CQC report explained · a nursing home
What the CQC found at Highbury House Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2022
Requires Improvement; inspectors found kind, attentive care but unsafe medicines, infection control and record-keeping.
This was an unannounced focused inspection on 26 and 29 July 2022. One inspector visited, spoke with people, relatives, staff and visiting professionals, observed care and checked care, medicines, recruitment, safety and management records.
The home was rated Requires Improvement overall. Safe and Well-led were both rated Requires Improvement. Inspectors found medicines were not always managed safely, some infection control practices were poor, and checks on environmental risks and records were incomplete or inaccurate.
There were also positive findings. Staff were described as kind and available, staffing had improved, people were protected from abuse, and managers were approachable. The home had breached Regulation 12 on safe care and treatment and Regulation 17 on good governance. The provider was asked for an action plan and will be monitored.
Staff availability
Inspectors found staff attended to people in a pleasant and timely way. Staffing had improved and staff had time to spend with people.
“Staff had time to sit with my relative, to massage her hands which was really important to her.” from the report
Safeguarding
People said they felt safe. Staff had safeguarding training and knew how to recognise and report possible abuse or discrimination.
“Staff had received training on safeguarding, this included recognising any signs of abuse or discrimination and responding appropriately.” from the report
Medicines
seriousSome as-required medicines did not have clear instructions for staff. Two people's medicine records did not include a photograph or allergy information, and checks of agency nurses' medicine skills were not evidenced.
“Specific PRN guidelines to inform staff to ensure these medicines were given in a consistent way and in accordance with the prescription were not in place.” from the report
Infection control
seriousSome staff wore masks incorrectly. Inspectors found poor practice in laundry and sluice areas, including overflowing bins and unclean or poorly stored commode pots.
“In addition, the sluice rooms were not clean and practice within these did not promote good infection control practice for example, bins were overflowing onto the floor and commode pots were piled on top of each, some were not clean.” from the report
Environmental safety
seriousHot water was not checked in every area, window restrictors were not routinely checked and the passenger lift safety certificate was unavailable.
“There was no system to routinely check that the window restrictors were suitable and working effectively.” from the report
Quality monitoring and records
seriousThe home's audits did not identify several medicines, infection control and environmental safety problems. Some fire evacuation, bedrail, equipment and agency induction records were incomplete or inaccurate.
“The quality monitoring systems had not been effective in all areas.” from the report
- 01What changes have you made to PRN medicine instructions, allergy records and photographs since the inspection?
- 02How do you check that agency nurses are competent to administer medicines?
- 03What has been done to improve the laundry and sluice rooms, including bin storage and cleaning of commode pots?
- 04How are hot water, window restrictors and the passenger lift now checked and recorded?
- 05What evidence can you show that the action plan for Regulations 12 and 17 has been completed?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive carried over from the previous inspection. This explanation was written from the published report of 16 September 2022 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, October 2019
Rated Requires Improvement; inspectors found kind and personalised care, but staffing, care records, meals and leadership needed improvement.
This was a planned, comprehensive inspection. It took place on 9 and 10 July 2019, with the first day unannounced. Inspectors reviewed records, observed care and mealtimes, and spoke with people, relatives, staff and a health professional.
People were treated with kindness and respect. The home offered activities, welcomed visitors and supported people's cultural, religious and communication needs. The building was clean, medicines were managed safely and people were supported to access health professionals.
There were concerns about staffing, especially at weekends and at night. The home relied on agency staff to cover vacancies, and some people and relatives reported delays with call bells and personal care. Care plans did not always reflect current needs, and one person's food did not match their assessed swallowing needs.
The overall rating fell from Good at the previous inspection, published in October 2016, to Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement. Caring and Responsive were rated Good.
Kind, respectful care
Staff gave people choices and supported their privacy, dignity and independence. Inspectors saw positive relationships between staff and people.
“We observed positive interactions between staff and people and staff knew people well.” from the report
Personalised activities
Activities reflected people's interests and abilities. Staff also provided extra one-to-one time for people at risk of isolation or who stayed in their rooms.
“A structured activities programme was available for people to take part in.” from the report
Clean environment
The premises were clean and well presented. Staff used protective equipment appropriately and equipment was kept clean.
“The premises were clean, well presented and people were protected from infection.” from the report
Medicine safety
Medicine records and competency checks were in place, including for agency nurses. Inspectors saw medicines being given patiently and safely.
“Medicines were stored and managed safely, including medicines that needed special storage arrangements.” from the report
Supportive new manager
The new manager was well regarded by people and staff and had already made some changes. The group manager continued to provide support during the transition.
“The manager was newly in post and was well regarded by people and staff.” from the report
Staffing and call bells
seriousThe home used agency staff to cover vacancies. People and relatives gave mixed feedback about staffing and reported delays in getting help, especially at weekends and at night.
“People had given us mixed feedback about how responsive staff were to call bells.” from the report
Out-of-date care records
needs fixingSome care plans did not reflect people's current needs or gave contradictory instructions. Care staff did not initially have access to the main care records.
“Care plans did not always reflect people's current needs.” from the report
Complaints follow-through
needs fixingFormal complaints were recorded, investigated and resolved, but relatives disagreed about whether complaints led to consistent and lasting action.
“We received mixed feedback from relatives about whether complaints resulted in consistent and sustained action or improvement.” from the report
- 01How many permanent care and nursing staff are now in post, and what staffing arrangements are in place at weekends and overnight?
- 02What are the recent call-bell response times, and what happens when a response is not prompt?
- 03How do you make sure every person's care plan is current, consistent and available to all care staff, including agency staff?
- 04How do you check that kitchen staff receive and follow each person's current speech and language therapy dietary guidance?
- 05What improvements have been made since the inspection to staff supervision, training and the handling of complaints?
This was a planned comprehensive inspection that looked at all five key questions and the premises and care provided; the overall rating changed from Good at the previous inspection to Requires Improvement. This explanation was written from the published report of 16 October 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 Highbury House Nursing Home
3 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- September 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- October 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 17 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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