff and people.
The main shortfall was that staff had not been trained in how to break away from physical attacks. Reports showed that staff had sometimes been punched and kicked, although inspectors found people were not at risk at the time. The home was rated Good overall and Good in all five areas.
Safe staffing
Inspectors found enough staff to meet people's needs, including support in the community. The provider also carried out checks to make sure staff were suitable.
“There were enough staff to care for people and the provider checked staff were suitable to work with people.” from the report
Safe medicines
Medicines records had no omissions, stock matched the records and medicines were stored securely. Staff were trained and their competence was checked.
“People received their medicines safely and the provider had robust systems in place.” from the report
Kind and respectful care
Staff were patient, listened carefully and understood how people communicated their needs. People were involved in choices about their care and daily lives.
“Staff were caring and treated people with dignity and respect.” from the report
Personalised support
Care plans included people's health needs, history, preferences and aspirations. Staff supported some people to build skills for more independent living.
“People's care plans reflected their physical, mental, emotional and social needs, their personal history, individual preferences and interests.” from the report
Management oversight
The management team was visible and the provider used audits, meetings and feedback to monitor the home and improve care.
“Good governance systems were in place to check the quality of the service and to gather feedback from people, staff and professionals.” from the report
Protection from physical attacks
needs fixingStaff had not received breakaway training, despite incidents in which staff had sometimes been punched and kicked. The provider was considering suitable training but had not made a decision by the inspection.
“The provider had not trained staff to protect themselves from physical aggression.” from the report
- 01What breakaway training has been introduced since the inspection, and have all relevant staff completed it?
- 02How are risks of physical aggression assessed and reviewed for each person?
- 03How would the home support my relative's acquired brain injury, mental health needs and any history of substance misuse?
- 04What activities would be available for my relative, and how would their preferences shape the activity plan?
- 05How would my relative and family be involved in reviewing the care plan and raising concerns?
This was an unannounced inspection covering all five quality areas, including the premises and care provided; the home did not provide nursing care. This explanation was written from the published report of 25 September 2018 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 9 High View Road
2 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- June 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2018GoodSafe: GoodWell-led: Good
- October 2016Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not ratedCaring: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
- May 2015Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not ratedCaring: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
- September 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 7 January 2011.
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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