CQC report explained · a residential care home
What the CQC found at Highbury Rise
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, October 2023
Highbury Rise is rated Requires Improvement; inspectors found kind, personalised care, but unsafe medicines and heatwave arrangements led to a Regulation 12 breach.
This was an unannounced inspection on 7 September 2023. The inspector spoke with people, relatives, staff and a health professional, and checked care records, medicines records, staff records and quality checks.
People and relatives generally said they were happy and felt safe. Staff were described as kind, people had personalised care plans, and staff knew them well. The effective, caring and responsive parts of the service were rated Good.
Inspectors found that medicines records were not always accurate or complete. During a heatwave, the plan to keep people cool and hydrated was not followed consistently. Management checks had not identified these problems, so Safe and Well-led were rated Requires Improvement. The previous overall rating was Good in 2017.
Kind and respectful care
People, relatives and a health professional gave positive feedback about how staff treated people. Inspectors observed that people appeared comfortable and at home with the staff team.
“My general observation is that the care staff I have seen, are supportive and talk to the residents appropriately and in a caring manner.” from the report
Personalised support
Care plans included people's preferences, health needs and communication requirements. Staff knew people well and supported them in their chosen way.
“Care plans were detailed and gave information to staff so they could support people safely and appropriately.” from the report
Staff training and supervision
Staff received training relevant to their roles and regular supervision. Staff told inspectors they felt equipped to support people.
“Since I started my role I have had lots of training both online and physical which has given me the confidence to carry out my role confidently and effectively.” from the report
Choice and involvement
People were involved in daily decisions and care planning. The home was found to be working within the principles of the Mental Capacity Act.
“We observed staff explaining things and giving choices to people to get them involved in their daily decisions.” from the report
Medicines records
seriousMedicines records were not always accurate or complete. There were concerns about missing patch records, inaccurate medicine quantities and a missing plan for one medicine prescribed as needed.
“Medicine records were not always completed accurately.” from the report
Heatwave safety
seriousDuring very hot weather, people upstairs did not always have drinks, working fans or protection from direct sunlight. The heatwave plan was not being followed, and inspectors said this placed people at risk.
“Therefore, due to the shortfalls in relation to medicines management and the lack of robust heatwave management people were placed at risk.” from the report
Management oversight
needs fixingAudits and checks were in place but had not identified or managed the medicines and heatwave problems effectively. This contributed to the Well-led rating of Requires Improvement.
“Systems in place did not ensure that there was sufficient oversight of the management of medicines.” from the report
Lift and building condition
needs fixingRepeated lift breakdowns meant people were frequently left in their rooms and caused frustration. Some communal areas also needed refurbishment because of chipped paintwork and unpleasant smells from carpets.
“The lift had been repeatedly breaking down which had meant people were frequently left in their rooms.” from the report
Waiting for support
needs fixingAlthough people and staff usually felt staffing levels were enough, inspectors heard about a person waiting an hour for help to use the toilet and saw another person without their call bell.
“A person told us that another person the previous evening had been waiting for the toilet for an hour as staff were busy.” from the report
- 01What changes have been made to check medicine quantities, as-needed plans, patch records and patch body maps?
- 02How will staff make sure the heatwave plan is followed, including access to drinks, fans, shade and suitable meals?
- 03Has the new lift company resolved the repeated breakdowns, and what is the backup plan if the lift fails again?
- 04How are audits now checking that medicines and heatwave risks are identified promptly?
- 05What action has been taken about the chipped paintwork, malodorous carpets and people waiting for support?
This was an unannounced comprehensive inspection covering all five key questions, the premises, care provided and infection prevention and control measures. This explanation was written from the published report of 20 October 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, October 2017
Highbury Rise was rated Good; inspectors found safe, kind and well-organised care, with some records and activities needing improvement.
This was an unannounced inspection on 10 October 2017. Inspectors spoke with people living at the home, relatives, staff, managers and health and social care professionals. They observed care and reviewed care plans, medicines information and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People were described as safe and well cared for. Staff knew people well, respected their choices and provided care that met their needs.
Inspectors found some areas to improve. Medicines records were not always accurate. Night staff had not practised a fire drill since 2015, although the home told inspectors this was completed after the inspection. Activities and some parts of the environment also needed further development.
People's choices respected
People could choose aspects of daily life, including when they went to bed. Staff supported privacy and involved people in care planning.
“People were offered choice and staff respected this.” from the report
Suitable staffing
Inspectors found enough staff to meet people's needs, with care provided in a timely way. Recruitment checks were also in place.
“We noted that the home was calm throughout the inspection and people's needs were met in a timely way.” from the report
Strong leadership
The management team was visible and approachable. Quality checks, staff meetings and meetings with people and relatives were in place.
“There was an effective quality assurance system in place.” from the report
Access to professionals
People were supported to see health and social care professionals when needed, including GPs, dentists and specialist teams.
“People were able to see health and social care professionals when needed.” from the report
Medicine records
needs fixingTwo of five medicine stock counts did not match the records. A controlled medicine entry was also missing from the controlled drugs register, so further monitoring was needed.
“However we found that for two of the five medicines we counted that the number of stock did not tally with records.” from the report
Night-time fire practice
needs fixingNight staff had not taken part in a fire drill since 2015. The manager later told inspectors that this had been completed after the inspection.
“However, we noted that the staff who worked at night had not had a fire drill since 2015.” from the report
Activities programme
minorActivities were available, but the new activities organiser was still learning about people's interests and establishing a routine for everyone.
“However, we noted that the activities organiser was fairly new to the service and was still getting to know people, their interests and establish a routine that met everyone's needs.” from the report
Dementia-friendly environment
minorInspectors said some areas could be improved for people living with dementia, including more tactile and accessible items of interest.
“However, we noted that some areas of the home would benefit from making the environment more dementia friendly” from the report
Mealtime arrangements
minorInspectors identified ways to make mealtimes more enjoyable, including serving tables together and avoiding gloves that could make eating feel clinical.
“In addition, staff were wearing gloves for either serving meals or supporting people to eat, this gave the impression that it was a clinical task and not an enjoyable meal.” from the report
- 01How are medicine stock counts and controlled medicine records checked now?
- 02When do night staff practise fire evacuation procedures, and when was their most recent night-time drill?
- 03What activities are currently offered for people with different interests and abilities?
- 04What changes have been made to make the home more dementia friendly?
- 05How are mealtimes organised now, and how do you make them feel calm and enjoyable?
This was an unannounced inspection covering all five key questions and the overall rating, following the previous inspection on 20 October 2015. This explanation was written from the published report of 20 October 2017 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 Rise
3 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- October 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 14 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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